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Interview with Dr. Robert Zaleski

Aired January 2, 2003 - 08:02   ET


DARYN KAGAN, CNN ANCHOR: Other health news today, the skyrocketing cost of malpractice insurance. It's prompting some doctors across the country to consider leaving the medical profession altogether. The situation is reaching crisis proportions in West Virginia, where some surgeons are not showing up for work. A similar problem has been averted in Pennsylvania for the moment.
Whitney Casey has the story now from Wheeling, West Virginia.


WHITNEY CASEY, CNN CORRESPONDENT (voice-over): A flat lined E.R. But in West Virginia, it's the doctors pulling the plug.

UNIDENTIFIED FEMALE: Are you having trouble?

CASEY: A slew of surgeons walked out of work Wednesday afternoon in protest to what they call skyrocketing medical malpractice insurance rates, a scenario that was averted in eastern Pennsylvania when earlier Wednesday morning nearly 50 surgeons planned a walkout of the emergency room.

(on camera): So there would have been sort of an emergency in the emergency room?


CASEY (voice-over): But in the eleventh hour, physicians in Pennsylvania were resuscitated by Governor Elect Ed Rendell, who promised $220 million of insurance aid. But doctors say the quid pro quo is not a panacea, just a Band-Aid.

(on camera): What caused this crisis?

DR. JERRY GILBERT, UROLOGIST: Well, I think in Pennsylvania it's fairly clear that the payouts for medical malpractice have skyrocketed in the last six years. And if you're going to pay out increasing claims, then you're going to have to pay increasing insurance premiums. With that, we've lost a lot of insurance companies in Pennsylvania who cannot afford to do business in Pennsylvania anymore.

CASEY (voice-over): So how does this impact the patients?

GILBERT: If this continues, we will not have insurance and if we don't have insurance, we will no longer be in the State of Pennsylvania and then they will not get appropriate medical care. CASEY (on camera): The doctors point their finger at the lawyers and the legal system, where the lawyers then put the onus back on the doctors, saying that if they only weeded out the bad doctors in their own medical community, that their insurance premiums would be sure to go down, claiming that over half of the medical malpractice payments come from only five percent of U.S. physicians.

(voice-over): And this isn't the first time doctors have tried mass walkouts. In July, 150 doctors at University Medical Center in Las Vegas walked out, prompting the hospital to shut down its trauma center for 10 days. The action helped enact a law capping damages in medical malpractice payouts and doctors in other high premium states, from Oregon and Washington to Pennsylvania and New York, are pushing for new laws in their states. They hope that that would put a cap on the amount of malpractice payoffs, a move that medical malpractice attorneys say is a sham.

THOMAS FOLEY, ATTORNEY: And the idea of insurance is to make the victim as whole as possible. And you put caps on, that's going to amount to immunity with respect to these doctors.

CASEY: And as the debate intensifies, so, too, does the community support for the doctors.


CASEY: We're here in a hospital in West Virginia. And as you can see, this is the E.R. It's empty. There are doctors here, but there are no surgeons. They are on strike. They're having a protest, a work stoppage. And this is exactly what they want you to see, an empty E.R., because they're saying this is a foreshadowing of what could be, empty E.R.s because, not only because of affordability, but also because availability. They say that a lot of the insurance agencies are not insuring doctors anymore, so they can no longer even get insurance even if they want it -- Daryn.

KAGAN: Whitney Casey.

Whitney, thank you so much.

We wanted to get a sense from a doctor what this is like and why he made that decision to go on strike. And so we've called on one of the surgeons taking part in the work stoppage.

That doctor is Dr. Robert Zaleski. He's an orthopedic surgeon at the same hospital, at Wheeling Hospital.

And Dr. Zaleski joining us this morning.

Doctor, good morning.

Good to have you with us.


Thank you for having me.

KAGAN: Give us a sense personally just how bad the situation is, first of all, in terms of cost. How much does it cost for you to have malpractice insurance every year?

ZALESKI: On average the last six to seven years my malpractice premiums have been in the range of $125,000 to $150,000.

KAGAN: And is that paid totally out of your pocket or is it subsidized by a hospital or by part of your practice?

ZALESKI: I am responsible for that and it is not subsidized by any outside agency.

KAGAN: Now, doctor, give us a sense of just how bad the shortage of doctors is right now. As I understand it, surgeons like yourself have decided not to take, do any elective surgery, not to take on any new patients, but also not to do any emergency surgery.

ZALESKI: I can only speak for myself. I know that the number of qualified surgeons has decreased in this area. It, in my feeling, is a quality of care issue. We used to have three neurosurgeons. We now have none. My colleagues, I think, are in the same position that I'm in and my decision is a personal one in hopes of improving the quality of care to the patients of this area.

KAGAN: So if somebody across the street broke their back and needed spine surgery, that would, that could not be done at the hospital where you're standing right now? They'd have to go somewhere else?

ZALESKI: At this time it probably would have to go somewhere else unless their life was in danger at that moment, and I'm sure there would be intercession by qualified physicians in this hospital.

KAGAN: Dr. Zaleski, give me a little bit more insight how you came to this point where you are ready to stop performing surgery. There are definitely some people who would consider that as a doctor to be irresponsible considering there are people who need care in your area.

ZALESKI: If I should leave because I cannot afford the cost of keeping my office open, the same patients would be without my care. I still look at it as a quality care issue. My insurance has risen over a factor of a hundred times since I started to work here in 1980. My malpractice is, next year, has already been quoted to be $150,000. I don't have $150,000 available in my checking account, but would have to borrow the same.

The people of this area have been feeling this issue for several years slowly and gradually. For at least three years, my colleagues and I have taken every normal measure to influence and touch base with the state legislature, however to no avail. We...

KAGAN: And so it's come to this in order to try to get attention for a very serious issue, which we have seen in the piece before you, not just affecting West Virginia, but doctors and patients all across the country.

Dr. Zaleski, thank you for taking time this morning for giving us the doctors' perspective.

We appreciate it.

ZALESKI: Thank you.


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