Harvard-Affiliated Doctors Lean Against Strike

Although many Massachusetts physicians are considering a job action in response to a statewide crisis in health care and skyrocketing malpractice insurance rates, Harvard-affiliated doctors are not feeling the same financial pressures as their colleagues.

Since the University's self-insurance group, Controlled Risk Insurance Company (CRICo.), provides its physicians with low-cost malpractice insurance, Harvard doctors say they have remained relatively insulated from financial troubles. Meanwhile, many obstetricians, orthopedists and neurosurgeons in the state have threatened to drop their practices to protest high medical malpractice insurance rates and state caps on medical costs.

Recent retroactive rate hikes for medical malpractice insurance will affect the approximately two-thirds of all practicing physicians in the state who are insured by Joint Underwriting Association (JUA).

This change may cost some physicians as much as $40,000, driving some to set up new practices in other states, others to join self-insured medical care clearinghouses, such as Health Maintenance Organizations (HMO), and some may protest their financial troubles by going on strike, according to area physicians.

"A group of orthopedic surgeons is threatening a Day X some time in February to protest the high malpractice rates. If they don't see these patients, it's no joke," said Melvin J. Glimcher, Harriet Peabody Professor of Orthopedic Surgery.

Harvard doctors, most of whom are insured by CRICo., haven't felt pressure of that magnitude, said Glimcher.

In a prepared statement released yesterday, J. Robert Buchanan, the general director of Massachusetts General Hospital, announced that hospital affairs would be carried on as usual. "We will continue, as we always have, to treat as many patients as possible," he said.

Glimcher, a Children's Hospital and Medical Center orthopedist, stressed the same point. "None of the senior people are involved [in the strike]. I doubt that there are a significant number who are participating within the University system," he said.

Brigham and Women's Hospital representative Katherine Harper added, "I have talked to several doctors, and to my knowledge none are striking or refusing to accept patients in protest."

"They don't have the [insurance rate] increases that Joint Underwriters has," she said.

In 1984, JUA set the insurance rate for obstetrics at $21,800 yearly, while CRICo. charged $11,300 for substantially more extensive coverage, according to risk management experts at Harvard.

Hospital officials said that, although Harvard doctors are not participating directly in the purported strike, a job action would affect Harvard-affiliated hospitals by substantially increasing emergency room patients, and that officials have prepared for that increase by stocking supplies and adding personnel.

Hospitals expect neither to profit nor to lose from the increased patient load.