Physician shortages from rising malpractice premiums are leading to increased patient risks:
Pregnant women in Oswego County facing complicated births must go to Upstate Medical University in Syracuse to deliver their babies.“In Oswego County, there is no longer an obstetrician who will take on high-risk pregnancies, and attempts to get someone to come to that county to do that have not been successful,” said Gerald Hoffman, executive vice president of the Onondaga County Medical Society, which serves Syracuse and Central New York.
For expectant parents, that can mean a 45-minute drive to the hospital in good weather – far longer in bad weather – and added risk to both mother and child.
The situation is troubling, patients and those in the medical profession say, and it’s likely to get worse.
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{ 20 comments }
Once again, cost of care is not the issue with med-mal, it’s access to care.
There are going to be areas of practice where doctors will not choose to practice because of liability.
It doesn’t matter if your insurance is $10,000 or $20,000 or $100,000….when you’re facing a ten million dollar judgement.
So what is the after-expense income of these providers. A good six figures (150K)? Not enough money not to abandon their patients? If such is the case then these folks need to have their privileges to practice revoked and society at large needs to consider a system that is more attuned to putting the patients first over the pocketbooks of the providers. Providers failing to provide access to care are breaking the tacit agreement that allows their field to govern the supply of providers. Either provide access to care or step aside (see the Missouri fight against midwives) and let those that actually care for patients provide care.
“It doesn’t matter if your insurance is $10,000 or $20,000 or $100,000….when you’re facing a ten million dollar judgement. “
How many physicians have ever paid a malpractice judgment out of their pocket?
But hey, I think you’re right – every podunk place in the US is entitled to a specialist of every kind. Bring on single payer.
The problem with high risk OB, like many other specialties is multifold. The litigation issue is the end result. To do high risk medicine, you need a facility with all the resources. In OB for example, is there a high risk NICU, neonatal anesthesia. ETC. If you try to procatice without these, any attorney will argue a bad outcome is due to failure to meet the standard of care.
When we look at lawsuits, attorneys always look at the money and where it comes from. As physicians, it is the emotional pain of already being in a situation that is beyond your control, being accused of not fixing something that is beyond your control and lastly having your life tied up for years.
As a side note, most small towns do not have legal specialists for all types of law.
“In OB for example, is there a high risk NICU, neonatal anesthesia. ETC. If you try to procatice without these, any attorney will argue a bad outcome is due to failure to meet the standard of care.”
This is incorrect, as the standard of care is that of a reasonable person with access to the same equipment and such as the defendant. Although other PHYSICIANS have discussed moving to national standards.
As for what attorneys and physicians look at, unless you’ve been both, it’s hard to say.
You’re right though, there aren’t specialists for every type of law in small towns. So why should the lack of doctors for every specialty be a big deal? Unless you believe people have a “right” to health care, that is.
Unfortunately, I believe the high rates of malpractice payments for OB/GYNs comes from the false idea that pregnancy and childbirth are safe because they are natural. True, childbirth and pregnancy are safer today than they were 50 years ago – but there are risks inherent in any birth. Once upon a time people understood that.
We all want to procreate – but we don’t want to face the fact that pregnancy is inherently dangerous for many women. This is especially true for women with co-morbidities.
In truth, it is partially the fault of women who have pushed the false idea that men and women are equal. We are not physically the same and have unequal medical needs. When the media stops making pregnancy and birth sound like it is an accessory – rather than a medical condition that needs to be managed by either a midwife or doctor – we will continue to see malpractice rates to spin out of control.
Our insistence on not teaching scientifically based sex education and health to our population is part of this. People don’t really know what is normal because they think the things they see on TV are “normal”. TV has very little to do with reality, but try explaining that to the average young person.
Pax,
MLO
>>So what is the after-expense income of these providers.
Meaningless if they face a judgement that could wipe them out in one fell swoop.
>>A good six figures (150K)?
That’s just a little bit above the starting salaries offered to the better law firm grads.
>>Not enough money not to abandon their patients?
If the doctor says he/she won’t take on care in the first place, it’s not abandonment. If the doctor won’t continue care and refers out with locally proper notice, it’s not abandonment.
>>If such is the case then these folks need to have their privileges to practice revoked and society at large needs to consider a system that is more attuned to putting the patients first over the pocketbooks of the providers. Providers failing to provide access to care are breaking the tacit agreement that allows their field to govern the supply of providers.
Society broke the “tacit agreement” a long time ago. Starting with the word “Provider”. Reap the whirlwind.
>>Either provide access to care or step aside (see the Missouri fight against midwives) and let those that actually care for patients provide care.
Go ahead. Waiting to see the midwives do the high-risk obstetrics. Actually, dreading it, in that they find ways to drop the problem back in the lap of the primary docs. I’ve already experienced that with other non-physician practitioners who want to play doctor and expand their scope of practice.
>>How many physicians have ever paid a malpractice judgment out of their pocket?
Are you willing to provide a personal guarantee to indemnify me were I to face one?
…..crickets chirping…..
“Meaningless if they face a judgement that could wipe them out in one fell swoop.”
What’s the chances of that happening? I mean, if you’re saying that they’re not going there because of that fear, I assume you know. Is it more or less than a massive judgment resulting from driving a car and hitting someone? Have you stopped driving?
“Are you willing to provide a personal guarantee to indemnify me were I to face one?”
No, do you get a personal guarantee of indemnification from someone else on every contract you enter into for more money than you have? Before you ever get in a car?
The whole “could be wiped out by a judgment” cry would be more meaningful if you had any idea of the actual risk. If there was much of a chance, I’m sure all the tort “reformers” would have touted it by now. Since they don’t, you can bet it’s nearly nonexistent, absent alcohol abuse by the physician or something like that.
ACTUALLY being wiped out or not clearly doesn’t matter. If the perception is such and this is producing critical shortages, isn’t that a problem? and $150k clearly isn’t enough, if there are shortages (wouldn’t be enough for me, & i’m not a high-risk OB).
and clearly the idea that there is an “obligation to society” is nonsense, and nobody is being forced to deliver babies in Oswego County or anywhere else.
Yet he’s not willing to indemnify for the risk that doesn’t exist.
Hope the upstate docs make it clear the reason they travel is the trial bar. The ladies can look at the back of the phone book for the guaranteed lawyer ad.
Maybe they’ll do the delivery.
If there were no lawsuits, will those same docs agree to live there indefinitely, and always guarantee there will be a specialist?
Because if you’re going to scare people into thinking that lawyers ran off the docs, when you end the ability to hold your negligent self accountable for your actions, the patients are going to want SOMETHING back. Because apparently they now have a RIGHT to health care – specifically certain specialties, under your logic.
Wow.
No guarantee of indemnity for a risk that supposedly doesn’t exist (massive malpractice judgement).
Yet real quick to ask for guarantees himself.
I ask for no guarantees. I accept the fact that living in a rural area means you give up some services. You’re the one who is saying that we in the hinterlands shouldn’t have to give anything up.
>>>”So what is the after-expense income of these providers. A good six figures (150K)?”
Not enough, evidently.
And what makes you think that $150K is a competitive figure for the level of responsibility and the hours demanded? What makes $150K “good?” Good for what? (I personally don’t think “six figures” gets “good” until it hits $700K.)
>>>”Not enough money not to abandon their patients?”
Relocating your practice is not abandonment, regardless whether there are convenient or available practitioners left in a given location. No one is guaranteed a right to availability of medical specialists, ever, anywhere. The departing doctor is not required to find his patients suitable alternative providers.
>>>”If such is the case then these folks need to have their privileges to practice revoked . . . “
That is laughable. Revoked by whom, the hospitals who can’t attract practitioners to work in the first place? Obviously you don’t work in professional recruitment.
>>>”and society at large needs to consider a system that is more attuned to putting the patients first over the pocketbooks of the providers.”
Privileges are not the right of freeloaders to bestow on those whose services they don’t wish to pay competitively to have (unless you have been elected to Congress, that is.)
What “system” do you have in mind there, slavery?
>>>”Providers failing to provide access to care are breaking the tacit agreement that allows their field to govern the supply of providers.”
Last I heard, fee still paid for service. That is how it works even in that wonderful world of “single payer.” What other “tacit” agreement are you referring to? Are you implying that there is some form of “tacit” agreement that doctors should have licenses (last I looked, I had to have one; no one asked my agreement.) Or are you implying that there is some sort of agreement that prohibits non-doctors from providing medical care? If you think that, don’t tell all the the podiatrists, dentists, oro-maxillo-facial surgeons, nurse midwives, nurse anaesthetists, nurse practitioners, licensed clinical psychologists, optometrists and chiropractors about that, they will be mighty upset. Or do you think the public is willing to accept care from anyone who can fog a glass without showing some ability to meet a standard of expertise? If you know that to be the case, please say where, because I don’t hear it where I work.
>>>”Either provide access to care or step aside (see the Missouri fight against midwives) and let those that actually care for patients provide care.”
Or something like that, until they discover that they are in over their heads, at which point, we return to the subject of this post.
“No guarantee of indemnity for a risk that supposedly doesn’t exist (massive malpractice judgement).”
No one said it didn’t exist, they said it was miniscule. But I’ll tell you what, if you want me to indemnify you, send me your claims history to start and then I’ll interview you and I’ll price it for you. How much coverage do you want?
>>No one said it didn’t exist, they said it was miniscule.
Ah, progress.
It would appear the obstetricians felt the “miniscule” risk was not worth it.
It would be progress if I was saying something different. The only progress is you learning to read.
Maybe that’s why, maybe not. Maybe they got offered better jobs. Maybe they got divorced and wanted to get away from the ex. We don’t know because none of those allegedly leaving were interviewed. I don’t know how it works in your industry, but most others require some facts before reaching conclusions.
Maybe they were carried off by aliens. Believe what you want.
Anything to avoid facing the fact that tort reform works, I suppose.
There’s nothing to believe because they weren’t quoted. It’s just speculation.
If by “works” you mean inhibits the ability of housewives, the elderly, and children to find representation when they are injured by negligent parties because insurance lobbyists have arbitrarily set the value of their lives, then yes, you’re absolutely correct.
Go insurance industry!! See you during the next recession, doc, when another “crisis” develops. Talk about “believe what you want.”
150K in NYC is NOTHING! You talk about pcoketbook lining? It’s like “head above water”. Who decided that doctors aren’t allowed to make more money if they worked harder? Or smarter? Its the GOD&^%*ED AMERICAN WAY??? Who are the Commies no this site who tlak about torts being the right of the injured, but think doctors should all make the same crappy salary and not a penny more?? Go to China then.
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