High Medical Malpractice Premiums Are Driving OB-GYNs Out of the Business. How Will Women Cope?
There is a shortage of doctors across the United States, particularly in obstetrics and gynecology, with over half of counties without a single OB-GYN. Most of these are rural counties, with over 10 million female residents. According to a 2017 report from the American College of Obstetricians and Gynecologists, the United States could be short as many as 22,000 OB-GYNs by 2050. This comes as the Centers for Disease Control and Prevention reports a steady increase in maternal mortality rates over the past 25 years. Experts say OB-GYNs' insurance risks likely are contributing to the shortage. Paula Sullivan, senior vice president at insurance broker Marsh, said, "We have more and more pregnant mothers that are presenting with little or no prenatal care, and their OBs are still expected to deliver the perfect baby, often having very little knowledge of the mother or the baby's physical condition or well-being. That can definitely also lead to some claim frequency and severity.' Eric Gardzina, senior vice president of risk management at the Ob Hospitalist Group, added that "from a risk perspective, the risk of poor outcomes is increased when you have fewer and fewer physicians that are there and able to see these patients. The maternal mortality rate will continue to climb if this continues … We see these physicians who are working multiple shifts and without a doubt are becoming stressed out, burnt out from that. And it leads to folks that just get out of medicine altogether or stop practicing." He said medical malpractice premiums for OB-GYNs are "probably four times as much, on average, as a regular family practice, general practitioner physician would pay." The higher premiums can be attributed to the risk of adverse outcomes and claims. Citing a 2018 report, the Association of American Medical Colleges said, “Nearly two out of three OB-GYNs face legal action at some point, the highest rate of all specialties." Further, verdicts involving OB-GYNs tend to be high, especially given that "mother and separately bring causes of action," Sullivan said. One solution to reduce burnout for OB-GYNs would be to hire more hospitalists.
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