Defensive medicine and obstetrics.
OBJECTIVE
To test the hypothesis that physicians with greater malpractice claims exposure, either through personal experience or in their practice environment, will use more prenatal resources and have a higher cesarean delivery rate than physicians with lesser claims exposure.


METHODS
Retrospective cohort study using county malpractice defendant rate data from the Washington State Physicians Insurance and Exchange Association and prenatal care, delivery method, and self-reported obstetric suit experience data from the Content of Obstetrical Care Study database.


METHODS
Washington State obstetric practices.


METHODS
Stratified random samples of obstetrician-gynecologists and family physicians.


METHODS
The rates of obstetric ultrasound use, referral and consultation, prenatal care resource use, and cesarean delivery.


RESULTS
After controlling for patient, physician, and sociodemographic characteristics, we found no difference in prenatal resource use or cesarean delivery rate for low-risk patients between physicians with more and less exposure to malpractice claims.


CONCLUSIONS
This study does not support an association between the malpractice experience or exposure of individual physicians and an increase in the use of prenatal resources or ceserean deliveries for the care of low-risk obstetric patients.
D002585:Cesarean Section / Q000706:statistics & numerical data* / Q000639:trends; D015331:Cohort Studies; D003675:Defensive Medicine / Q000706:statistics & numerical data* / Q000639:trends; D005194:Family Practice / Q000706:statistics & numerical data / Q000639:trends; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D009774:Obstetrics / Q000706:statistics & numerical data* / Q000639:trends; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data* / Q000639:trends; D011247:Pregnancy; D011295:Prenatal Care / Q000639:trends; D012189:Retrospective Studies; D012424:Rural Population; D016216:Ultrasonography, Prenatal / Q000706:statistics & numerical data* / Q000639:trends; D014505:Urban Population; D014861:Washington / Q000453:epidemiology