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US survey: patients losing access to neurological care

17 June, 2003

Issues over liability are forcing neurologists in the United States to make hard choices about their practices, according to the results of a professional medical liability survey completed by the American Medical Association and the American Academy of Neurology (AAN).

Officials with the AAN, which surveyed the 403 neurologists who participated in the study, say that the practice of neurology is changing rapidly: neurologists are turning down complex cases, discontinuing certain services or no longer seeing patients.

The survey showed that among the 199 neurologists who have made at least one change in their practices over the last two years:

  • More than 51 per cent have begun referring complex cases instead of treating them. When asked how important professional liability pressures were in making the decision to refer, 91 per cent said they were "somewhat" to "very" important.
  • More than 33 per cent have stopped providing certain services. When asked how important professional liability pressures were in making that decision, 84 per cent said they were "somewhat" to "very" important.
  • More than 11 per cent are no longer treating patients. When asked how important professional liability pressures were in their decision to stop providing patient care, 75 per cent said they were "somewhat" to "very" important.

Reasons cited for changing insurance companies within the last two years were insurance premium increases and insurance companies' failure or withdrawal from the market.

Medical liability insurance premiums are soaring to the highest rates since the mid-1980s. Neurologists' mean annual premium for professional medical liability insurance coverage in 2002 was $13,800, compared with $10,200 just a year earlier.

The results indicate that neurologists and patients alike are facing a medical liability crisis. The current medical liability system could impact the practice of neurology, where some lawsuits result in a small percentage of patients receiving awards while others find it more difficult to access care.

Catherine Rydell, executive director of the AAN, said:

"The medical liability survey findings are evidence that legislative reform is necessary for preserving patient access to neurological care."