title: The impact of the medical malpractice crisis on OB-GYNs and patients in southern New Jersey.
abstract: The results of this study indicate that the current medical malpractice crisis has created significant insurance affordability and accessibility problems for OB-GYNs in southern New Jersey. Even more important is the result that shows this crisis as beginning to have a very real impact on patient access to care. The average cost for malpractice coverage per physician increased from $34,616.67 in 2000 to $78,818.18 in 2003. This represents a 128% increase in just four years. As dramatic as these premium increases appear, the fact that many physicians have had to reduce their coverage in order to afford any malpractice coverage at all has not yet been taken into account. The increase in premiums particularly affects solo practitioners, such as those practicing in the more rural areas of southern New Jersey, because they are unable to take advantage of the economies of scale that larger practices enjoy. It is also the case that premium increases are even higher for high-risk subspecialties, such as maternal and fetal medicine. Certified nurse midwives are just beginning to see significant increases in their premiums as well. Fourteen point three percent of practices got quotes from three carriers this year, and 12.2% of practices got more than three quotes. This may indicate that there are physicians who are unable to find affordable coverage. More than one quarter of OB-GYN practices (26.5%) reported that their current carrier dropped one or more of the physicians in their practice during the most recent renewal period. Close to half of the practices (49%) that responded to the survey indicated that they came across at least one carrier who refused to provide a quote for liability coverage, while 14% of the practices indicated that more than three carriers refused to provide a quote. This indicates a significant problem with access to coverage. The current malpractice crisis already has had an impact on the way in which physicians practice medicine. Most significant, thirteen practices in the region indicated that at least one of their physicians had stopped delivering babies, two additional practices indicated that they had ceased delivering or caring for high-risk babies, and six practices indicated that at least one of their physicians had ceased performing surgical procedures. There are even more strategies that physicians in southern New Jersey are considering for the near future. Clearly, physicians believe that patient access to care is already a problem in southern New Jersey. If premiums do not stabilize in the very near future, there is every indication that southern New Jersey will have a severe access to care issue for its obstetrical patient population. Unfortunately, a recent report on the nation's medical malpractice insurance crisis predicts at least two more years of continuing financial problems for medical malpractice insurers. Despite the fact that New Jersey's state legislators ended their session without enacting any new tort reform laws, physicians across the state continue to apply pressure for passage of a bill to help the current medical liability crisis. Physicians plan a new round of lobbying and demonstrations beginning October 7, 2003.
authors.forename: Judy
authors.initials: J
authors.lastname: Donlen
authors.forename: Janet Spicer
authors.initials: JS
authors.lastname: Puro
mesh_terms: D002322:Career Mobility; D005249:Fees and Charges; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007351:Insurance, Liability / Q000191:economics*; D016365:Liability, Legal / Q000191:economics*; D008318:Malpractice / Q000191:economics* / Q000331:legislation & jurisprudence; D009515:New Jersey; D009774:Obstetrics / Q000191:economics*; D000078329:Workforce