Getting Kentucky out of the dark ages by improving access to care and lowering costs.


By Robert Couch, MD

It happens every day in Kentucky’s healthcare system. You are sick and want to see a physician, but there is a long wait. Instead of waiting, you go to the emergency room, where costs are significantly higher. Once treatment is received, you may be told additional tests are needed to rule out more serious conditions. This means more costs in the form of high deductibles, more time spent away from work and more emotional stress awaiting results that may not reveal any problems.

I know this story all too well because I practice emergency medicine and experience it every day. Kentucky is the land of epidemics: poor health outcomes and increased healthcare costs due to high rates of heart disease, obesity and drug abuse. Kentucky’s antiquated legal liability system is another contributing factor. The fear of being wrongfully sued hangs over the entire medical system, forcing increased and unnecessary costs upon Kentuckians.

Legal Threats

Unfortunately, mistakes can happen by medical professionals. Those mistakes should be compensated to the patient. But the threat of legal action forces patients to pay too much for tests that in other states would be deemed unnecessary because of more modern forms of patient financial recovery. In Kentucky, much needed legislation is pending that would create a similar system.

Independent medical review panels consisting of three medical experts, picked by both the patient and the medical provider, would render an expert opinion as to whether a mistake occurred. This is a more efficient process for everyone, including the patient since it would be given great weight in any malpractice litigation, forcing quicker settlements or dismissals. It does not prevent the patient from still pursuing action in court if they choose.

Other states that have created similar systems by passing tort reform also find it easier to entice physicians to practice there. States compete for the limited number of physicians available. Physicians often choose to practice in states that have tort reform because they know they can more adequately treat patients without the fear of an unjustified lawsuit.

Kentucky’s system of fear, high cost and bad health will get much worse as Medicare and other insurers pay for treatment that is inefficiently delivered. Kentuckians will not fare well in such a system without tort reform.

I try to recruit physicians all the time, only to lose out to tort reform friendly states like Indiana or Tennessee. A recent Louisville Courier-Journal article noted that healthcare jobs will be good for Louisville because, nationally, healthcare jobs stimulate job growth in other industries. But it will not and cannot happen here without our elected leaders in Frankfort passing common sense legal liability reforms.

-Robert Couch, MD is a board-certified emergency physician in Louisville, Ky.



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