The fear, stress and cost associated with medical malpractice claims is contributing to health care shortages across Georgia, particularly in rural areas, industry leaders told state lawmakers during a recent litigation reform discussion.

Gov. Brian Kemp met with doctors and health care executives Thursday in Macon as part of his multiyear plan to rein in civil litigation. He said he wants to hear all sides of the debate and is focused on "trying to find that balance where all Georgians can be protected."

Medical professionals told Republican and Democrat legislators that potential solutions include caps or other limitations on certain types of damages that can be awarded in malpractice cases. Georgia already caps punitive damages at $250,000 in many personal injury lawsuits.

Caylee Noggle, president and CEO of the Georgia Hospital Association, said juries are desensitized to large numbers and have lost the perception of the difference between $10 million and $100 million.

"Georgia's current health care liability laws contribute to higher costs, drawing scarce resources away from patient care in our communities, negatively impact providers' ability to treat patients and fundamentally endanger the existence of many health care facilities across our state," she said.

The Georgia Trial Lawyers Association, however, recently said Georgia's court system is "the envy of the world" despite attempts by "propaganda groups funded by large multinational corporations" to bully Georgia judges and mislead state legislators with claims that Georgia is a "judicial hellhole." It said a fair and healthy civil justice system has been and will continue to be good for business in Georgia.

Trevor Newberry, assistant general counsel at PruittHealth, said Georgia medical providers have no choice but to settle malpractice claims, even when they have a strong defense. The risk of a runaway verdict at trial is too great, he said.

"I'm in mediation 200 times a year trying to settle cases because I know I can't try them," Newberry said. "We have an average settlement in long-term care of just over $200,000. Y'all do that math. It's unsustain- able, frankly."

Scott Steiner, president and CEO of Phoebe Putney Health System, said the amount it must pay before liability insurance kicks in has tripled in four years, to $15 million per claim. He cited research finding 80% of jurors feel that if a case reaches trial, it must have merit.

"Reasonableness has left the building," he said. "What used to be $200,000 is $5 million. We're not here to make it harder for patients to seek justice. We're talking about fairness, and I think that's what we've lost."

Joel Judah, a Navicent-affiliated gastroenterologist in Macon, said the plaintiff attorney billboards he sees along I-75 every morning are "a reminder that I've got to practice perfect medicine." He said doctors are inclined to order what likely are unnecessary tests or treatments out of fear that they might miss something and be sued.

It's a phenomenon called defensive medicine, said Wellstar-affiliated emergency medicine specialist Brett Cannon. He said the result is increased costs and hospitalizations.

Chad Ray, an obstetrician gynecologist and professor at Augusta University, said Middle Georgia lost one of its best obstetricians last year when the cost of her malpractice insurance became unfeasible. He said her departure from the profession affected a lot of families.

"The juice was not worth the squeeze any longer," he said. "She was one of the busier solo practitioners in our region. She provided excellent service and care. It was not a matter of her being sued."

Van Loskoski, CEO of Stephens County Hospital in Toccoa, said it had to end childbirth services in 2021 as it couldn't recruit physicians for that work. He said doctors don't want to practice high-risk care in rural areas where they're on their own and face full responsibility if something goes wrong. The hospital's medical malpractice insurance premiums dropped 13% after it ended labor and delivery services, he said.

"The legal climate is effectively financially incentivizing you to restrict health care services," he said.

Kemp's third and final roundtable on litigation reform will be held Oct. 8.