After those rulings, COPIC saw an increase in the number of cases it had to defend that alleged disfigurement, Mr. Dikeou said. In 2003, the cases forced the legislature to sit down with cap supporters, and they forged a compromise that amended the law to overturn those decisions. The compromise was that the cap on noneconomic damages was raised from $250,000 to the present $300,000.
The compromise means that Colorado's double-digit increases should be over, said Alethia Morgan, M.D., president of the Colorado Medical Society and a member of the board of directors of COPIC.
“I expect that next year we will see single-digit increases again,” she said.
The cap on awards is just part of what Colorado is doing to keep rates down, said Douglas H. Kirkpatrick, M.D., vice president of the American College of Obstetricians and Gynecologists.
Dr. Kirkpatrick, who practices in Denver, noted that in 2003 the Colorado legislature passed an “I am sorry” law. The law allows physicians to work with a patient who has had a bad outcome, and even take responsibility for the situation, but prevents anything they say during that process from being allowed into court.
COPIC is being proactive as well. The company recently completed a 3-year, pilot program designed to encourage physicians to deal with patients who have had an adverse outcome before they file a suit.
The physicians who signed up for the program agreed to report to the company any adverse outcome within 24 hours of its occurrence. When a report was made, the company stepped in to work with the doctor and the patient, with an emphasis on listening to the patient, and even admitting mistakes where they were made.
The goal was to preempt the patients' concerns and anger from turning into the kind of antagonism that prompts a malpractice suit. The program even disbursed money to patients when it was needed for further medical care or because of missed work, with a limit of $30,000.
The pilot program was so successful that it is now being adopted company wide, Mr. Dikeou said. During the 18 months the pilot program was fully in place, 592 encounters were reported. Of those, 360 cases involved discussions with the patient and nothing more. In 232 cases, some disbursement of money was made, but in every case it was much less than would have been spent even fighting a suit that was dismissed, he said.
So far, no suits have been filed.
“We're doing stuff here in Colorado that nobody else is doing right now,” Mr. Dikeou said.