High Malpractice Costs Force an Increasing Number of Nevada Obstetricians to Leave Hospitals
A growing number of obstetricians in southern Nevada are relinquishing hospital staff privileges in order to avoid working the emergency shifts that they say drive up their already high malpractice insurance rates, the Las Vegas Review-Journal reports. At least 10 area obstetricians are giving up their privileges at several hospitals, and nearly 40 either have left or are preparing to leave the area, according to figures from the Clark County OB/GYN Society. To maintain privileges at area hospitals, most obstetricians must occasionally cover shifts in emergency rooms, which sometimes requires them to treat women without regular obstetricians who come to the ER with pregnancy or postpartum complications or in labor. Such women are less likely to have received prenatal care. "The women without prenatal care can suffer from a wide range of things: high blood pressure, uncontrolled diabetes, bleeding disorders that can lead to stroke or seizures, things that are health risks to both [the woman] and baby," Dr. Rafael Juarez, a doctor who recently gave up his privileges at several hospitals, said. Obstetricians are more at risk for lawsuits than many other physicians, and ER obstetricians are more likely to be sued by patients with no prenatal care because the risk of complications is higher and there is "no doctor-patient relationship," according to Dr. Shelby Wilbourn, another obstetrician who has asked for a leave of absence from a local hospital.
Southern Nevada's "medical malpractice crisis" could have a negative effect on health outcomes in the area, Dr. Dale Carrison, director of the emergency room at University Medical Center in Las Vegas, said. Carrison said that if an obstetrician is not available to cover an ER shift, an emergency doctor -- who may not be trained to deal with certain obstetric problems -- will be forced to take care of women needing obstetric care. Most ER doctors can perform routine deliveries but cannot perform emergency caesarean sections, deliver breech infants or handle other pregnancy-related complications, the Review-Journal reports. Allan Stipe, president of Sunrise Hospital in Las Vegas, said that while he is "concerned" that physicians are resigning from the facility, there are still enough obstetricians to cover emergency room shifts (Babula, Las Vegas Review-Journal, 4/24).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.