Malpractice premiums paid by doctors in surrounding states can be significantly lower than rates in Wyoming, according to the fee schedule of a major Wyoming insurer.

The Doctors Company is one of three medical malpractice insurers in the state. UMIA, a small Utah-based insurer, also does business in the state, while the third, the Ohio Health Insurance Company, announced in March that it would leave the state this year.

Premiums that The Doctors Company charges in the surrounding states of Nebraska, Idaho, North Dakota and South Dakota are markedly lower than in Wyoming.

For instance, an obstetrician in Wyoming who has never been sued pays about $87,000 a year for malpractice insurance with The Doctors Company. A physician in the same specialty in South Dakota pays the company just under $29,000.

Rates for a general practice physician in Wyoming who does not provide surgery or hospital care are about $15,300. The same doctor might pay about $6,700 per year in Idaho.

Montana, Colorado and Utah doctors pay lower premiums in many specialties, too.

"Most of (those other states) have very significant tort reform," says Dr. Richard Anderson, president and CEO of The Doctors Company based in Napa, Calif.

Nebraska and Colorado, for example, both cap total damages - Nebraska at $1,250,000 and Colorado at $1 million, with pain and suffering damages limited to $300,000.

For noneconomic damages, South Dakota has a $500,000 cap, Montana a $250,000 cap, and Idaho and Utah both cap damages at $250,000 but adjust for inflation, according to American Medical Association figures for 2003.

"That leads to much lower rates in those states," Anderson said.

Where physician recruitment is concerned, doctors coming out of medical school typically owe $100,000 or more in student loans. If they can save $20,000 on medical malpractice insurance by going to another state, that's what they'll do, Anderson said.

Dr. Steven Bonin, a Casper oncologist, seconded that assertion.

"We do kind of disagree with the people who say tort reform does not work," he said.

"There are other states, particularly in Texas, where it has worked," Bonin said. "People will still say that malpractice rates still go up, but there's a difference from rates going up 8 percent, vs. going up 150 percent."