Now is the time for doctors to acknowledge the value of public scrutiny for fellow doctors who make mistakes, lawmakers say.

Lawmakers are debating a $1 million cap per victim on jury awards in medical malpractice cases. Physician organizations favor a cap.

But lawmakers say they want to hear that doctors also value the tougher licensing and discipline standards for physicians that the Legislature is expected to consider as well.

Shielding the public will come first in both of those debates, about a half-dozen legislative leaders interviewed said.

Jim Harrison, R-Richland, and chairman of the powerful House Judiciary Committee, is among legislators who wonder if physicians want the best of both worlds.

Harrison said he asked during a committee hearing on the medical malpractice bill what physicians are doing to improve their profession from within.

“I didn’t get much of an answer,” the Columbia lawyer said. “It sounds like there are some doctors ... who want relief (from lawsuits) but are blocking what would be better self-policing.”

Physicians’ organizations say the two issues should be viewed separately and that patient safety comes first.

“There is no correlation between the two,” said Todd Atwater, director of the 6,700-member S.C. Medical Association.

Dr. William Hueston, president-elect of the 1,400-member state Academy of Family Physicians, agrees with Atwater.

Hueston also points out that proposed changes to licensing and discipline procedures for doctors are improvements over current law.

But some lawmakers aren’t convinced the proposed changes in physician discipline and public scrutiny of that discipline are aggressive enough.

“They want us to protect them by giving them caps,” said Sen. Brad Hutto, active in the medical malpractice debate in the Senate and husband of a pediatrician.

“But the other side of that coin is they must be better able to police themselves,” the Orangeburg Democrat said.

House Democrat James Smith concurs.

“We certainly ought to be raising the standards,” the Columbia lawyer said.

“If the number one concern of the physicians advocating tort reform is patient safety ... and not self interest,” Smith said of the malpractice bill, “then they will pursue as vigorously the policing of their profession. These are not mutually exclusive.”

Smith particularly wants tougher examination of doctors sanctioned in other states who want to move to South Carolina.

Sen. Glenn McConnell, too, said he favors a disciplinary process that allows more public scrutiny of doctors.

“If we’re going to have licensing, we have to come down on the side of having a more open process,” the Republican lawyer from Charleston said. “I just think you instill more public confidence.

“I’m going to be very reluctant to start sealing records,” McConnell said of secrecy provision in discipline cases.

McConnell, the Senate president pro tem, also opposes cases bouncing between the state’s medical board and the Administrative Law Court.

In the past year, sanctions against two doctors have ignited a debate over which agency has the final say in discipline cases and which of those venues — if either — is open to the public.

“The direction of reform up here is to stop the process of going from the agency to the courts and then back to the agency,” McConnell said.

The medical board ordered West Columbia alternative medicine physician Dr. James Shortt to stop intravenous infusions after one of his patients died. The case went to the administrative court and remains unresolved a year after the patient, Katherine Bibeau, died.

Shortt has agreed to limit his practice while his case is argued. The board continues to list him as having no disciplinary violations.

Hilton Head Island cardiologist James Johnston, whom the board sanctioned three times because of alcohol impairment, blocked his discipline by appealing to the administrative court. A newspaper’s lawsuit to open the records and settle the jurisdictional question was argued last week before the state Supreme Court.

House Speaker David Wilkins said he is not persuaded doctors are trying to protect themselves both ways.

Wilkins said he will wait until the medical board’s proposed changes are submitted as legislation.

“It’s just in the embryonic stages,” the Greenville Republican said.

But Columbia attorney Richard Gergel worries the outcome might be heavily pro-doctor.

“They don’t want any public accountability — that’s the theme here,” said Gergel, who sued Shortt on behalf of the Bibeau family.

“If you undercut the civil accountability system (by limiting lawsuits),” Gergel said, “you really undermine the only balance there is.”

Reach LeBlanc at (803) 771-8664 or cleblanc@thestate.com.