Two Surgeons In Operating Room
31 May 2017

Iowa Governor Signs Medical Malpractice Reform Into Law

Iowa Governor Terry Branstad has signed into law a new bill that will limit the amount of noneconomic damages available to patients injured by medical malpractice. The legislation’s enactment marks a major victory for the State’s Republican policymakers, who have made the controversial goal of “tort reform” a top priority in 2017.

Iowa Enacts Tort Reform, Hopes To Limit Doctor Negligence Claims

Under Senate File 465, damages meant to compensate patients for their pain and suffering will be limited to a maximum of $250,000, roughly in line with similar legislation passed in Texas, Kansas, Montana and West Virginia. Thirty-five other states have some form of damages cap for malpractice claims, although most jurisdictions place the limit higher than $250K.

Doctors Perform Laparoscopic Surgery

The category of “noneconomic damages,” according to the new law, encompasses any damages meant to compensate patients for their:

  • pain
  • suffering
  • inconvenience
  • physical impairment
  • mental anguish
  • emotional pain and suffering
  • loss of chance
  • loss of consortium
  • any other nonpecuniary damages

An amendment to the bill added by Iowa’s House lifts the cap for cases involving permanent impairment, substantial disfigurement or wrongful death, according to the Des Moines Register. So-called economic damages, things like medical expenses that can be easily-quantified, are not affected by Iowa’s recently-passed statute.

Medical Witness Standards & Certificates Of Merit

The law will, however, make other alterations to the medical negligence landscape in Iowa:

  • Raising the standards for expert medical witnesses
    • in order to testify, expert witnesses will now need to be licensed to practice “in the same or a substantially similar field as the defendant” and have actively practiced within the five years before the alleged negligence
  • Certificates of merit
    • before discovery can begin in any case, the plaintiff will have to serve the defendant with a “certificate of merit,” in which an expert medical witness testifies to the alleged negligence or wrongdoing

Meanwhile, the definition of an “adverse health care incident” has been loosened somewhat. Iowa’s earlier statutes characterized a compensable adverse event as “an objective and definable outcome arising from or related to patient care that results in the death or serious physical injury of a patient.” The word “serious” has now been removed, allowing viable malpractice claims to be filed for any “personal injury or death” arising as a result of improper care.

The category of “health care providers” has also been broadened to explicitly include osteopathic physicians, licensed chiropractors, licensed practical nurses, registered nurses, dentists, optometrists and pharmacists.

Iowa’s Shortage Of Doctors Drives Malpractice Changes

The bill gained relatively-wide support in Iowa’s two Chambers of Congress, passing the State’s House of Representatives by a vote of 65 to 32 and its Senate by 37 to 12. State Republicans hope that limiting malpractice lawsuits, and eliminating supposedly “frivolous” claims, will help the Hawkeye State attract and retain more physicians.

After signing the law, Governor Branstad had this to say: “I’m proud to say we train some of the best and brightest doctors and other health professionals at our medical schools and nursing schools[,] however, we rank as one of the lowest in the country for doctors per capita.” Branstad’s last claim is likely to be true. Iowa has been struggling to deal with a serious shortage of physicians for years, even recruiting doctors from over-seas.

While the State is home to a high proportion of medical students, it also has one of the lowest doctor-to-patient ratios in the nation. Iowa is particularly bad at retaining physicians who were educated in-state.

Restricting Patient Rights Won’t Solve State’s Physician Problem

But there’s little evidence that any of these problems will be fixed by “tort reform,” an influential movement in conservative circles that sees medical malpractice lawsuits, not medical errors, as the epidemic threatening America’s healthcare system. Vastly outnumbered in the Iowa Congress, Democratic representatives say the State’s new reform bill doesn’t take the issue of medical errors seriously enough.

In 2016, researchers at Johns Hopkins University ranked errors in medical care as America’s third-leading cause of death, alerting the public to what many observers have now come to call a “crisis” in healthcare.

Iowa’s medical malpractice landscape, on the other hand, is remarkably quiet. As the patient rights group Iowa Association for Justice suggests, malpractice claims in the State have dropped by more than 50% over the last 15 years, leading to a precipitous decline in medical negligence insurance premiums for doctors.

For Docs In Iowa, Low Insurance Premiums & High Salaries

In fact, credit reporting service WalletHub ranked Iowa as the second best state for physicians in 2016, using a robust analysis of data from the Census Bureau, Department of Health and Human Services and malpractice insurers. After adjusting for regional cost of living, WalletHub found that doctors in Iowa make the fourth highest median annual wage in America, while paying some of the cheapest insurance premiums.

Iowa’s new malpractice reforms aren’t good policy, according to the Iowa Association for Justice. They’re a power grab. “Capping how far a jury can go to hold bad actors accountable is arbitrary government overreach,” the non-profit wrote in a statement quoted by The Gazette. “It’s just plain wrong.”

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