Ob gyn practice and the future of healthcare

OB-GYN Practice and the Future of Healthcare There used to be a time when doctors used to trudge all the way to the homes of their patients to help an expectant mother deliver her child. Such things are hush-still in the past with doctors becoming too busy. With too many patients per doctor, things are quite different today, which could become worse in the future. With doctors performing childbirth duties getting scarce day by day, a survey report from the American College of Obstetricians and Gynecologists (ACOG) indicates a shortfall ranging from 9,000 to 14,000 ob-gyns practice in the next two decades. As it is only 6 out of 7 obstetrician-gynecologists are delivering babies. There are more than 20 states that have gone on crisis mode (red alert) already with the number of obstetrician-gynecologists, woefully inadequate to handle the current patient needs. There are two striking reasons that can be attributed to this sorry situation. The first reason being the difficulties of aging obstetricians and their inability to keep up with the busy and grinding schedules, which the specialty demands. Secondly, it is very difficult for an obstetrician-gynecologist to sustain the practice after paying the stiff additional cost, which has to be paid towards covering malpractice insurance. This is more keenly felt by doctors not performing the minimum number of deliveries to break even. Currently, the obstetricians have to shell out for liability insurance, which is the second highest among all practices, with neurosurgeons ranking first by paying the highest premiums for liability insurance. Most obstetricians would give up treating pregnant women rather than fight malpractice claims that end up nowhere. Insurance affordability and the threat of lawsuits looming large seem to be major deterrents. The malpractice premiums can be reduced by close to 50%, if obstetrical duties are eliminated by doctors. The early gestation weeks are the most risk prone with complications like bleeding, ectopic pregnancy, and in worst case scenarios miscarriages most likely to arise. However, treating such complications does not call for malpractice claims as is the popular misconception. The problems arise during the advanced stages of pregnancy, or during delivery, including birth injuries to the babies. For neurologically impaired babies, the claim payments have hovered around $1.5 million on an average. Hence, It is better that the malpractice insurers provide coverage treatment during the first trimester, as well as the early second trimester pregnancies, for the complications arising during those stages. As far as liability coverage is concerned, gynecology and obstetrics are not very different from each other. A doctor may be offering early pregnancy care, though not actively involved in delivering babies. The risk profile, though different is never considered so by the insurers. The premium and coverage need to be customized according to each case or circumstance, depending on the risk profiles, taking into consideration patient

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volume and other hospital privileges. The bottom line is that unless there is a thought on malpractice coverage, the pressure will mount on the dwindling breed of ob-gyns who would rather be better off offering general practice services.

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