Why do physicians stop practicing obstetrics? The impact of malpractice claims

Article Abstract:

Many physicians have stopped practicing in the medical specialty area of obstetrics in the past 10 years. During this period of time there has been a significant increase in the number of malpractice claims against these practitioners. Higher malpractice premiums and physicians' concerns over being in a malpractice suit are major reasons for leaving the practice of obstetrics. Claims data from a large physician-sponsored insurance company were used to study the issues surrounding obstetricians' stopping practice in this specialty. A physician-owned and -operated professional liability company sponsored by the Washington State Medical Association was used in this study. During the study period, 25 percent of physicians stopped practicing obstetrics. A greater proportion of family practice physicians discontinued the obstetric portion of their practice than obstetricians, but the rate of new obstetric malpractice claims was three times higher against obstetricians than against family physicians. The physicians who discontinued the practice of obstetrics were older, practiced in an urban area, and were more frequently in a solo practice. For both groups studied, there was an association between advancing age and the propensity to discontinue the practice of obstetrics, all other factors being equal. Obstetricians who were involved in more claims were slightly more likely to stop practicing obstetrics; however, the seriousness of the claim had no statistical significance in relation to practice patterns. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physicians, Statistics, Medical malpractice insurance, Washington (State)

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Characteristics of physicians with obstetric malpractice claims experience

Article Abstract:

The malpractice crisis has had a major effect on the practice of obstetrics. Malpractice claims and the costs of malpractice insurance have continually risen in the past few decades. This study examined if there are any common characteristics of physicians involved in obstetric malpractice claims. Data were obtained from a physician-owned professional liability company for the period of January 1982 to June 1988. A total of 844 physicians were covered through this carrier for at least some time during that period. Usable data were obtained from 591 of these physicians. There were 203,414 deliveries attended by these physicians during the six-year period. Fifty-three physicians (9 percent) experienced malpractice claims, yielding a rate of 0.32 claims per 1,000 deliveries. Physicians experiencing malpractice were more likely to be older, to be obstetricians, and to have higher monthly delivery volumes. The risk of malpractice per delivery was significantly lower for physicians performing more than 200 deliveries per year, compared with those performing less than 200 per year. The results indicate that annual delivery volume is a better indicator of the likelihood of malpractice than specialty; insurers might consider using that factor, instead of specialty, when setting malpractice insurance rates. (Consumer Summary produced by Reliance Medical Information, Inc.)

Demographic aspects, Malpractice, Obstetricians

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Defensive medicine and obstetrics

Article Abstract:

Physicians who have exposure to malpractice claims do not appear to increase their use of prenatal diagnostic tests or cesarean section for low-risk obstetric patients. Researchers evaluated county malpractice defendant rate information from the Washington State Physicians Insurance and Exchange Association and data from the Content of Obstetrical Care Study database. The final group studied was comprised of 209 physicians who were either family physicians or obstetrician-gynecologists. Physicians who had been previously exposed to malpractice claims were found to be no more likely than those with no such exposure to do more prenatal screening and both groups had the same caesarean section rate for their low-risk patients. One reason defensive medicine apparently is not being practiced in the field of obstetrics is because malpractice has affected the practice of physicians in general, not just those physicians who have had experience with malpractice claims either personally or in their group practices.

Social aspects, Cesarean section, Defensive medicine

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