Meet the obstetric version of hospitalists, known as laborists.
Faced with rising malpractice premiums, and the increasing financial pressure to see more patients in the office, more obstetrician/gynecologists are ceasing to deliver babies. In fact, according to Massachusetts’ largest malpractice carrier, more than half of the OB/GYN’s they cover have dropped obstetrics.
It’s no wonder, as “an obstetrician-gynecologist in Massachusetts generally pays between $75,000 and $100,000 a year for malpractice insurance; that amount drops to between $30,000 and $50,000 when a doctor gives up obstetrics and sees patients only for gynecological problems.”
Some mothers may not like meeting the doctor who will be delivering their baby for the first time at the hospital. However, like other patients who are being managed by hospitalists, they increasingly have no choice, and can only blame the skyrocketing cost of malpractice and the dysfunctional physician payment system for the proliferation of hospital-based doctors.
Related posts:
- Malpractice woes affecting midwives
- Physician payment reform by capitation, will it work this time?
- Health care today: Payment and fear of malpractice takes priority
- Malpractice caps on malpractice premiums
- Are patients refusing doctors who no longer do hospital work?
- Should hospitalists control hospital beds?
- Physician payment reform is the key to fixing the health care system
{ 7 comments }
Truthfully, you don’t spend that much time with the doctor during delivery anyway.
It’s almost all the nurses and there you get whoever is working when you get admitted.
Of course, a better option is to use a midwife instead of an MD.
I was actually going to say the same thing as anonymous. It is the nurses who labor the woman for hours on end. The physician usually shows up when the patient is complete and pushing, or if a cesarean section is needed. I would like to put a plug in for nurse midwives. They follow low risk women, but they tend to stay at the bedside the whole time a woman is laboring. They also have great patient outcomes, and usually satisfied customers!
A better option is to use a midwife. Unless anything goes wrong. Then you’ll be saying “Jeez, maybe it was not a better option”.
Answers like this are why being a doctor sucks nowadays.
The malpractice premiums stated in Kevin’s post do not represent the national averages. The OB/GYNs in my group pay about $50,000 in premiums, and the big money only comes if you do the entire global OB package. The post makes no sense, at least based on my experience.
@MIke: Midwifery is a better option, as supported by the Cochrane review recently. As far as complications, those are handled quite nicely in most European models where the MW is in charge of ~80% of low risk patients and the physician only steps in when the patient is high risk or has a complication during delivery.
@Deron: I think doing “the entire global OB package” is exactly what Kevin was talking about. If OB/GYNs are forced to limit the scope of their practice by malpractice premiums, isn’t that a bad thing?
Deron,
Where I am OBs pay $70,000 per year. I have a friend in Illinois who pays $120,000 per year and in Florida it’s gone as high as $250,000 per year which is why many of them have been forced to go bare. It varies depending on where you practice, and if you are an OB/GYN you should know that.
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