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Pennsylvania obstetricians, reeling from some of the highest liability insurance premiums in the country, are leaving their practices in record numbers. Many are retiring early, choosing to practice in neighboring states, or giving up the delivery of babies altogether as they try to grapple with the nearly impossible financial burden of soaring malpractice insurance costs.
And they’re not the only ones suffering from the situation. According to a recent report from the Pennsylvania Medical Society, the state’s dwindling number of obstetricians is having a direct impact on the care expectant mothers receive. While the situation hasn’t reached epidemic proportions yet, the report says it will soon if state medical liability laws aren’t changed to address frivolous lawsuits and other abuses of the medical liability system, according to Michelle Vichnin, MD, an OB/GYN from Reading, PA, and member of the Council on Policy and Governmental Affairs of the Pennsylvania Medical Society.
"The situation is out of control and, unless changes are made, could lead to a rationing of medical care in Pennsylvania," Vichnin says. "Although malpractice laws are intended to protect patients, unfortunately there have been many unfounded complaints and a resulting financial strain on all Pennsylvania obstetricians who must share in escalating insurance costs."
The society, which has advocated for patients and their physicians for more than 150 years, is aggressively urging the state legislature to reform current laws it says jeopardize the ability to sufficiently provide necessary medical care for expectant women in Pennsylvania.
Gerard Klinzing, MD, chairman of the department of family practice at Main Line Health Hospitals in suburban Philadelphia, says, "Patients will continue to lose access to care if we don’t fix Pennsylvania’s medical liability system. In the last year, the number of our obstetricians has declined by more than 10% due primarily to rising liability insurance costs."
Another Pennsylvania medical practice devoted solely to obstetrics and gynecology, cited in the report, says its premium for private malpractice insurance nearly tripled this year. On the verge of bankruptcy, the practice decided that two of its seven physicians would stop delivering babies just to cut its nearly $1 million premium in half. Statewide, the Pennsylvania Medical Society has received numerous reports from obstetricians who have stopped practicing or given up high-risk procedures. A reduction in obstetricians increases patient load for remaining doctors who already have practices bursting at the seams. In some cases, obstetrical patients become a priority while other women wait for necessary gynecologic care or preventive exams.
"The situation is as frustrating for doctors as it is for patients," Vichnin says. "Doctors must be able to spend a reasonable amount of time in the examining room in order to develop a relationship that leads to better understanding and healing of the patient."
Recruiting new physicians to fill the gap isn’t necessarily the solution either. Young doctors often are unwilling to practice in Pennsylvania because of the malpractice environment. New obstetricians generally look to practice in states where malpractice liability laws already have been reformed. "Young doctors typically begin their careers carrying more than $100,000 in debt from educational and training costs," Klinzing says. "They sometimes find it economically impossible to pay off student loans and also purchase liability insurance in Pennsylvania."
Over the past two years, 66% of Pennsylvania physicians involved in recruitment have had difficulty persuading new doctors to practice in the commonwealth, according to the Pennsylvania Medical Society.