February 15, 2008


OB-GYNs fear rising insurance costs

Local doctor worries she may be forced to close her practice


Bob Ellis/staff photographer   
Dr. Anna Marie Garcia, left, goes over a patient’s chart with registered nurses Carrie Lang and Amanda Brown in a maternity hallway Thursday at the Cortland Regional Medical Center. Garcia will march in a rally March 4 in Albany to protest a proposed surcharge on doctors and high malpractice insurance rates, which she says threaten her medical practice.

Staff Reporter

The rising cost of medical malpractice insurance and a potential $50,000 surcharge on New York state doctors could drive Cortland’s two obstetrician-gynecologists out of business.
“If we were to pull out, this means obstetrics will die in Cortland County,” said Dr. Anna Maria Garcia, owner of Renaissance OB-GYN. “My concern is, where does this leave women?”
Dr. In Whan Oh of OB-GYN Associates is Cortland’s other OB-GYN. Oh was out of town and could not be reached for comment.
Obstetricians and gynecologists pay the second highest medical liability insurance rates of medical practitioners, after neurosurgeons. The risk associated with the field, especially obstetrics, results in about 90 percent of practitioners being sued at least once in their career, often for millions of dollars.
Garcia, who says she is fortunate to not have been sued, pays about $52,000 in medical malpractice insurance a year, about double what she paid five years ago. She pays another $23,000 for her midwife.
Figures from the state show that in the Cortland area Medial Liability Mutual Insurance Co.’s base insurance rates for obstetricians and gynecologists have increased 42 percent in the last four years.
At the same time, reimbursements for Medicare have dropped 3 to 5 percent, Garcia said. That can make for a difficult time paying overhead costs for her practice, which includes 13 salaried employees, and paying off the investment in her practice.
“There are many times I go without collecting a salary,” Garcia said, noting she is lucky to have a husband, Ephrahim, who works full time at Cornell University. “If I can’t afford to keep my door open, no one else will.”
Other potential consequences of high malpractice rates include staff layoffs, doctors spending less time with each patient, higher insurance costs for patients and fewer young people entering the fields of obstetrics and gynecology, Garcia said.
The state seems to be recognizing high medical malpractice costs for medical practitioners in general are a problem, largely due to insurance company debt resulting from increased litigation and payouts, and has created a task force to propose solutions to the problem.
One solution task force Chair Eric Dinallo has suggested is a $50,000 surcharge on New York state doctors for the insurance companies. Doctors across the state are rallying against the idea. On March 4 medical practitioners across the state, including Garcia and some local obstetric and gynecology staff and medical practitioners in other fields, are headed to Albany to lobby against the proposed surcharge and high malpractice insurance rates.
Ephrahim Garcia said he has never seen his wife so passionate about a political cause.
“She’s never protested anything in her whole life, and now she wants to go to Albany,” he said. “She’s pretty passionate about this. She thinks it’s almost like an assault on the viability of being an OB-GYN in New York state.”
At the end of the month Garcia plans on speaking to the hospital’s entire medical staff about the issue of high medical malpractice insurance costs.
Garcia, who encourages everyone to contact his or her local state representative to protest increased malpractice costs, said she had heard that certain obstetricians in Ithaca and Syracuse have stopped practicing due to the high malpractice rates. She didn’t know their names.
A crisis seems to be brewing, she said, potentially mirroring a recent mass exodus of obstetricians from Nevada, where malpractice insurance costs soared. Garcia proposes the state fix the problem by imposing a cap on the amount of money plaintiff’s can recover from doctors for emotional damage.
Other states have imposed such a cap, which the vice president of medical affairs for Cortland Regional Medical Center also supports.
“It puts limits on the amount people can sue for pain and suffering and other noneconomic damage,” said Dr. Richard Rohr. “California has had it in place for many years. You can only get up to $250,000 for pain and suffering, and there’s not anywhere near the problem with rising insurance rates that’s taking place in New York and other states.”
Rohr said another alternative, which could be difficult given the state’s fiscal status, is the state could give medical insurance companies money to bring them out of debt.
Rohr said high malpractice rates have implications for physician recruitment. The hospital hopes to add two obstetrician-gynecologists in the near future, partly related to its plans for a new obstetric wing, which could be a challenge, he said.
“We’re going to do it, but this is going to make it a lot harder,” he said.




County to reduce number of voting sites

Staff Reporter

CORTLAND — The county plans to consolidate the number of polling places from 42 to 28 for the next general election in November.
Democratic Election Commissioner Bill Wood told the county Legislature’s Personnel Committee Thursday that consolidating the number of polling places will save money on the number of voting machines that must be purchased and number of polling inspectors.
Cutting costs for holding elections is critical for the county because federal mandates for new voting machines are expected to increase costs to counties, Election Commissioner Robert Howe said this morning.
Each poll eliminated saves $425 for each primary and $665 for each general election.
The cost of new paper ballots that are needed by the new machines would cost about $14,000 per election and the new federal rules require additional training of poll workers and more maintenance of machines, Howe said.
A total of 31 new machines will be purchased to comply with the federal Help America Vote Act. The machines will operate as both a ballot marking device and as a voting machine and will cost $370,000 if machines are purchased for only 28 polling places. The county will have to pay 5 percent of that cost.
The county Legislature’s Personnel Committee endorsed a resolution Thursday to match funds from HAVA to buy the machines. The full Legislature will have to vote on the funding.
Wood said after they are purchased, the machines will be sent to Albany to be tested and then shipped to Cortland.
“They are due in Albany on April 3,” Wood said. “My gut feeling is that we will get the machines in June, July latest.”
He added that a training program is being created and will be submitted to the state within the next couple of weeks.



County nears agreement on wind study

Staff Reporter

Cortland County is considering an agreement with a company that wants to study the feasibility of building wind farms in the northeastern area of the county.
The draft agreement was discussed at Thursday’s meeting of the county Legislature’s Agriculture, Planning and Environment Committee.
TCI Renewables is seeking an agreement with the county to lease land at the landfill in Solon to erect a meteorological tower to test wind speeds over at least four seasons.
The company would gather all the data from the test tower and would pay the county a flat rate of $1,500. County Planning Department Director Dan Dineen said the test tower would be a pole between 100- and 150-feet tall and collect data for TCI for a year and a half to two years.
Dineen told the committee TCI contacted the county last year about putting wind towers in the northeastern portion of the county.
He added that preliminarily the company has estimated that 30 wind towers would be placed throughout Solon, Cuyler, Truxton and at the Cortland County Landfill.
For several years the county has been interested in a wind study for a potential wind farm. TCI came forward with a proposal about six months ago, Dineen said.
The company also wants to consider converting methane gas produced by the landfill into electricity.
“There needs to be approximately 50 acres of separation between the (wind) towers,” Dineen said. “I don’t believe they’ve talked to the towns yet but it’s probably a good time to start talking about land use regulations in those towns.”
Dineen said the towers would be 300 to 350 feet tall, with blades approximately 200 feet long.
“It’s my understanding that one tower would provide enough power for 10,000 homes,” he said.
TCI Renewables had sent a license and operation agreement to the county to lease county land for its wind tests. Dineen said the county had sent it back because the wording was directed more toward a private residential landowner than a public entity.
The county also sent back a contract agreement that stated the county would exclusively work with TCI for 30 years.
“We would like to see a shorter term, like two to three years,” Dineen said. “We want to see the results of the meteorological study to see if a wind farm is even feasible before we enter into a 30-year agreement.”




Virgil OKs church zoning change

Reigning Miracle Ministry on Douglas Road hopes to expand into a bible college

Staff Reporter

VIRGIL — The Town Board approved a zoning change Thursday for a Virgil church that intends to expand into a bible college.
The vote was 4-1. Board member Mary Beth Wright voted against the change.
Zoning on Reigning Miracle Ministry’s 16.5-acre parcel at 2910 Douglas Road will go from light industrial to planned unit development.
Wright said she voted against the change because the church lacks a public sewer system, which she noted is a requirement of a PUD in the town’s zoning, and does not have plans to install one.
“Nobody’s convinced me it’s going to be OK,” Wright said about the lack of public sewer system plans.
The church would have to connect to an existing sewer line to meet the requirement, County Planning Board Director Dan Dineen said this morning.
The closest lines are 1 1/2 to 2 miles away in Cortlandville, he said.
Dineen said there’s a possibility that the town of Cortlandville is going to extend its sewer lines to the western end of a planned business park on Route 13 that borders Virgil.
Those sewer lines would still be about one-quarter mile away from the church, Dineen said.
The town Planning Board voted Nov. 1 against approving the zoning change, partly because the town’s zoning requires public sewer.
Dineen said the Town Board is within the law in approving the zoning change.
“It is OK for the town to waive the (town) requirement for public water and sewer,” he said.
Town Board members said Thursday they are OK with setting the requirement aside for the time being provided the county Health Department accepts Reigning Miracle Ministry’s septic plans.
The church now uses a well and a septic system.
The church property consists of a mobile home, a church building with a school inside and a colonial-style home.
Plans for the site include a second mobile home for children’s ministry staff, classroom buildings, dormitories, a gymnasium and a large church building that would bring the parcel’s building square footage to 55,718 from 9,282.




Dryden settles on list of roads that it will fix, pave this year

Staff Reporter

DRYDEN — The Town Board accepted a highway agreement Wednesday outlining the roadwork the highway department plans to complete this year.
Highway Superintendent Jack Bush said the following roads would be paved, some needing a base coat and others that will be paved over the current surface.
The roads to pave are Hunt Hill Road, from Ellis Hollow Road to house No. 244, including a storm drain above Brooktree Lane; Herman Road, from Mott Road to Fall Creek Road; West Malloryville Road, from Fall Creek Road to Morris Road; Red Mill Road, from West Malloryville Road to Hile School Road; Walden Lane, Utility Drive, Quarry Road, Peaceful Drive, Brooktree Lane, Lone Oak Road, Beechnut Terrace, Sunny Slope Road, Hickory Road, Hickory Circle and Sunny Knoll Drive.
Bush said the portion of Hunt Hill Road being paved is the last section that needs paving. He said it is the most difficult portion because it includes a steep hill and a deep ditch off the roadway. The project will include filling in the ditch so motorists could drive back onto the road if they slide off it.
Other roads will receive surface treatment — oil and stone. These are: Canaan Road; Star Stanton Road; Beam Hill Road, from Route 38 to the end; Dug Road; Orion Drive; Bradshaw Road; Dutcher Road; Old Dryden Road; Sweetland Road; Hile School Road, Ed Hill to seasonal section; Morris Road; West Malloryville Road, from Morris Road to Peruville Road; Beam Hill Road, from Irish Settlement to the end; Snyder Hill Court; Eagleshead Road; Hunters Lane; Deer Run; Woodland Road; Sunny Slope Road; Hickory Road; Hickory Circle; and Red Mill Road. Yellow Barn Road, from Foothill Road to Midline, includes a large concrete box culvert replacement between Bear Circle and Corn Crib Road.