Threat of suit affects ob/gyn practice

September 18, 1990|By Fawn Vrazo | Fawn Vrazo,Knight-Ridder Newspapers

A majority of the nation's obstetricians and gynecologists -- almost 78 percent -- have been sued for malpractice at least once in their careers, a new national study shows.

That figure has gone up nearly 10 percent since 1987 and is now at an all-time high, said officials of the American College of Obstetricians and Gynecologists (ACOG). The average ob-gyn has been sued three times.

The statistics do not mean "that 78 percent [of ob-gyns] are bad docs, though we are the first to admit there are bad doctors," ACOG president-elect Richard Schwarz said last week.

"I think that there is probably an increasing awareness on the part of patients that this is the way you can gain some compensation."

The survey of members of the nation's largest society for ob-gyns found obstetricians were increasingly sued for stillborn babies and the deaths of newborns, and the number of suits over brain-damaged newborns remained high. On the gynecology side, a significant number of suits involve claims that doctors failed to diagnose cancer, most often breast cancer.

When malpractice suits go to arbitration or a court decision, doctors win nearly 69 percent of the time.

What this shows is "many cases ... are without merit," said Dr. Schwarz, a New York physician.

"A baby may be born with damage that isn't necessarily the result of liability ... but it's costly to care for those neurologically damaged infants, and the only recourse those patients have is the court system," he said.

Using a sample of 2,213 physicians meant to represent the ACOG's 29,000 members, the study mirrored earlier research that showed fear of lawsuits had had a profound impact on the practice of obstetrics in the United States.

By 1989, the new study found, 25 percent of doctors said they had decreased high-risk obstetric care; 10 percent had decreased their number of deliveries and 12 percent said they had stopped practicing obstetrics entirely.

The study, conducted by Opinion Research Corp. of Washington, also found that:

*The number of doctors who have been sued more than once is up sharply. Nearly one-quarter -- 23.4 percent -- reported four or more malpractice claims by 1989, the study said, compared with 13.5 percent in 1987. The average number of claims filed against all ob-gyns in the survey was 3, a near-doubling of the 1.7 average claims per doctor reported in 1987.

*The average payout in all malpractice cases settled in or out of court was $211,320, an increase over the $140,606 reported in 1987. The average amount paid to the plaintiffs in obstetrical malpractice cases was $311,378, compared with $221,379 in 1987. Obstetrical claims involving brain damage or other major injuries to infants averaged $600,000.

*Ob-gyns, who historically experience more lawsuits than doctors in any other specialty, paid 3 percent more for liability insurance in 1989 than in 1987, with annual insurance payments now averaging $38,138. Still, the study noted, the 3 percent increase is far less than a 90 percent leap in ob-gyn insurance rates that occurred between 1982 and 1984.

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