Why The High Cost Of Insurance For Ob/Gyns?
Despite advances in American health care, tragedies can happen. Any number of factors, many beyond a physician’s control, can open the door for problems. There may be no medical case fraught more with liability, chances for error and bad luck, than obstetric medical care.
Despite the advances in American healthcare, things can still go wrong. When they do, the first questions often asked is: “Who is responsible?” “Why did this happen?” and “How can we sue?”
When tragedy happens during childbirth, the questions are ranked up x10.
In May 1972, Anna and Robert Robak kept an appointment with the OB-GYN clinic at Fort Rucker Alabama where Robak, a U.S. soldier was stationed.
Anna, one month pregnant, was examined by Dr. Joshua Roth. He tested her for rubella, german measles, and gave her a pregnancy test. The pregnancy test was positive and the rubella test said she didn’t have german measles despite having a rash and fever. A few days later, Anna returned to the clinic and again was tested for german measles. This time the rubella test came back positive.
No one connected with the clinic, including Roth, told Anna she had rubella. Anna gave birth to Jennifer on January 12, 1973. The baby had a rash all over her body and suffered from a host of other complications and problems, including:
- Hearing loss,
- Bilateral cataracts, and a
- Heart defect
Since birth, Jennifer has had two operations for cataract removal and has been through occupational and physical therapy. She is industrially blind and has a profound hearing loss and can’t speak intelligibly. Glasses and hearing aids have had limited benefit and she will need deaf-blind care for the rest of her life.
The Robaks sued under the the Federal Tort Claims Act. They sought recovery of expenses for the care, education and maintenance of Jennifer. The government, the defendant in the case, made a motion to dismiss which was denied by the court.
The main issue in whether a cause of actioned existed for wrongful birth. The cased had to be decided under the law in places in 1972 when Jennifer was born.
There was the sticky problem of theocratic laws.
In 1972 Alabama, abortion was illegal unless the life of the mother was in jeopardy.
The details of the case are spelled out in Robert ROBAK and Anna Robak, Plaintiffs-Appellees, Cross-Appellants, v. UNITED STATES of America, Defendant-Appellant, Cross-Appellee.Nos. 81-1038, 81-1099.
Are Ob/Gyns With Holding Information?
Next to neurosurgeons, obstetricians are the most often sued physicians in the nation. It isn’t uncommon for settlements to pass $1 million. According to surveys by the American Medical Association, 70% of obstetricians have been sued at least once.
Even though a malpractice lawsuit doesn’t necessarily mean bankruptcy for the OB, suits are still painful, embarrassing and time consuming.
OBs do everything they can to avoid being sued. They don’t work when tired, they make every effort to improve communications with hospital staff and exercise caution by requesting extra ultrasounds for high-risk patients.
Not only have the steps made doctors put greater emphasis on providing safe care, it also causes physicians to withhold information and lie.
In 2012, a survey of over 1,800 practicing doctors, one-fifth admitted to not telling their adult patients about serious medical errors they made in the previous twelve months.
In some cases, the threat of lawsuits has prompted doctors to stop delivering babies.
A survey of over 5,500 OB/GYNs by the American Congress of Obstetricians and Gynecologists found 8% had stopped practicing obstetrics in the past three years because of a fear of lawsuits and higher malpractice insurance premiums. While premiums can vary by region, they can reach almost a quarter-million annually.
Many OB/GYN decisions are forged by many factors. Some line up with the patient’s best interests, others don’t. While all obstetricians want to deliver safe and healthy babies, the choices they make chasing that goal might not always be the most medically sound.