Ob-gyns continue to change their practice because of liability insurance rates, fear of claims
Results are in from the 2015 American Congress of Obstetricians and Gynecologists' Survey on Professional Liability, covering the period 2012 through 2014. This latest survey reflects a negative liability environment in that nearly 40% of ob-gyn survey respondents have made one or more changes to their practice as a result of the affordability and/or availability of professional liability insurance, and nearly 50% have made one or more changes to their practice as a result of the risk or fear of professional liability claims or litigation.
*Published in November-December 2015 issue of Clinical Review
Obstetric Practice Changes
Of the survey respondents who reported making changes to their obstetric practice because of insurance affordability or availability or both, 9.6% reported increasing the number of cesarean deliveries and 8.4% indicated they stopped performing or offering VBACs. Additionally, 13.6% decreased the number of high-risk obstetric patients, 6.4% decreased the number of total deliveries, and 3.9% stopped practicing obstetrics altogether.
Gynecologic Practice Changes
Of all ob-gyns who reported making changes in their gynecologic practice due to the affordability or availability of professional liability insurance, 12.0% decreased gynecologic surgical procedures. An additional 4.9% stopped performing major gynecologic surgery, and 1.4% stopped performing all surgery.
Changes in Practice Economics
Relative to changes in practice economics, 13.1% of all ob-gyn respondents reported they had reduced their salary by greater than 10%; 2.6% of respondents reported relocating their practice to another state or to another jurisdiction within the same state; and 0.4% ceased carrying liability insurance coverage completely.
At least one professional liability claim was filed against 73.6% of respondents during their professional careers, with an average of 2.59 claims per ob-gyn. Of these, 41.1% reported they experienced at least one professional liability claim filed against them as a result of care rendered during their residency training.
Top Obstetric Allegations
• Neurologically-impaired infant (27.4%)
• Stillbirth/neonatal death (15%)
Top Gynecologic Allegations
• Patient injury - major (27.9%)
• Patient injury – minor (23.4%)
• Delay in or failure to diagnose (21.5%)
The majority of survey respondents were female (56.1%). The average age of survey respondents was 51.4 years.
The 2015 Survey on Professional Liability is the twelfth survey conducted since 1983 to assess the effects of professional liability litigation and related liability insurance issues on the practice of obstetrics and gynecology. The entire population of American Congress of Obstetricians and Gynecologists (ACOG) Fellows and Junior Fellows in practice in the 50 states, the District of Columbia, and Puerto Rico were surveyed and, as was the case in 2012, the questionnaire was available exclusively online. Junior Fellows still in residency and fellowship (subspecialty) training, Founding Fellows, Life Fellows, members of the Armed Forces District, and members living outside the 50 states, the District of Columbia, and Puerto Rico were excluded from the survey.
In total, 32,425 Fellows and Junior Fellows in practice were surveyed. The final 4,294 completed surveys were coded and analyzed using Statistical Package for Social Sciences. Data analysis yielded frequency distributions and percentages for each of the survey questions. The final data represents only those 4,294 obstetrician-gynecologists (ob-gyns) who responded to the survey.