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New York Obstetrical Care & Liability: Information and Statistics Crisis Environment
- After the July 2007 announcement of a 14% increase in medical liability premiums, state insurance commissioner Eric Dinallo said, the hike was "necessary to stave off an industry-wide crisis…After years of failing to confront the fundamental problems that have led to this current environment, we have inherited the worst of both worlds – physicians who cannot afford to practice medicine, and insurers whose financial condition is rapidly eroding." (Source: New York State Insurance Department)
- New York was declared a liability “crisis” state by the American Medical Association in 2003. (Source: American Medical Association)
Rising Costs, Loss of Ob-Gyns
The Medical Society of the State of New York’s 2007 Legislative Program provides information about the state’s medical liability climate, including the following facts:
- From 2001-2007 in Long Island, New York City, and the Lower Hudson Valley, liability insurance costs for ER physicians and general surgeons rose 95-105%, for internists and radiologists, 86-95%, and for Ob-Gyns 77-86%.
- From 2000-2004, the Mohawk Valley lost 35% of Ob-Gyns.
- The average payout for all medical liability awards (including settlements) went up 25% between 2001 and 2005.
(Source: “Legislative program: 2007,” Medical Society of the State of New York, Albany)
The latest American College of Obstetrics and Gynecologists (ACOG) press release on New York liability issues reveals that:
- Since 2003, 8.7% of Ob-Gyns in New York have stopped practicing obstetrics and 12.6% have decreased the number of deliveries they perform as a result of high medical liability premiums.
- 92% of New York Ob-Gyns report that they have been sued at least once. Nationally, Ob-Gyns have an average of three claims against them during their career.
- From 1999 to 2004, hospitals in downstate New York saw a 147% cumulative increase in the cost of liability premiums.
- Since 2003, 66.3% of Ob-Gyns in New York have made one or more changes to their practice due to the affordability and/or availability of professional liability coverage.
(Source: July 2, 2007 ACOG Press Release concerning increase in NY malpractice premiums)
“Protect Patients Now,” an initiative of Doctors for Medical Liability Reform (DMLR), has information about New York on its website:
- Out-of-control medical liability lawsuits have driven doctors' insurance premiums up by nearly 150% since 1999, with many of the largest liability awards in the nation - some exceeding $90 million - occurring in New York City, according to Kenneth E. Raske, president of the Greater New York Hospital Association. ("Malpractice Costs Up 150 percent Since 1999, Hospitals Say," New York Times, 1/6/05)
- 4,000 doctors left New York between 2000 and 2002, out of a total of 50,000 practicing physicians in the state, according to Morris Auster, associate counsel for the Medical Society of the State of New York. ("Panel raps litigation costs," Journal News, 10/16/03)
- Liability concerns caused 16% of New York obstetricians to give up obstetrics in just 18 months in 2001 and 2002, according to a survey by the American College of Obstetrics and Gynecology. ("At Breaking Point; LI doctors rally patients against high malpractice costs," Newsday, 01/26/03)
- Nearly 43% of the cost of a delivery in the Downstate area goes to pay for liability insurance, according to the ACOG. ("Malpractice insurance rates rise 8.5 percent," The Post-Standard, 06/16/03)
- New York has been given the Red Alert designation as one of fifteen states that are "most at risk," by the American College of Obstetricians and Gynecologists. ("ACOG's red alert on Ob-Gyn care reaches 23 states," Health Insurance Law Weekly, 9/19/04)
(Source: Protects Patients Now)
Physician Stories
Stories/quotes from individual New York physicians illustrating how medical liability affects physicians and their practices are available on the ACOG website. These include the following:
- “If the proposed 16.6% is allowed, I will stop delivering babies after 30 years, even though I wanted to continue for another 5 years. It just wouldn't be worth it even though I love what I do. I was recently served with papers alleging a neuralgic injury to a baby even though the baby is fine according to pediatric records. The deposition is next week and I asked my attorney why this should proceed even if they won't disclose the injury and he said ‘because that's the way it is in New York.’”
- “It is sad to limit the skills I was trained for— not to perform abdominal procedures as the primary surgeon— because economically it is not affordable. If things continue this way, I have no choice but to give up OB all together. In fact it is absolutely disadvantageous to provide OB service as a private practitioner. IT COSTS TOO MUCH TIME AND MONEY.”
(Source: ACOG)
An article in New York Magazine provided more anecdotal evidence on the effects of liability and defensive medicine:
- “Overall, malpractice has made good doctors worse rather than bad doctors better because of the fear that you’re missing something and you may be sued for missing a diagnosis.”
- “[D]oes extra testing do any real harm to the patient?” asks New York Magazine. “Sure,” responds one cardiologist, “Procedures have their own risks: unnecessary cardiac catheterization, unnecessary downstream testing when you pick up something that’s not important on a test that you shouldn’t have ordered in the first place. Then you go chasing incidental findings, again, further fear of being sued. So, testing breeds more testing. And it can be a vicious cycle.”
(Source: New York Magazine, see pages 3-4 and 6-7, in particular)
National Data:
- 76% of doctors say fear of liability has hurt the quality of their care in recent years.
- Doctors and hospital administrators say fear of liability is the leading factor discouraging medical professionals from openly discussing and thinking of ways to reduce medical errors.
- Only two-thirds of doctors say their hospital staff is encouraged to report errors.
- 43% of nurses feel prohibited or discouraged from doing what they think is right for the patient because of rules or protocols set up for liability protection.
(Source: Common Good Fear of Litigation Study: The Impact of Medicine, conducted by Harris Interactive, April 11, 2002)
- Nearly half of America's counties lack an Ob-Gyn: Of 3,143 counties in the nation, 1,541 do not have a practicing Ob-Gyn to deliver needed care.
- One in seven Obstetricians no longer delivers babies.
(Source: American Medical Association, Fast Facts)
- Over 25% of Ob-Gyns have decreased the amount of high-risk obstetric care they provide.
(Source: American College of Obstetricians and Gynecologists, 2004 Survey; cited in “Federal Medical Liability Reform,” Alliance of Specialty Medicine, July 2005)
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