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Obstetrician exodus causes concern
The Las Vegas Review-Journal ^ | Monday, October 28, 2002 | JOELLE BABULA

Posted on 10/28/2002 3:24:26 PM PST by Willie Green

For education and discussion only. Not for commercial use.

Doctors in emergency rooms see increasing number of mothers lacking prenatal care

More than 50 sick infants were hooked up to tubes, encased in glass incubators or afflicted with other maladies Thursday at Sunrise Hospital's Neonatal Intensive Care Unit.

They are some of the most critically ill babies in Las Vegas. Many of them won't be able to go home for weeks or months because they were born too early or suffer from heart or lung problems, ailments that often can be prevented or lessened with prenatal care, neonatologist Philip Riedel said.

Las Vegas health care workers fear that, as obstetricians continue to leave town, the frequency and acuity of sick infants will rise because of limited access to prenatal care. Most area hospitals have lost dozens of obstetricians since the beginning of the year, and some are seeing an increase in the number of women giving birth in emergency rooms without ever having prenatal care, hospital officials say.

Area obstetricians are leaving Las Vegas because they cannot find or afford medical malpractice insurance, according to the Clark County OB/GYN Society. Many of the approximately 80 remaining obstetricians have limited the number of patients they see to keep their insurance rates affordable.

"We've lost 43 obstetricians since the beginning of the year due to the medical malpractice issue," said Allan Stipe, president of Sunrise Hospital and Medical Center. "That's huge. It's gravely concerning considering we'll have 23,000 babies (valleywide) to deliver in the next 12 months."

The hospital now has 53 obstetricians to deliver babies, Stipe said. He also said the number of women who come to the emergency room in labor with no prenatal care has increased 10 percent.

"As we progress through the next several months and doctors begin renewing their insurance policies again, that's when we're going to see the real impact," Stipe said.

Riedel, medical director of Sunrise Hospital's Neonatal Intensive Care Unit, says it's too soon to say whether mothers and their infants have been affected by the exodus of obstetricians. He did say, however, that the infant unit is filled with babies who are more critically ill than usual.

"We are full with very sick kids," he said. "And it's safe to say that, if you have no prenatal care, there's a greater likelihood your baby is going to end up in the intensive care unit."

Obstetrician John Martin said the community couldn't afford to lose one obstetrician, let alone 30. He says if his insurance premium increases too much when he renews in April, he'll have to leave, too.

"This isn't so much about when doctors are leaving or how many are leaving anymore. It's about the doctors who are left and how many patients we can safely handle," Martin said. "When we can't handle any more, where are those women going to go? As we lose doctors, it's going to increase the illnesses that we'll see in infants and moms in the emergency room."

According to Riedel, prenatal care can prevent premature birth, the leading cause of hospitalization for infants.

"We do see women in the emergency room who have no idea they are in preterm labor, and by the time they get to us, it's beyond our ability to stop the delivery," Riedel said.

Early labor can be stopped under the care of a doctor with medication and bed rest, Riedel said. He also said babies born too early -- more than three months early -- die half the time or often suffer from long-term lung disease, brain and heart problems.

Another problem that can endanger the life of the mother is high blood pressure associated with pregnancy, called pre-eclampsia. Doctors can monitor for the condition during prenatal care and keep it under control.

"If it's not controlled, pre-eclampsia can be life-threatening to the woman and she'll have to deliver the fetus immediately," Riedel said.


TOPICS: Business/Economy; Culture/Society; Government; US: Nevada
KEYWORDS: healthcare; insurance; malpractice; tortreform
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Hospital Ordered To Pay Over $55M To Girl Injured During Birth: Obstetrician Not Found Liable

Obstetrician Carved His Initials in Mom's Abdomen

1 posted on 10/28/2002 3:24:27 PM PST by Willie Green
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To: Willie Green
My wife defends obstetricians from ambulance chasers.

There are two typical plaintiffs: (1) welfare moms who smoke crack and drink malt liquor throughout their pregnancy and then blame the doctor when their child is born brain-damaged and (2) forty-something first-time moms who put off motherhood for a quarter-century and who cannot accept that the pregnancy they paid thousands to have is a high-risk one.

2 posted on 10/28/2002 3:29:11 PM PST by wideawake
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To: Willie Green
This is a nationwide problem with malpractice insurance rates skyrocketing on a geometric scale...especially in the neonatal field.
3 posted on 10/28/2002 3:34:16 PM PST by evad
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To: Willie Green
From a USA Today story from last April:

The environment in Nevada has insurers scared of backing anyone with a record or physicians in specialties that are frequent lawsuit targets. One obstetrician, Cheryl Edwards, left 30 pregnant patients behind and relocated last year to California, where a state law caps jury awards at $250,000. Her insurance premium is $17,000 a year there; it would have been $150,000 a year in Nevada, she says.

Another obstetrician, Guy Torres, said he'll probably stop delivering babies this fall when his insurance policy runs out. He faces a premium of more than $200,000, which is only slightly less than he'd make in a year for delivering 15 babies a month.

http://www.usatoday.com/news/healthscience/health/healthcare/2002-04-09-malpractice.htm
4 posted on 10/28/2002 3:38:00 PM PST by PAR35
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To: evad
True! I know it's happening down here in Florida. To paraphrase Hamlet: "The problem lies not in our stars, but in our greedy, bottom feeding, scummy lawyers."
5 posted on 10/28/2002 3:38:35 PM PST by scouse
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To: wideawake
You are right ... the biggest problem with all medical malpractice ... not just OB/GYN issues ... is frivilous lawsuits. Women who really ARE injured and less likely to see justice because of the 99% who are filing frivilous cases simply to get their hands in the pie ... or because they've been talked into it by unscrupulous lawyers.

However, the trial-lawyer bought-and-paid-for Democrats blame insurance companies and put more mandates on them. They're solution is more government ... as more insurance companies go out of business because of increasing regulations, the socialists are secretly pleased because they get nearer their goal of government-run insurance.

We need to elect Republicans far and wide. We need to put a stop to the trial lawyers, pass real and substantive tort reform laws, and end the deep pockets lawsuits.

I commend your wife!

6 posted on 10/28/2002 3:40:52 PM PST by Gophack
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To: Willie Green
Would the last obstetrician to leave Las Vegas please flip off the maternity room light swit...

How's that again?

Whaddaya mean, "...slip away in the dead of night"???

7 posted on 10/28/2002 3:41:35 PM PST by Savage Beast
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To: Willie Green
The cause is simple: Lawsuits. Everybody wants a perfect Gerber baby. If if doesn't turn out that way, the lawyers descend. Cause. Effect.
8 posted on 10/28/2002 3:42:28 PM PST by Bush2000
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To: Willie Green
Another problem that can endanger the life of the mother is high blood pressure associated with pregnancy, called pre-eclampsia. Doctors can monitor for the condition during prenatal care and keep it under control.

Wrong. Another reporter displays the ultmate value of a free and apropriate public education...

9 posted on 10/28/2002 3:43:55 PM PST by patton
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To: patton
....as I display my inability to spell in Englisch....
10 posted on 10/28/2002 3:46:32 PM PST by patton
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To: Bush2000
Everybody wants a perfect Gerber baby..

One of the many legacies of the baby boomer generation..of which I am a member.

Instant gratification, it can't be my fault, I'm gonna sue you. Certainly a disappointing bunch as a whole...
..with a few exceptions ;-)

11 posted on 10/28/2002 3:47:26 PM PST by evad
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To: evad
One of the many legacies of the baby boomer generation..of which I am a member

I hear you, brother. Although technically I'm a boomer (by virtue of having been born in the last year of that generation, 1964), it seems like we're a generation apart ...
12 posted on 10/28/2002 3:59:15 PM PST by Bush2000
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When will we see campaign ads targeting Big Law?
13 posted on 10/28/2002 10:52:14 PM PST by D-fendr
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