December 10, 2018

Virginia Lawyers Weekly interviews President Richard Szucs about the upcoming General Assembly session and his new role at the Medical Society of Virginia.

By: Matthew Chaney

The intersection of medicine and law extends beyond cases of medical malpractice, despite what some lawyers may think. To state the obvious, every lawyer at some point has been a patient. Conversely, every physician’s practice is regulated by the law.

Richard Szucs, the newly installed president of physician advocacy group the Medical Society of Virginia, treads the line between the two, working to represent the interests of more than 30,000 physicians, physician assistants, students and specialists throughout the state, to ensure that their needs, and the needs of their patients, are properly considered when legislators make the rules.

He recently came to the Virginia Lawyers Weekly office to discuss his organization’s role in state and national politics, the group’s legislative agenda for the 2019 General Assembly session and the need for dialogue between lawyers and physicians.

Szucs, a practicing radiologist, took office in late October, after previously serving as the president of the Richmond Radiological Society, the Virginia chapter of the American College of Radiology and the Richmond Academy of Medicine. He said his past experience has taught him the importance of getting to know the people who make the laws.

“It’s more than just showing up in a white coat on one day during the session,” he said. “It’s about developing a relationship. Anyone who does advocacy knows it’s really all about building relationships.” He said, that as with any political perspective, it’s important for physicians to get involved and for legislators to take the time to hear from them. He said that this is one of the most vital roles that organizations like MSV and RAM play, noting RAM’s upcoming legislative breakfast at Chippenham Hospital on Nov. 29 and their legislative reception at Ortho Virginia on Dec. 6.

He said that while MSV is currently finalizing their advocacy plan for the upcoming General Assembly session, there are several lingering issues that still need to be addressed.

Among these is Medicaid reimbursement for physicians.

“For a number of years, the reimbursement by Medicaid has fallen below the cost of providing care,” he said. “While we support Medicaid expansion and we think it’s a great thing, we need to fix the reimbursement for physicians because if you give people coverage, but there’s nobody who can afford to see them, this doesn’t give access.”

Szucs also discussed issues concerning insurance prior authorization and surprise billing. While he said he understands the need for prior authorization in some situations, there are others where patients suffer due to systemic inefficiencies.

He cited situations where patients receive treatment on a fail-first basis, trying older, more cost-effective treatments first to determine if they work before moving on to more expensive, newer and, often, more effective treatments.

“The problem is, if the patient changes insurance, sometimes the new insurer will make you go all the way back through all those steps,” he said. “So you’re taking the patient off something that’s working, putting them on something that you know isn’t going to work, and in some cases, for example with advanced arthritis, that’s harmful to the patient because they suffer cartilage loss and damage to the joints because they’re not on the medication that’s working.”

He said one possible solution would be to reward physicians who do things the right way by not immediately ordering the most expensive, unnecessary treatments, with an expedited path through the process.

“There needs to be a better way to do that so it’s not so burdensome for patients and physicians,” he said.

On the matter of surprise billing, Szucs said there needs to be a way for patients to get the help they need without being penalized for going to see a doctor who happens to work with an out-of-network specialist. Conversely, he said it’s also important that the out-of-network physician gets compensated for the work they do.

“We’re trying to work on that.,” he said. “We think that the insurance company should pay that other physician the usual average amount that they would pay for that service and it should go directly to that physician.”

On the topic of medical malpractice, Szucs said that his organization has done a good job in recent years maintaining an open dialogue with organizations like the Virginia Trial Lawyers Association on issues like the medical malpractice cap and last year’s bill to create a cause of action for loss of consortium.

“We try to be very open and communicate that when things come up that are of interest to physicians and lawyers, that we work together as stakeholders, rather than try to fight each other in public,” he said.

He cited the loss of consortium bill from last year’s legislative session which would have effectively allowed family members of people who suffer personal injuries, including those which occur as a result of medical malpractice, to sue for negligence, bypassing the medical malpractice cap.

“It came up, but we were willing to go and talk with the lawyers about that and the lawyers were willing to talk with us,” he said. “We need to have dialogue and conversation so we can understand each other’s positions and find something that works for everybody.”

Outside of advocating politically, Szucs said his organization offers a whole litany of services to physicians ranging from educational resources to malpractice insurance to business assistance to wellness opportunities.

Ultimately Szucs said that the work the Medical Society of Virginia does is not just for the good of the physicians, but for the patients who live and work in the state.

“We always try to advocate, not just on behalf of ourselves, but for the patients of the Commonwealth,” he said. “We’re trying to serve the public.”