Insurance takes its toll on Wyoming doctors

WHEATLAND, Wyo. – Jeremy Katzmann has had enough.

One of only three doctors in this southeast Wyoming town of 3,500, Katzmann is on call every other night. His 3-year-old son cries when his pager goes off, and Katzmann has been unable to recruit new partners while malpractice-insurance costs skyrocket.

So the 32-year-old Wyoming native has decided to take his wife and child to Florida, where he will work with seven partners.

“It doesn’t look like a bright future to stay in practice here,” he said.

Katzmann is among dozens of doctors who are leaving Wyoming, blaming malpractice-insurance premiums for forcing them out.

“I would say it’s a crisis situation for small-town Wyoming medicine,” said Dr. Doug Schmitz of Torrington, one of only two surgeons in an area of northeast Wyoming the size of New Jersey. “I’ve been trying to recruit a surgeon for 16 years.”

Ballooning malpractice-insurance rates are a problem nationwide, with physicians staging protests or walkouts in states including Mississippi, West Virginia, New Jersey and Pennsylvania.

But doctors in Wyoming pay about $20,000 more per year for malpractice insurance than doctors in neighboring states, according to the Wyoming Medical Society. The group said 50 of the state’s doctors have either retired, relocated or restricted practices in the past year.

Doctors have implored lawmakers to enact caps for some malpractice awards, such as for pain and suffering – limits in place in all six states that border Wyoming. But some oppose the effort, saying it would hurt patients who suffer catastrophic injuries.

The Wyoming Legislature will take up the issue during a special session beginning Monday, alarmed by the exodus of doctors, malpractice costs and a lack of insurance carriers.

In Congress, Democrats last year blocked a bill that would have limited malpractice damages across a range of cases. Thirty states have enacted damage caps, including 16 that now limit attorney fees.

“There is some evidence – limited statistical evidence, more anecdotal – that tort reform does in fact help,” said Lawrence Cluff, who co-wrote an extensive report on malpractice costs for the General Accounting Office last year.

Dr. Jodi Kaigh of Casper will be watching the legislative session closely. She moved to Wyoming from Missouri six years ago because she liked the open space and abundant sunshine, but she is now paying $100,000 a year for malpractice coverage and is expecting a rate increase soon.

“It goes up every year,” she said. “Two years ago, I was paying $40,000.”

She estimates 13 doctors have left or decided to leave Casper in the past year.

“No one’s taking their place. No one is coming,” Kaigh said. “It’s becoming unaffordable. It’s going to be quickly more than I make. I’m already having to use my retirement fund to stay in business.”

Patricia Spiker, who lives with her diabetic husband in Chugwater, 25 miles south of Wheatland, said it’s “almost impossible” to see a doctor unless the situation is an emergency.

“Sometimes you have to wait three weeks before you get in, and that’s just not right,” she said.