|Leaving the Delivery Business - Insurance costs drive away
Skagit Valley Herald
Skagit Valley, WA - 5/21/02 - Half of the
area’s obstetricians will stop delivering babies as a result of
a sudden spike in malpractice insurance costs.
Five are getting out of the business, leaving
six obstetricians to cover Skagit County.
“The deluge is about to hit us,” said Sedro-Woolley
family practice physician Vanoy Smith, who Monday saw his first
patient turned away by a Mount Vernon obstetrician.
“By July or August there are going to be a
very large number of patients seeking care,” he said.
The American College of Obstetricians and
Gynecologists last week called Washington one of nine “red
alert” states where liability insurance is threatening the
availability of physicians to deliver babies.
Malpractice insurance is one of the biggest
costs for an obstetrician — ranging from $50,000 a year to
$200,000 nationally. The costs took another hit when the
second-largest insurance carrier in the state, Washington Casualty
Group, pulled out of the medical liability market.
Insurance premiums for obstetricians increased
167 percent between 1982 and 1998, the physicians’ association
reported earlier this month.
Premiums are expected to increase another 15
percent this year.
For doctors already squeezed by stable or
declining revenues that don’t cover rising costs, the increase
in malpractice premiums was the last straw.
“We’re paid less by the insurance
companies,” said Dr. Nadine Burrington of the North Cascade
Women’s Clinic in Mount Vernon. “It’s sad because it’s
something that we’ve enjoyed doing for a number of years.”
She is getting out of the business along with
her two partners, Drs. Robert and Barbara Pringle. The three will
continue to conduct annual exams, Pap smears and other procedures.
But they won’t be delivering babies. They have
delivered about 300 babies annually.
Other doctors may be able to deliver babies. But
a lack of specialists, including those who specialize in
performing Caesarean sections, puts the burden on other doctors,
Smith said he had planned on discontinuing
obstetrics altogether before finding out last week of the five
doctors’ departure. Smith said he might have to dedicate a
portion of his family practice for obstetrics.
Dr. John Knudsen, who practices obstetrics at
the Mount Vernon Women’s Clinic, is staying in the business, at
least for now.
“I’m not giving up on OB,” he said.
Knudsen is sympathetic to his colleagues who are
finding it more cost-effective to stop delivering babies.
“You have to balance the cost of malpractice
against income,” he said. “If he or she is a specialist in
that field, it’s becoming unfeasible to do it anymore.”
Because the Department of Social and Health
Services sets medical fees, consumers will not see doctors raising
their prices, even though doctors are paying more in malpractice
insurance, Knudsen said.
“This situation is going to worsen,” he
The hospitals in Mount Vernon and Sedro-Woolley
are trying to recruit more obstetricians to fill the vacancies,
said Ann Raish, an assistant administrator with Affiliated Health
On Friday, Raish briefed the boards overseeing
the two hospitals on the reduction in obstetricians.
“There is a crisis in Skagit County right
now,” Raish said. “We are meeting with all the OB/GYN
physicians to see if there are any actions we can take to assist
Both physicians who deliver babies at the
Anacortes hospital are remaining in the fields, according to
Island Hospital spokesperson Dennis Richards.
For those struggling to get access to
malpractice insurance, state regulators are trying to help by
streamlining the application process.
State Insurance Commissioner Mike Kreidler
announced a Market Assistance Plan that allows doctors, hospitals
and clinics to file one application for a pool of insurance
companies. The plan does not help pay premiums.
“It’s not a panacea,” said Sandi Peck, a
representative of Kreidler’s office.
To truly address malpractice insurance problems
will require limits on how much can be paid out through lawsuits,
The Legislature addressed the issue in the
mid-1980s, but the state Supreme Court ruled that caps on
malpractice suit awards were unconstitutional, Peck said.
“We’re certainly concerned about that,”
Taya Briley, the director of legal services and
health policy with the Washington Association of Public Hospitals,
said liability insurance premiums have doubled in some
“The state is really seeing an emerging crisis
with liability and medical malpractice,” Briley said.
Because the state Supreme Court threw out limits
on lawsuits, the answer for liability insurance ills could rest
with congressional action. A bill before the U.S. House of
Representatives called the Health Act of 2002 seeks to place caps
on jury awards.
“If there was a federal cap on jury awards,
that would help this state as well,” Briley said.
Obstetricians getting out ...
Dr. Nadine Burrington, Mount Vernon
Dr. Daniel Logen, Mount Vernon
Dr. Doug Madsen, Mount Vernon
Dr. Robert Pringle, Mount Vernon
Dr. Barbara Pringle, Mount Vernon
... and staying in
Dr. Daniel Bynum, Mount Vernon
Dr. Jan Delli-Bovi, Mount Vernon
Dr. Kathy Garde, Anacortes
Dr. William Hinderstein, Mount Vernon
Dr. John Knudsen, Mount Vernon
Dr. Robert Prins, Anacortes
Source: Affiliated Health Services list of
doctors who specialize in obstetrics, interviews with doctors.