West Virginians might get a glimpse of a bleak future for two days next month.
On Feb. 19 and 20, the West Virginia Medical Association hopes that most doctors' offices in the state close their doors as physicians go to Charleston to meet with lawmakers during the 2001 legislative session.
The event, called "White Coat Day at the Legislature," will not only give doctors a chance to discuss a predicted shortage of physicians but also show residents what a doctorless future would be like, said Dr. Doug McKinney, vice president of the state association and a Bridgeport urologist.
"The state medical association is starting a big push to let people know about this," McKinney said. "We hope every doctor in the state closes their doors to go to Charleston."
According to the association, recruiting new doctors to the state, and retaining the ones already here, is difficult for four reasons:
n West Virginia has the highest tort, or personal injury law, costs in the nation.
n Malpractice insurance rates in the state are much higher than in surrounding states.
n West Virginia is one of only two states to charge physicians a 2 percent tax on their gross income to help fund Medicaid.
n Declining reimbursement rates from government-run insurance plans, such as Medicare or the Public Employees Insurance Agency.
Those factors combined make the state less attractive to new doctors and already have forced some to move, said Dr. Shiv Navada, president of the Harrison County Medical Association.
Navada now is the only neurologist in Harrison County following the recent departure of another. His new patients have a seven-week wait for appointments.
The same factors that keep new doctors away from West Virginia might one day force Navada to leave, he said.
"I have lived here 10 years," he said. "My youngest daughter was born here. I don't want to move, but if push comes to shove, I will. If things get completely out of control, I'll be forced to pack my bags and leave."
And he is not alone.
Dr. Saad Mossallati, a Nutter Fort cardiovascular and thoracic surgeon, said he is considering leaving the state. One reason is that he cannot find another doctor to join his practice.
"I've been looking for three years," he said. "I have interviewed several people who have declined."
When asked why they do not want to join, most have cited the higher premiums, Mossallati said.
Navada pointed out that one of every two doctors in the state will be sued this year. That is 21Ú2 times more frequently than for doctors in Ohio.
Even though doctors won 85 percent of the cases filed between 1995 and 1999, the lawsuits drive up the cost of malpractice insurance because of legal fees.
Those insurance rates can be more than double what they are in neighboring states, he said. One example from the association shows that the annual malpractice premium for an obstetrician/gynecologist in this state is $75,155. That compares to $48,406 in Ohio, $40,651 in Kentucky and $23,321 in Pennsylvania.
Mossallati said that malpractice premiums make up about 25 percent of the overhead costs for his practice, which includes six doctors.
Another issue is the Medicaid tax, which is used to help provide services to the poor.
"As a principal, it is very unfair," Navada said. "The same standard should apply to everything else."
Navada offered, as an example, charging clothing manufacturers such a tax to provide clothing to the poor and imposing similar taxes on other industries.
Raising fees to offset the costs will not work because private and government insurance programs will pay only so much, Mossallati said. The solution, he said, is changing the law.
Staff writer Paul Darst can be reached at 626-1404 or by e-mail at email@example.com.