By Katie Waechter
Access to healthcare in Nevada is an issue that nobody can deny. As a state, Nevada has consistently been clustered at the bottom when it comes to services and access. In terms of physician per capita, Nevada ranks 45th among active physicians, 48th for primary care physicians, and 49th for general surgeons. The healthcare community has been working to create better access for decades. Although progress is slow, it’s been palpable in the form of new medical schools, residencies, and new opportunities for doctors to move to the state. That progress will disappear overnight if new laws are passed to eliminate medical malpractice reforms in the 2023 Nevada Legislature.
Quick History of Med Malpractice in Nevada
In recent years, medical malpractice caps have become a highly debated topic in the state and across the country. Medical malpractice occurs when a healthcare provider is negligent in providing medical care to a patient, resulting in harm to the patient.
In Nevada, healthcare providers are required to carry medical malpractice insurance. The amount of coverage needed varies depending on the type of healthcare provider and the risk associated with their practice. Medical malpractice insurance is essential for healthcare providers because it protects them in case of a malpractice claim. If a healthcare provider is sued for medical malpractice, their insurance company will provide legal representation and pay damages if the provider is found to be at fault. Without insurance, healthcare providers would have to pay legal fees and damages out of pocket, which could be financially devastating and discourage doctors from practicing in the first place.
Nevada operated with very few medical malpractice laws until the early 2000s, making it challenging for both doctors and insurance companies to move into the state. The result of the lack of restrictions on med malpractice hit a tipping point in 2001, When doctors saw premium rates double or triple basically overnight. The damage this caused was significant. Doctors left our state at an alarming rate. Insurance companies drastically raised premiums for the doctors who did stay. Malpractice premiums increased as much as 200% to 300% on some medical specialties during the crisis. And many medical malpractice insurers pulled out of the Nevada market altogether. There were 11 medical malpractice insurers in the state in March 2002, and six of those companies had pulled out of the market by 2004.
Many physicians, OB/GYNs, and surgeons could not find medical malpractice insurance or afford the rates for the insurance in Nevada, leaving them no choice but to leave the state or retire early. But it wasn’t just affecting the doctors. It became very challenging for citizens in the state to find adequate care. Something needed to be done.
That’s when the Keep Our Doctors in Nevada (KODIN) initiative began. Their mission was clear: keep doctors in Nevada and put reasonable medical malpractice restrictions in place so doctors aren’t paying insurance premiums they cannot afford.
Keep Our Doctors in Nevada Initiative
To keep doctors in our state, KODIN created a ballet initiative to ask the Nevada public what they wanted to do about medical malpractice in the state. The issue landed on the ballot in 2004. The people voted and chose to keep our doctors in the state by implementing tighter restrictions on medical-malpractice lawsuits and bringing medical liability premium costs down. And it paid off. Insurance companies stopped fleeing the Nevada market, lowered premium rates, and doctors could afford insurance premium rates moving forward in a more stable market.
Before the KODIN initiative was passed by ballot in 2004, medical malpractice laws were unrestricted, and attorneys could collect millions in noneconomic damages (and keep much of that money for themselves in the form of fees). Attorney fees were not limited; they could retain a “negotiated” percentage of the awards. AMA President Donald Palmisano, M.D., said at the time, “this measure gives voters the opportunity to put an out-of-control legal system back in check and make sure that doctors can afford to continue to practice and care for patients in Nevada.” KODIN asked to improve access to care by capping noneconomic (or ‘pain and suffering’) damages to $350,000, limiting attorney fees, and putting a timeline on when a lawsuit can be filed. Other important areas of medical malpractice reform included reducing frivolous lawsuits, scaling attorney legal fees, and patient safety. These laws and regulations were put in place to protect both healthcare providers and their patients.
What Do the Caps Really Mean?
The medical malpractice cap of $350,000 applies to only noneconomic (or ‘pain and suffering’) damages. Economic damages (lost wages, lifetime medical care, etc.) are UNLIMITED and exempt from the cap. In other words, a plaintiff can recover the full amount for losses like the cost of medical treatment (past and ongoing), “care or custody,” lost income, and reduced earning capacity. Noneconomic damages are meant to compensate the plaintiff for the negative effects of medical malpractice that aren’t easily calculable. Caps provide a sense of stability and predictability for the medical community, which benefits both patients and providers because it keeps costs down.
Trial lawyers are now on the record seeking to roll back every protection that safeguards Nevadans’ access to doctors when and where they need them. The laws are not perfect, but eliminating them completely will push Nevada back to the healthcare crisis days of the early 2000s. Your Nevada Doctors is ready to fight for access to care and hope to protect the future of patient care in Nevada.
Your Nevada Doctors Initiative
Your Nevada Doctors (YND) is a patient-first advocacy group fighting to protect access, affordability, and availability of healthcare for all Nevadans. The group was formed in 2020 to carry forward the work of KODIN in 2004. YND emphasizes the unique and special relationship that patients have with their doctors. The mission of YND is to keep healthcare accessible and affordable for all Nevadans.
In 2004, Nevadans chose to protect doctors and patients by reforming medical malpractice. In 2023, those same questions are at stake, and the trial attorneys are going straight to the legislature to ask for rollbacks.
Trial attorneys and lobbyist organizations from other states are asking for a complete rollback of every protection that has been put in place – including issues that gave Nevada stability, like attorney fees and noneconomic caps. Their issue is not patient care or access. All they talk about is the money. They claim the law restricts Nevada juries, but juries are not required to consider caps when reaching a verdict in medical malpractice. The trial attorneys do not talk about the patient who cannot find a doctor in their area for months. If the patient cannot see a doctor because insurance premiums have driven them out of the state, or cannot afford the doctor because the cost is too high, then malpractice won’t even matter. If there is no cap, it will be a serious problem for the citizens of Nevada.
Your Nevada Doctors met with local healthcare providers in January 2023. During the meeting, one worried Nevada doctor explained, “if this goes forward, I might as well close up shop. The ripple effect is staggering.” We need more people in healthcare, not less.
Why It Matters for You
Medical malpractice is important to everyone in healthcare. KODIN stabilized Nevada’s healthcare crisis and provided protection for both doctors and patients in the early 2000s. YND seeks to keep laws in place that cap noneconomic damages, control attorney fees, and ensure that the patient (or plaintiff) gets the reward in the event of malpractice – not the attorney.
This is an issue for all Nevadans because everyone needs healthcare. Democrats. Republicans. Hospitals. Insurance companies. Doctors. And patients all support keeping the medical market in Nevada stable and keeping malpractice reform in Nevada. Access is the issue, and without limitations on medical malpractice caps, Nevadans will never get the access to care that they deserve.
The voters of this state already voted on this issue less than 20 years ago. Since then, the state has implemented various measures to reduce the number of frivolous lawsuits, improve patient safety, and reduce the financial burden on healthcare providers and patients. Now, the trial attorneys want to bypass voters and push their agenda through the 2023 legislative session. They are not thinking about patients; they are thinking about lining their pockets.
Healthcare in Nevada is complex. It’s true that access to care in the state still has a long way to go. There are many problems to fix, but eliminating med mal caps is not the way to do it. If the medical malpractice reforms are undone now, it will undo all the progress that the healthcare community has worked so hard for over the past 20 years.
Patient access to care is on the line right now. It is up to the people of Nevada to tell our legislators that undoing medical malpractice caps will severely hurt patient access to care for years to come. All the hard work that’s been done to build new medical schools, improve education, and create residencies will be shattered. We must make our voices heard and come together as a healthcare community to fight for our patients and our future.
About the Author
Katie is on a mission to help organizations and businesses in the mental health and healthcare space tell their stories and help the people who are struggling. She graduated from the University of Nevada, Reno with a Bachelor’s in Psychology and from the University of North Texas with a Master’s in Information Science with a focus on mental health informatics before starting her own business in 2018.
Katie’s company, Watch Media Group, is a writing firm specializing in healthcare and mental health copywriting and ghostwriting services. Learn more, or connect with Katie, through her website.