Editor's Desk


Doctors and Hospitals

Perhaps the most startling fact that will jump out at you from reading this month’s cover story on North Carolina hospitals is that, in most cases, they are the largest employer in the communities they serve. New Hanover Regional in Wilmington, for example, employs nearly 4,500 people. Moses Cone in Greensboro has 7,000 workers; and more than 8,000 people count on paychecks from Duke University Medical Center in Durham, the state’s largest.

Here’s another eyeopener: The 137 hospitals in the state treated nearly 1 million patients last year, more than any state – including Georgia – surrounding us. Our hospitals generated more than $17 billion in revenues. Collectively, that would make them 117th on the Fortune 500 list, right below Sara Lee.

We’re rightfully proud of the state’s long history of providing its citizens with excellent medical care. We have some of the nation’s finest medical schools, which produce well-trained, caring physicians. But as our cover story, which begins on page 38, also makes clear, we can no longer take for granted that a well-qualified doctor practicing at a modern hospital will be readily available the next time we get sick. That’s because the soaring cost of doing business is about to put them out of business.

The average premium paid by North Carolina surgeons for malpractice insurance went up 50 percent from 2000 to 2002, to $100,000 a year, which the American Association of Neurological Surgeons says places the state in a “severe crisis.” Hospitals across the state also must carry malpractice insurance, and their costs have tripled in three years to a collective $75 million. Those and other factors – such as the fact that a third of our hospitals now regularly run in the red -- prompted the American Medical Association to worry aloud that the state is showing acute problems in its healthcare system.

Hospital administrators can quickly count off several reasons for these soaring costs, including declining Medicaid reimbursements; the huge burden of treating the uninsured, which amounted to $1.3 billion last year; and the stunning cost of today’s medical technology.

But it’s the skyrocketing costs of liability insurance that most alarms hospital officials, who quickly cite one fact to make their point: the average jury award in medical malpractice cases has nearly tripled in recent years, to $3.4 million. A number of these runaway jury awards forced four medical malpractice insurance companies to stop doing business in the state.

That should tell us that we need to take a cold, hard look at tort reform in North Carolina. It’s been several years since the General Assembly last revised the state’s tort laws, a movement which NCCBI helped lead. Let’s do this now, before our best doctors leave North Carolina for friendlier states and before our hospitals get even sicker. -- Steve Tuttle

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