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Uninsured plastic surgeons leaving patients to pay for their mistakes

Article-Uninsured plastic surgeons leaving patients to pay for their mistakes

Uninsured plastic surgeons leaving patients to pay for their mistakes

Nearly 6,900 doctors in Florida lack malpractice insurance or other coverage, colloquially referred to as “going bare,” a USA TODAY investigation has found. When they maim and kill, there’s less recourse, leaving patients damaged physically and financially, with families struggling to pay medical bills.

Those physicians have been disciplined 44% more frequently over the past decade, and they are more likely to have committed criminal offenses – mostly for driving under the influence, according to USA TODAY’s analysis. In all, 110 of those physicians without insurance are licensed to practice in Florida after facing disciplinary action in other states.

While only a handful of states require doctors to carry malpractice insurance, lack of coverage creates a serious mismatch with Florida’s status as a national destination for discount plastic surgery procedures, including the Brazilian butt lift. 

In Florida, 1 in 5 board-certified plastic surgeons elected not to carry medical malpractice insurance, based on USA TODAY’s analysis of insurance information reported by doctors to the Department of Health. That figure does not include doctors who perform plastic surgery without certification, which Florida allows. Omulepu, for one, was not certified.

This can enable doctors with repeated medical malpractice cases to stay in business without having to pay higher insurance premiums. 

Despite the high level of risk involved in some plastic surgery procedures, including the fat transfer process of a Brazilian butt lift, Florida’s oversight system has few built-in checks and balances. 

The state only enacted stricter regulations after a USA TODAY and Naples Daily News investigation earlier this year revealed dangerous practices in two clinics overseen by the same doctor. Eight of the clinics' patients died after surgeries, nearly a dozen more needed to be hospitalized. 

It was the fifth time since 2014 that such legislation had been proposed.

In Florida, doctors self-report whether they carry medical malpractice insurance. The Florida Department of Health does not verify whether they are telling the truth. Nor does it confirm that doctors without insurance have other funds available to pay claims that arise.

In three of the cases examined by USA TODAY, doctors told the Department of Health that they carried malpractice insurance. When a patient’s attorney asked later, those doctors said they did not have it. 

Even when patients can find an attorney willing to take their case and manage to get court judgments for their injuries and financial setbacks, they may not be able to collect. 

The Florida Financial Responsibility statute requires physicians to pay judgments up to $250,000, but federal bankruptcy law creates a loophole in which physicians can file for bankruptcy instead. According to a 2010 article in the University of Miami Law Review, the state medical board can’t discipline them for doing so. 

In the end, Grife said, it is the patients who lose. He described it as an epidemic that affects thousands, if not tens of thousands of patients each year. 

"In Florida, unfortunately, there are many plastic surgeons who do a lot of harm to patients – who either kill them or leave them on death's door," Grife said, "and then they do not have the means to compensate the patients that they've harmed."

Florida lawmakers gave doctors the ability to opt out of medical malpractice insurance in 1986. The legislation was designed in part to avert a growing crisis: doctors quitting over the rising cost of insurance premiums. 

A decade earlier, more than 20 insurance companies canceled malpractice coverage and withdrew from the market, citing an increase in the size of awards and settlements in Florida, according to a report from the U.S. General Accounting Office (GAO). Congress was examining what federal officials called a nationwide liability insurance crisis to determine whether the U.S. government should intervene. 

The Florida case study found insurance companies that remained in the state instituted dramatic rate increases. Premiums in Miami-Dade and Broward counties – considered a separate market from the rest of the state – rose even higher. 

By the 1980s, insurance premiums were so high that some doctors chose to retire early or practice elsewhere, according to the GAO report. Some neurosurgeons resigned in protest. 

Daniel Sumner, then Florida’s deputy state treasurer, testified before Congress that the cost of malpractice coverage was so high it had influenced obstetricians “to get out of the business of delivering babies.” 

The Tort Reform and Insurance Act of 1986, Sumner said, solved those problems and others. 

"In Florida, nobody will go out of business because they can’t find insurance they have to have," he told a House subcommittee. 

The legislation brought sweeping changes to the state’s insurance regulations. Tucked into it was Chapter 458, which for the first time allowed physicians to forgo medical malpractice insurance. 




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