The contentious medical malpractice debate will move from small committee rooms to the spotlight of the full Senate this week when two significant bills reach the floor.
Senate Bills 97 and 250 address different aspects of what lawmakers say is a mounting crisis in Nevada an exodus of doctors, particularly in the south, who are fleeing costly medical malpractice insurance premiums.
The committee testimony on both bills has been heated.
In fact, the Nevada Board of Medical Examiners offered to resign soon after an initial hearing on SB389, a bill that in large part has been folded into SB250.
"They seriously considered it and I can't blame them," said Michael Hillerby, deputy chief of staff for the governor, who appoints the board.
Hillerby said the board, at the time, wasn't given a chance to defend itself against criticism made in the Senate Committee on Commerce and Labor, where SB389 and SB250 were heard.
At the meeting, Scott Craigie, a lobbyist for the Nevada Medical Association, introduced minutes from a 2001 meeting of the board in which its reserve was discussed, including creating a "building fund" as a way to keep the money out of the hands of legislators.
Lawmakers would like to tap the board's $3.3 million reserve to create a fund to subsidize doctors' medical malpractice premiums.
The subsidy fund is intended as a short-term solution to keep doctors in the state while other reforms, including caps on damage awards and possibly tighter controls on insurance rates, have time to take effect.
The board contends it needs the reserve for future legal costs associated with litigation it is routinely involved in.
"I would agree we have a real crisis and I want to keep our doctors," said Cheryl Hug-English, a physician and the board president.
"But the medical board's purpose is to license and discipline doctors.To encompass us in this other role is inappropriate to me.
It's not our purpose."
That's not how at least one lawmaker sees it.
"I'd like to hear your solution to the problem then," said Sen.
Ann O'Connell (R-Clark).
"You don't seem to be part of the solution."
The board was also faulted for its operating budget.
"I look at the budget, in view of the crisis we're in, and your priorities seem so insignificant to me," said O'Connell.
"I wish I could see the necessity of all this.
I don't get it."
The board has also been criticized for making licensing requirements for doctors too strict, which has made it more difficult to bring new physicians to the state.
"We're criticized for being tough on physicians, and we're criticized for not being tough enough," said Hug-English.
The latter is a reference to two now notorious doctors in the state who were responsible for the majority of malpractice claims in the last few years.
At last week's meeting, Hug-English, in response to a question from O'Connell, said that Assembly Bill 1, passed in a special session last year, gave the board the tools needed to better and more quickly
discipline bad doctors.
In response to the licensing issue, the board last week proposed an amendment to SB250 that would allow the governor to declare a shortage in a physician specialty - for example, a shortage of obstetrician/ gynecologists in Clark County, which is reportedly the crux of Nevada's current problem.
The board could then relax the licensing procedure for ob/gyns in order to attract more such specialists here.
Hearings on SB97 in the Senate Committee on Judiciary may not have been as fiery, but it pitted two major industries against one another.
The bill was drafted by the political action committee Keep Our Doctors in Nevada and is designed to place a tighter cap on medical malpractice awards.
The bill was amended in committee, to the dismay of both the doctors who initially backed it and the trial attorneys who opposed to it.
It now includes a provision requiring cases to first be heard by a district judge before going to trial, a similar idea to the medical screening panel that was killed by AB1.
The bill passed out of committee, 4-3.
Both SB97 and SB250 are amended, requiring another reading after this week's reading before they can be passed out of the Senate.
