The American College of Emergency Physicians is pushing lawmakers to break patient gridlock

Richmond, Va -- Virginia's system of emergency health care is nearly failing, plagued by low funding and the lack of meaningful legal reform, a doctors' group said Tuesday.

The American College of Emergency Physicians slapped the state with a D+, ranking it 46th out of 50 states. It called on state lawmakers to enact several measures to break patient gridlock and improve the legal climate for doctors. The General Assembly convenes today.

"This is not something we in Virginia are used to when compared to other states," said James Dudley, an emergency room doctor at Riverside Tappahannock Hospital and president of the college's Virginia chapter. "It's not something we're proud of."

One of their complaints - low Medicaid reimbursement rates - is part of a larger issue that budget writers will struggle with during the 60-day session. The federal-state health insurance program for the poor and disabled continues to eat up more of the state budget, and lawmakers are proposing various ways to rein in the cost.

This is the first year the college has issued report cards, and many states received lukewarm or poor grades. No state earned an A, and only three states and the District of Columbia earned a B. The most common grade was a C.

The report does not fault the quality of medical care in Virginia but access to care.

"Once you get to the emergency room department, once you get through the doors, your care will be excellent," said Derik King, medical director of the emergency department at Henrico Doctors' Hospital. "What we're talking about is the ability to get through the emergency department doors."

Medicaid plays a key role in emergency medicine.

If rates were higher, more family doctors and pediatricians could afford to take on more Medicaid patients, King said. And if that happened, fewer people would end up in emergency rooms for problems that could have been prevented.

The group wants a 10 percent across-the-board increase in reimbursement rates for all physicians. Gov. Mark R. Warner has proposed a 3 percent increase in fiscal year 2008.

"We really don't think that's a significant enough amount," King said. "We think 10 percent this year would go a long way toward fixing the problem."

In the area of malpractice, the group wants to see a $250,000 cap on noneconomic damages for medical liability lawsuits, which is damage other than monetary losses, such as for pain and suffering.

"That's really what drives the insurance premiums up," King said.

Del. Phillip A. Hamilton, R-Newport News, is a senior budget writer who specializes in Medicaid and health funding.

"We will look at funding for a number of providers," he said. "We do understand the great need on the whole reimbursement issue."

Published: January 11, 2006