The impact of medical legal risk on obstetrician-gynecologist supply.

Abstract:

OBJECTIVE:To evaluate the effects of medical legal risk on practice location of obstetrician-gynecologists. METHODS:We used the American College of Obstetricians and Gynecologists (ACOG) Membership Record to determine the number of Fellows and Junior Fellows by state. We obtained state malpractice premiums from the Medical Liability Monitor and state birth rates from the National Center for Health Statistics. The American Medical Association (AMA) "Crisis" and ACOG "Red Alert" designations, as well as state malpractice premium levels, were used to approximate malpractice risk. We examined the changes in state births to obstetrician-gynecologist rates from 1995 to 2003 by using the Student t test and Mann-Whitney tests. Comparisons were made between states of different risk levels. RESULTS:We found no significant difference in the percentage changes in births per Fellow or births per Junior Fellow between AMA "Crisis" and remaining states, nor between ACOG "Red Alert" and Safe states. The percentage changes in births per Fellow were similar in the 10 highest-premium states and the 10 lowest-premium states. The percentage increase in births per Junior Fellow in the 10 highest-premium states was significantly greater than the 10 lowest-premium states (median 28.5% versus 5.0%, P = .03). CONCLUSION:Malpractice premiums appear to influence practice location of new obstetrician-gynecologists. Neither the AMA designation of "Crisis" nor the ACOG designation of "Red Alert" had supply implications in the analysis. More research on the interaction of malpractice rates and obstetrician-gynecologist supply is needed for informed decisions regarding malpractice premium management.

journal_name

Obstet Gynecol

authors

Robinson P,Xu X,Keeton K,Fenner D,Johnson TR,Ransom S

doi

10.1097/01.AOG.0000157468.12907.1a

subject

Has Abstract

pub_date

2005-06-01 00:00:00

pages

1296-302

issue

6

eissn

0029-7844

issn

1873-233X

pii

105/6/1296

journal_volume

105

pub_type

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