The Washington Times reports that doctors in Maryland are electing to work without malpractice insurance because they either do not want to pay the increased premiums or they cannot afford them.

The doctors say the rates are so high now that they also are considering whether to discontinue high-risk procedures or to close or move practices out of state. "I look at these options myself," said Dr. Brian Avin, a neurologist with admitting privileges at Montgomery General. "I don't go to the emergency room anymore. I've cut back on treating the indigent. We've cut back on Medicaid. That hurts. I went into medicine to do all of those things."[snip] Meanwhile, the Maryland State Medical Society said this week that as many as 40 percent of the state's physicians will close or relocate if premiums are not reduced.

And the Washington Post blames Edwards:

"The John Edwards we know crushed [obstetrics, gynecology] and neurosurgery in North Carolina," said Dr. Craig VanDerVeer, a Charlotte neurosurgeon. "As a result, thousands of patients lost their health care."

"And all of this for the little people?" he asked, a reference to Mr. Edwards' argument that he represented regular people against mighty foes such as prosperous doctors and big insurance companies. "How many little people do you know who will supply you with $60 million in legal fees over a couple of years?"

However, Ira E. Williams, author of First, Do No Harm: The Cure For Medical Malpractice
, says the Doctors, and the system in which they work, are also to blame, because bad doctors aren't ratted out sooner. Says Williams,

While Williams suggests that Doctors should do more to prevent this problem by being more forthright about their and their colleagues errors, he still thinks that medical negligence is best defined by someone other than lawyers, judges and juries. Still, Dr. Susan Van Pelt, who reviewed this book, disagrees with Williams' assessment:

He concludes that peer organizations have no teeth, and are run by good old boys more concerned with protecting their buddies than in good patient care. In fact, peer review organizations I have been involved in operate almost exactly like the IRPR he ends up recommending in his last chapter, and are staffed by diligent, caring people who honestly want the best for patients, though usually are less arrogant about being sure their approach is the only right one. Meanwhile, he ignores or belittles new approaches (like the aviation model) that actually stand likely to reduce the frightening statistics on medical errors. He gives his prejudice away on page 138 when he states "...the only solution is to identify, control, and discipline negligent practitioners," ignoring the fact that most errors are committed by competent, careful, and up-to-date doctors who are not perfect.

If we're going to demand perfection, we'd better find some other planet on which to get care, because humans are ill-fitted to deliver it. And even if humans could, could anyone afford it?