Doctors here are being more careful about accepting patients, but are not turning people away based on where they live, several sources said.

One question a health-care seeker might be asked, however, is whether they’ve ever sued anyone.

“All physicians of the state, until this calms down, are being advised to look for issues that might put them and their families at risk,” Vicksburg’s Dr. Daniel Edney said. “We have been advised to have a screening process” that would include questions about whether prospective patients have ever been plaintiffs in lawsuits.

Medical-malpractice insurance has become less available and more expensive in recent years in Mississippi and elsewhere. The Mississippi State Medical Association and other such state and national doctors’ groups have declared the situation a crisis. Several Gulf Coast surgeons went on strike from their practices two weeks ago.

“Physicians are being forced to make decisions we don’t like to make and haven’t made before, but we don’t know what else to do,” Edney said. He added that he had not increased screening in his personal practice.

Edney, who is also the elected speaker of the MSMA House of Delegates, said physicians who face patient emergencies no other doctors can treat and those on “unreferred call” are obligated to and will continue to treat any patient who needs care. Availability of those doctors will not change, he said.

For any patients who need emergency or on-call care, “The only screening process is, Are beds available?’ and Are we able to provide that level of specialty?'” Edney said.

For more routine matters, however, some people might have to shop harder to make an appointment.

That was the case for a member of his congregation, said the Rev. Rick Ritchie of Port Gibson. Ritchie said the woman was recently denied acceptance as a new patient by a doctor at Vicksburg’s River Region Medical Center and the woman believed the reason she was turned away was because of her residence in Claiborne County.

The woman “said it was because she was from Claiborne or Jefferson County,” Ritchie said of the denial of which he was told.

River Region spokesman Diane Gawronski said the doctor identified by the prospective patient regularly visits Port Gibson to see patients there, “so (her residence) would not be the issue,” she said.

Large jury awards in civil-liability cases, a category that includes medical malpractice, have become more frequent in recent years. Claiborne and Jefferson are two of several Mississippi counties that have been named especially “pro-plaintiff” by the U.S. Chamber of Commerce and other national groups.

In a 2002 special session, the Legislature enacted caps on punitive damages in civil lawsuits and tightened rules on where cases can be tried. The new rules would limit those treated in Warren County from suing for malpractice in courts located elsewhere.

Another Vicksburg doctor who, like Edney, serves on the state medical association’s board, Dr. Randy Easterling, also said there was “no organized effort to advise doctors to scrutinize locale” when deciding which new patients to accept.

“That came out of the problems we had with venue,” he said, adding that last year’s legislation resolved that issue. “There is no organized effort by River Region physicians to exclude patients from other counties,” Easterling said.

Edney also said that no residents of the area served by River Region, which includes Claiborne and Jefferson counties, would be denied care at the Vicksburg hospital.

“In Vicksburg, we are the safety net,” he said. “There is no resident of Claiborne County who cannot receive medical care here. That doesn’t mean that they can necessarily have their choice of physicians.”

MSMA general counsel Linda McMullen also said the organization was “not giving any organized advice” on the screening of patients. She added that patients’ having sued doctors may raise questions about those doctors’ ability to treat those patients with complete impartiality, and that the association does offer counsel to such doctors who were already defendants in lawsuits.

Beginning around the early 1980s, malpractice-insurance premiums rose sharply. A carrier that once insured about 20 percent of the national market, St. Paul, announced in December 2001 it would exit the business.

Trial lawyers have argued that losses from mismanagement in the insurance industry, including those in the declining financial markets of the early part of this decade, may have contributed at least as much to the rising rates.