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Mike Abrams, Executive Vice President of the Iowa Medical Society
Liability premiums are a constant source of anxiety for physicians nationwide. Concerns about premiums have given rise to bodies of law in every state, with high hopes that reasonable limits, expert witness standards, or certificates of merit would curtail the outrageousness of some of the more reckless, meritless cases.
Yes, Iowa has no cap. But as it turns out, our liability premiums are not as outrageous as some might think, at least in three specialties as compared to other states.
Medical Liability Monitor provides an annual comparison of liability premiums among the states. (See MLM's 2008 Rate Survey).
The five least expensive premiums in internal medicine: Minnesota, South Dakota, Wisconsin, Oregon, Idaho.
The five least expensive premiums in general surgery: Minnesota, South Dakota, Wisconsin, Iowa, North Dakota.
The five least expensive premiums in OB-GYN: Minnesota, Wisconsin, South Dakota, Texas, Iowa.
Three states appear on all three lists (Minn., SD, WI), and Iowa appears on two of the three. While South Dakota has a cap, neither Iowa nor Minnesota have gained such legislative protection.
I firmly believe in caps, and IMS fought hard and won legislative approval of a cap seven years ago, but Governor Vilsack vetoed the bill. Iowa physicians should not be apologetic about our liability premiums when recruiting physicians to our state. Our premiums are far more reasonable than physicians will pay in most other states.
We could all speculate about why our premiums are more affordable, but I believe it is partially a function of the liability company IMS started back in the 1980s (IPMIT). It was physician-led. In the early 1990s, IPMIT merged with the similar company in Minnesota (MMIC), and remains physician-led. I believe there's a lot to be said for a physician-owned, physician-led liability company in this environment. In our region, I believe physicians are keeping premiums reasonable in a very uncertain environment.