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The 12-physician Orthopedic Specialty Group, with offices in Fairfield, Stratford and Shelton, has put hundreds of Connecticut trial lawyers on notice that the cost for their attendance at depositions and trials is about to soar, due to rising malpractice insurance costs. In a May 7 letter to lawyers on its mailing list, Dr. Robert A. Stanton explained his group has “updated” its fees to a startling $12,000 per day for court appearances. It now charges a similarly exorbitant $4,000 for the first two hours of a deposition, and $1,000 per hour thereafter. “All services will be required to be paid in advance,” the letter states. Several lawyers said the hike appears to be a sharp departure from doctors calculating depositions and trial time on the basis of work time lost — normally in the $300-to-$600-an-hour range. As the treating physicians, doctors’ opinions are often critically important to establish the level of their patients’ damages. By substantially increasing such costs across the medical profession, doctors could effectively curtail many plaintiffs from accessing the legal system, according to trial attorneys interviewed for this article. It would make it less profitable for plaintiffs — and more risky for lawyers — to pursue personal-injury claims with less than $100,000 in anticipated damages, on a contingency fee basis, they warned. TRENCH WARFARE? Kathleen Nastri, the current president of the Connecticut Trial Lawyers Association, said the fee change “looks like payback” after doctors failed to win passage for caps on medical malpractice awards again this past legislative session. She said the fee increase could backfire. Lawyers still have the option of bringing the treating physician to court with a subpoena, and allowing the judge to set a reasonable fee. “No judge is going to pay an orthopedic surgeon $6,000 for a half day of trial,” Nastri declared. “That’s typically from 10 a.m. to 1 p.m.” A partner at one of the state’s pre-eminent plaintiffs’ firms, Bridgeport, Conn.’s Koskoff, Koskoff & Bieder, Nastri noted that osteopaths’ testimony is needed to help their injured patients pay medical bills and other damages. “Either these doctors don’t know, or don’t care, but the ones who will be hurt by these increases are their patients, not lawyers,” Nastri said, adding that such costs are typically borne by the client. The fee escalation “looks like we’re getting into trench warfare,” said John L. Bonee III, a Hartford, Conn., trial lawyer. A longtime proponent of civility in law practice, Bonee suggested, “Maybe it’s time that doctors and lawyers sit down in a big powwow and get this under control.” Timothy Norbeck, executive director of the Connecticut State Medical Society, said the fee hike isn’t an idea his group originated. “This is the first I’ve heard of it,” he said when reached last week. “Physicians are fighting for their professional lives,” he maintained, adding that the “misery index” for doctors is soaring due to insurance costs, a squeeze in Medicare rates, lower reimbursements and the new paperwork burdens of federal medical privacy regulations. Norbeck said a fee increase like this isn’t designed to be a money-maker for doctors. “They’re just trying to keep afloat,” he said. Stanton, who practices arthroscopic surgery and sports medicine, explained in the letter that the group’s medical malpractice insurance rates will nearly double come July 1, adding nearly $500,000 to its premiums. “We continue to work with our medical society representatives and legislators to positively alter the liability situation in Connecticut,” Stanton notes, requesting lawyers to help in the physicians’ efforts to lower malpractice costs. “Since you are in a unique position to facilitate change, we would appreciate your support in this matter.” In the letter, Stanton even casts a ray of hope: “should our malpractice rates decline, we will revisit our fee structure,” he promised. In an interview last week, Stanton said his group got the idea from another practice group, which also notified lawyers when it increased rates. He said the hike “was partially precipitated by the crisis with insurance” and was a message to attorneys that there is “a crisis in Connecticut.” He said he hopes to hear from lawyers, and wanted to discuss solutions. The OSG letters were sent two days after state lawmakers concluded this year’s session without passing legislation that would cap medical malpractice awards. Doctors have been seeking $250,000 limits on pain and suffering damages, without success, for the past two years. Trial lawyers contend that approach would foreclose recovery for any low-income plaintiff, including children, the elderly and nonworking spouses. Stanton said his letter had been planned for weeks, and was not triggered by the session’s close. If the new rates accurately reflected the value of doctors’ lost time, assuming a 2,000-hour work year, it would mean the OSG doctors stand to each make well over $2 million annually. However, Stanton said none of the doctors in his practice group, which has a 75-year heritage, make “anywhere near” that much. Richard L. Newman, who takes over as president of the CTLA on June 24, said the doctors’ remedy does not appear to be logically linked to the medical malpractice crisis. Stanton confirmed that none of his firm’s doctors testify or consult in med-mal cases. Newman, of Bridgeport’s Adelman, Hirsch & Newman, calculated that the 12-doctor firm, at the rate it plans to charge for depositions, would earn $32 million a year. “If they make that much, maybe $1 million a year for malpractice coverage isn’t so outrageous after all,” said Newman.

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