I dont get it.

If the hospital cant find doctors to deliver babies because of malpractice, why dont they just hire midwives?

You dont need a doc to deliver a baby unless you are a high risk pregnancy.

Its similar to me trying to find an electrical engineer to hook up my stereo system. You dont need an electrical engineer for something that trivial

Well I practice OB at the hospital in Madisonville, and this has been happening alot. Since the reimbursement rates are lower in KY ( about $900 for a KY medicaid delivery vs about $1700 when I practiced in MA), but the malpractice is almost as high (About 85K/yr in Ky, about 110k/yr in MA,) you need to deliver many babies to recoup the cost.

In Crittenden county they don't have the volume. In Madisonville, we do because we're a larger hospital serving a larger population. We are a tertiary care center as we have a NICU. As for malpractice, I work for a foundation that is self insured. So it really is the malpractice that is killing the OB at the smaller hospitals.

Lastly the malpractice for our midwives is about 40k or so per year... so that too is expensve for small hospitals.

In response to Anonymous 7:52 PM, its not as simple as just hiring midwives. Most, if not all certified midwives who deliver in hospital require back-up by an OB. Many hospitals who would hire midwives as employees would also need to hire an OB. For many, it's just not worth it.

This is what the Senate Bill intends to do to solve the problem being addressed: Its approval could lead to a $250,000 cap on jury awards for pain and suffering in medical malpractice lawsuits, which advocates say would help hold down doctors' premiums.

The medical malpractice rates are high. That is a given.

The solution is to put a cap on the compensation that can be received by persons who have successfully litigated a complicated medical malpractice claim all the way to a jury verdict which determined a breach of the standard of care occurred and the fair compensation for the particular losses and injury caused. That is stupid.

The cap doesn't seem to affect payout for medical and other expenses. Which is really the priority.

Just a quarter-million cap on these blowouts of "emotional distress" claims, perhaps ?

The problem is that patient care as a whole is suffering due to the current system. It needs to be changed. The proposed changes aren't ideal, but at least a step in the right direction. Lawyers fighting it should be ashamed of themselves - they are putting their own bulging pockets before public health concerns.

" Lawyers fighting it should be ashamed of themselves - they are putting their own bulging pockets before public health concerns."

If anyone needs to be ashamed, it's physicians. Not once have any of them made a serious proposal involving improving the quality of their services. Instead, they seek to reduce their premiums solely by saving their insurer money which they hope will then be passed down to them.

Or do you genuinely believe there is no room for improvement?

Anon 9.26am.

I presume you are a lawyer - am I correct?

You're diverting from the point I raised. Is income for yourself more important than public health ?

I don't know about the US, but Downunder medical boards will investigate any complaint against a doc, this is done openly, includes non-medical members, and if someone is incompetent, they are dealth with..appropriately.

The problem is all the money ending up in insurance company coffers, and lawyers pockets, and not helping those who really need it. Docs in the US, even here, are simply leaving high risk specialties as a result of the spiralling malpractice premiums - irregardless of how good or bad they are. Hardly anyone is entering their training programs. The shortage will only worsen, the way things are. Even OB/GYNs here who have never been sued are having to cease practice in that field because of the malpractice premiums.

Patient care is suffering in the current system. Here and there. That is the priority, not the interest of lawyers, or of physicians, for that matter.

"The problem is all the money ending up in insurance company coffers, and lawyers pockets, and not helping those who really need it."

How do you propose compensating those who have been injured by malpractice without lawyers or insurers? Will the layman just take his case to the doctor and the doctor will right a check? Or checks, as his medical bills come in?

CJD

Lawyer Insurance? Lawyer Insurance? They already have it. If you win, you win. If you lose, try again another time.

"I guess lawyers will have to charge less than 250$ hourly if they want to have clients. Maybe people should start taking some form of insurance for "lawyer coverage"."

There is. It's called prepaid legal. It's for sale in all 50 states. And many, if not most, lawyers do charge less than that.

"How do you propose my cash patients to pay for their office visit ? If that is their problem, their lawyer fee is also their problem."

With cash, or any alternative model you can think of. Why should everyone else's method of reimbursement be limited because you can't figure out how to make yours work?

You last two posters are mad because your reimbursement method is screwed up, but instead of trying to make it better, you want everyone else's to be screwed up. That doesn't make any sense. How does that help you? No one is arguing with you that the 3rd party payer system isn't working.

Forgive me for not spell checking.

You want to propose no-fault, then do so. Right now, though, that's not even a gleam in a legislator's eye.

Why you think the lawyer should have society's interest at the forefront instead of their client's is beyond me. Do you as a doctor have society's interests at heart when you treat a patient, or that patient's?

No fault compensation was proposed to the plaintiff lawyers association by occupational medicine specialists in NSW, along with other measures to remove the adversarial nature of workers compensation here. This system has been proven to have a deleterious effect on rehabilitation prospects.

The plaintiff lawyers refused to consider this - their argument : "our goal is to get the most money for our clients, not necessarily thier best health outcome".

We are talking about the system as a whole, more than individual scenarios. Doctors have an obligation to public health as well - for instance in regards to notifiable diseases.

I, personally, am a big fan of no-fault compensation separated from disciplinary matters.

The current system just ain't working.

"The plaintiff lawyers refused to consider this - their argument : "our goal is to get the most money for our clients, not necessarily thier best health outcome".

We are talking about the system as a whole, more than individual scenarios. Doctors have an obligation to public health as well - for instance in regards to notifiable diseases."

It's not the job of lawyers to improve the quality of your services. Those lawyers are exactly right - they have a duty to their client first and foremost. Your duty to your patient trumps any other duty you may have I would think, doesn't it?

Does New Zealand (which is where I presume you are) have universal health care?

I have been open about my "bias". Anon - are you a lawyer, and what type of practice do you...uh...practice ?

I don't think it's pointless. Perhaps this is the direction the US needs to be heading ? Your current system is very inefficient.