Missouri Lawmakers Relax Volunteers' Medical Malpractice Liability

Opening up the market for charitable work

Missouri lawmakers voted on Wednesday of last week to override Gov. Jay Nixon’s veto of SB 129, the Volunteer Health Services Act, which relaxes medical malpractice liability for volunteers.

“This is going to increase access to health care for thousands of Missourians at no cost to the taxpayer,”Sen. David Sater, R-Cassville, who sponsored the bill, told Watchdog.

The measure waives civil penalties against volunteers unless there is a “gross deviation from the ordinary standard of care or willful misconduct.” The change means health professionals can donate their services without fear of lawsuits.

The cost of liability insurance kept many retired physicians and other health workers from volunteering in their communities, Sater told Watchdog last month.

“We just want them to work within the scope of their practice and if they do that and follow the standard of care, which we have in the bill, then they won’t have to fear being sued for some frivolous stuff,” said Sater, a pharmacist by training.

The new law also allows health professionals licensed in other states to practice in Missouri as long as they are providing free care.

Charitable groups like the Tennessee-based Remote Area Medical rely on out-of-state physicians and nurses to staff their events. The organization holds weekend-long events across the country to provide free dental, eye and general medical care to thousands of underserved patients. People often drive for hours and camp out in their cars overnight to make sure they will get a spot in line.

Without out-of-state volunteers, RAM can’t see everybody who shows up.

“It’s a mathematical problem,” RAM founder Stan Brock said.

About 60 percent of the doctors and nurses who are volunteering at an event in Clinton, Tenn., next week are licensed outside of Tennessee, Brock said.

“To have this restriction that a doctor duly qualified in New Jersey is not allowed to cross state lines to provide free care in Missouri.

In 2011, RAM sent its mobile eyeglass clinic to Joplin to assist in the tornado recovery effort, but couldn’t do any work because the group’s optometrist and opticians weren’t licensed in Missouri.

In his July veto message, Nixon wrote that Missouri already has a system of free clinics and that any gaps in coverage “should be addressed within the system.”

Missouri becomes at least the eighth state to ease restrictions on volunteer health workers. In other states, similar legislation “has been extremely successful and thousands of patients have been served that otherwise would not have got the care that they need,” Brock said.

After passing the Missouri Senate 25-9, the override initially fell one vote short in the House. But around midnight the measure squeaked through on reconsideration, obtaining the necessary 109 votes.

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  • Fist of Etiquette||

    Nixon's stated reason for vetoing the bill is because it is, in his view, unnecessary not harmful. However, the people actually engaged in volunteer medical services seem to say otherwise. So I would like to know his real reason for not liking this legislation. I suppose probably malpractice and liability is such a big business that trial lawyers would heavily lobby the governor.

  • Rich||

    I would like to know his real reason for not liking this legislation.

    Perhaps a Tennessee-based optometrist raped his grandmother?

  • db||

    Beat me to the Tennessee/Volunteer joke.

  • Ted S.||

    So I would like to know his real reason for not liking this legislation.

    In his July veto message, Nixon wrote that Missouri already has a system of free clinics and that any gaps in coverage “should be addressed within the system.”

    Everything within the state; nothing outside the state; nothing against the state.

  • some guy||

    I always knew Missouri would lead the charge for meaningful healthcare reform... said no one ever.

    Good on them, though. And now we know that Gov. Jay Nixon is in tight with the tort lawyers (or did we already know that?)

  • ||

    And now we know that Gov. Jay Nixon is in tight with the tort lawyers a revolting un-wiped asshole

    FTFY

  • Generic Stranger||

    So they're no longer the Sue Me State?

  • Swiss Servator, Spare a Franc?||

    *golf clap*

  • Bo Cara Esq.||

    I am not sure that Governor Nixon does not have a point. We want to encourage volunteerism, but we also want people, even volunteers, to be responsible for their actions which may harm people.

    Think of a non-health care example. Someone volunteers to coach a little league baseball team. They do something that most people with sense would not do, but which falls slightly short of 'gross deviation of the standard of care' and kids are harmed. Should we wave it off because the coach meant well when he volunteered? Or should we still hold them accountable for doing something stupid which harmed people?

  • Being Waterboarded||

    There is a balance to be struck. When you are having trouble finding enough little league coaches because they are all afraid of getting sued, you are not at the right spot in that balance...

    I highly doubt the good governor is thinking of the children here...

  • Stormy Dragon||

    To extend the analogy, a lot of adult men have stopped volunteering with children because they're worried about being unjustified accusations of molestation.

    That doesn't mean the proper solution is a law saying all volunteers are immune to molestation charges, so that the Jerry Sandusky's of the world can get off scot free.

  • ||

    That doesn't mean the proper solution is a law saying all volunteers are immune to molestation charges

    Great analogy, except that the law in question does not grant blanket immunity from malpractice lawsuits to volunteer physicians. And, you know, there's no such thing as molestation by negligence, or molestation due to inadequate diagnostics, or non-negligent molestation liability since molestation is a crime that either occurred or didn't, rather than a nebulous range of potential actionable offenses like a tort. This is pretty stupid, even for you.

  • JWatts||

    To extend the analogy, ... right off a cliff.

  • JWatts||

    To extend the analogy, ... right off a cliff.

  • pmains||

    This is pretty stupid, even for you.

    Now, that's a magnanimous assessment.

  • Scruffy Nerfherder||

    Perhaps you should move to China, where Good Samaritans are held directly liable for anything bad that happens to the person they're helping. As a result, almost nobody helps anyone.

    As a broader question, does each and every accident require legal action?

  • Heroic Mulatto||

    As a broader question, does each and every accident require legal action?


    Yes.

  • Scruffy Nerfherder||

    Weird Al proves once again why he rocks.

  • db||

    Awesome. I love Weird Al.

  • Bo Cara Esq.||

    I hate to answer your question with one of my own, but does no accident require legal action?

    I imagine I will say that not each and every does and you will concede that some do, so now we are just talking about the standard of liability. Should it be 'gross deviation from a standard of care' or should we expect more from people, even when they are volunteering?

  • Scruffy Nerfherder||

    Should it be 'gross deviation from a standard of care' or should we expect more from people, even when they are volunteering?

    Again, I submit the example of China where there is no protection for Samaritans at all, hence there are no Samaritans.

    If I'm bleeding out, I don't want someone to worry about whether or not they'll get sued when they consider helping me. As the urgency of the situation rises, the liability for assistance should decrease.

  • Bo Cara Esq.||

    Does this bill apply only to emergency situations? Should it?

  • TANSTaaFL||

    In your world hundreds or thousands of people should be denied access to free/inexpensive care for diabetes, high blood pressure, vision problems, etc (leaving out emergency care)because MAYBE, just MAYBE, one day Dr. Giggles will sign up to volunteer or a couple people who would otherwise never get any care will receive less than stellar care.

    Folks like you are immediately skeptical of any voluntary interactions while maintaining a baseline of trust for government and the politicians that run it. In consequence, many people are denied easy access to things they need(usually underprivileged, since it is they who most need inexpensive items)

    Yet, somehow it libertarians who are crazy and cold-hearted.

  • JWatts||

    I hate to answer your question with one of my own, but does no accident require legal action?

    You really are failing to make any relevant point with a question like that. Your question is just a passive aggressive attack. I'd appreciate it, if you could argue in good faith.

  • CampingInYourPark||

    I am not sure that Governor Nixon does not have a point.

    Double negative powers activate!

  • db||

    There are good reasons to hold volunteers liable for their mistakes just as there are good reasons to relax liability for doctors and nurses. In the system we have, witg the incentives that have been set up? Unlikely that without a complete disassembly and unwinding of the legal regime surrounding malpractice law, that anything approaching sensible will be achieved.

    The change we get is seldom the change we need.

  • Scruffy Nerfherder||

    There are good reasons to hold volunteers liable for their mistakes just as there are good reasons to relax liability for doctors and nurses.

    Not sure I get you here. Doctors and nurses are working within a heavily licensed and regulated regime. Does that absolve them of responsibility for standards of care more so than volunteers working outside that system?

  • db||

    My point is more that the system over all sucks. The legal regime that enables malpractice lawsuits on flimsy grounds is a major reason that hospitals and other care agencies resort to pushing work to volunteers. The liability insurance costs artificially push up the cost of medical treatment and incentivize the use of volunteers for two reasons: they help control costs (free labor) and they reduce the cost of insurance (but only if they're exempted from liability.
    Few volunteers woyld be able or willing to pay for their own liability coverage and so it is an indirect cost to a hospital. A cynical way of looking at it is that bigger health care concerns are trying to reduce liability for volunteers as a rent seeking opportunity for themselves.

    The whole system is a vile snake eating itself while constricting society within it.

  • Robert||

    I think you've hit it. One of the big problems in the USA more than elsewhere in the world has been its movement against principles of liberty in its judicial sphere, and I'm afraid that problem is intractable. Every bit of legislation to curb judicial excesses is 2-edged, introducing new injustices as it gets rid of others, and the overall result of greater legislative control over the judiciary is anti-liberty IMO. The judicial problem has to be attacked at its root, which is within its own culture, mostly in law schools, and that's hard.

    See, the only way to reduce the problem of discouraging good samaritans is by precluding some hurt persons from judicial recourse. In some cases that will help, but in others will hurt; it's a blunt tool that doesn't fit all individual cases. We could similarly diminish the force of the War On Drugs by diminishing law enforcement generally.

  • AlmightyJB||

    I didn't see where anyone was being forced to attand these events. There should certainly be disclosure concerning the liability protection since that in itself is a deviation from the norm. But assuming disclosure this sounds like a win-win. I'm also guessing that there not doing open heart surgeries ant these events but more likely pretty innocuous general care.

  • Robert||

    And if we had a reasonable judicial system, the fact that people had notice and were there voluntarily would be sensibly accounted for in tort law. And legal represent'n would be cheap because the cost of lawyers wouldn't be bid up because of excessive litig'n increasing demand, and guild-like restriction of their supply.

  • John Galt||

    Having illnesses treated is a dangerous adventure. Americans seem to badly want inexpensive health care. If they realistically expect the latter they must accept the former.

    We can not both sue the hell out of medical providers and expect cheap treatment.

    The Missouri legislation should be welcomed by those desiring affordable care. Certainly it will be despised by lawyers and their clients.

  • JWatts||

    Perhaps, we should just let these 8 states continue on with reduced liability for a decade or so and then check and see if there has been a sharp increase in poor medicine associated with charitable medicine. If there hasn't been then we successfully tested the hypothesis.

    Obviously, if there were catastrophic events in the mean time, the states could jump in and change the law. But outside of anything abnormal, then why should anyone (besides tort lawyers) object?

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