A new study in Health Affairs by Mello, Studdert, Schumi, Brennan and Sage (SSRN abstract via Childs) finds, contrary to what might have been expected, that the supply of high-risk specialists in most medical specialties did not decline markedly in the three years following 1999, when insurance rates spiked upward. The big exception: obstetrics and gynecology, where the supply dropped 8 percent. Opponents of liability reform seized on the study as proof that concern about departing doctors was overblown. The state medical society, for its part, doesn't find the new study conclusive.
Few advocates on either side, however, are denying the crisis afflicting ob-gyn practice in Pennsylvania. The number of hospitals in Philadelphia that will deliver babies has dropped from 19 to 8 over the past decade. Statewide, 33 have closed over the same period. Reports the Inquirer:
The health council [Delaware Valley Healthcare Council, a hospital group] said the Medical Liability Monitor estimated malpractice insurance costs for obstetrician/gynecologists at $160,000 a year in the Philadelphia area. Some hospitals are now self-insured and gave widely varying estimates of their expenses. The hospitals must buy liability insurance not only for doctors they employ, but also for the hospitals themselves.
The big loss of doctors is particularly distressing for Patrick Knaus, vice president of strategy and business development at St. Mary Medical Center in Middletown.
"Where is the next generation coming from? It is really impossible almost to recruit OB doctors into Southeastern Pennsylvania," he said. "It�s a really difficult situation."