Doctors getting out of baby business because of high insurance

CBS 2 Chicago ^ | July 25, 2004 | AP

[valkyrieanne]

Yes, midwives have to have insurance, too. That's why so few do home births. If they are certified nurse midwives, they also have to operate under the "supervision" of an MD, which is a whole other liability issue in itself.

What states need to do is allow practitioners to "go bare," and to allow patients to sign a waiver acknowledging that they know the practitioner has no malpractice insurance.

[Timocrat]

The jury system was never intended to put simple-minded ignorant people in charge of second guessing the judgement of highly trained professional. People accused of wrongdoing are supposed to be tried by a jury of their PEERS. Some high school dropout who doesn't know the difference between a vein and an artery is most certainly not the peer of an obstetrician or neurosurgeon.

In a constitutional Republic every citizen is your "Peer". The problem with the Jury system at the moment is the way Jury Voir Dire is so abused. The ability of counsel to troll through hundreds of potential jurors to get jurors who will be sympathetic to their case is a big part of the problem.

Reform of the civil Jury system needs three steps.

1. Limit peremptory challenges to three ( having weeded out obvious conflicts via the usual questionnaire)

2. Adoption of the so called "English Rule" i.e. loser pays.

3.Treat plaintiff attorneys operating on a contingency basis and their clients as joint venturers. So an Attorney who is operating on a 30% contingency basis pays 30% of the other sides costs if their suit fails. This would cut out a lot of the frivolous suits before they ever start.

[GovernmentShrinker]

The problem is that society has become so technological and complex that the average citizen can't possibly comprehend the issues involved in something like a neurosurgery malpractice case. As a result, a whole legal industry has grown up around confusing and misleading said average (and below average) citizens in these cases. I am WAY above average, and yet the idea of me -- a banker -- trying to determine whether a neurosurgeon made the right call during surgery is totally preposterous.

Liability cases for computer security cases would be another area where specialized courts, with industry specialized juries should be used. Did the steps that company X used to protect confidential data on its networks fall so far of industry standards as to constitute criminal negligence? How the heck would I -- or anybody else who isn't intimately familiar with this field, have a clue. And no way are we going to get a viable education during the course of a trial.

[Timocrat]

And no way are we going to get a viable education during the course of a trial.

I think that's where you and I differ. I don't think it takes a genius to be instructed that these are in the standards in Neurosurgery or Systems Security and this is what actually happened in the case under review. If a Neurosurgeon leaves an instrument or swab in a patient that's obviously negligence. If he uses a standard medical procedure and for whatever reason the outcome is unsatisfactory he should not be liable. The reason Edwards is so rich is that he got a Jury to believe Junk science. Improving the quality of the Jury by severly restricting Voir Dire and adopting the "English" rule would eliminate most of these cases. Every professional should be given the benefit of the doubt. Most Doctors do not go around negligently killing their patients.

[Regulator]

My personal opinion is that the insurance companies shouldn't be dictating a doctors practice and medical decisions

No, they shouldn't, but the threat of lawsuits forces them to play defense right from the outset.

My comment on midwifes can perhaps be modified: people having children at home with only a midwife present are taking an enormous risk. In a hospital or birthing center setting, that risk is vastly reduced, on the assumption that an obstetrician and neonatologist are easily available.

[Regulator]

Granted it was a hospital birth and she called in the neonatal team when she saw the meconium and they snatched him the second he came out - but if it had just been her I bet she still would have done a superb job

Well, I don't think we would ever know.

My son was born 3 mos premature. I was only lucky that a level 3 NICU was only 2 miles down the road, and that a doc who was the star of the show at Stanford ran it, and he happened to be on duty when we came in. Seems he moved to my area because he couldn't afford a house in Palo Alto.

After spending months in that NICU seeing the babies come in, and the variety of commonplace problems which I had never heard of, I had one conclusion: the woman across the street who had a midwifed home birth was taking an enormous risk.

I can perhaps see a midwifed birth within a hospital setting, which is clearly what a lot of hospitals are doing to cut costs. But hovering in the wings should be all the right angels, ready to swoop in when needed. It's only fair to the children themselves, I think.

[Howlin]

Exactly.

[Regulator]

See post #28.

I love all of you NICU nurses. Period.

[Regulator]

Of course, I mean't post #26...

[Big Giant Head]

My comment on midwifes can perhaps be modified: people having children at home with only a midwife present are taking an enormous risk. In a hospital or birthing center setting, that risk is vastly reduced, on the assumption that an obstetrician and neonatologist are easily available

I'm of two minds here. While I see how trial lawyers are running up the cost of medicine and health-stuff, I also have delivered the last two of my children at home for more than $ reasons.

Hospitals are where the sick people go, and my last child to be born in a hospital caught some flu or something that had her in an O2 tent for a week. We've had other medical-personnel-decision-caused problems before and this was the last straw for us.

THe next two children were born at home. The delivery was more comfortable and relaxed, wifey was able to eat and drink whenever she wanted which helped keep her strength up, unlike in the hospital where she was essentially being prepared for surgery every delivery.

While it's comforting to have medical professionals around in case something goes wrong, they are often the cause of things going wrong. I don't know the names or functions of all the "standard" tests and procedures performed on moms and babies, including shots, eye drops, pokings and proddings. But I do know that they are done for the insurance company's peace of mind, or the doctor's, moreso than for the baby or mom.

Thanks John Edwards for making it more difficult.

[smonk]

yeah, but it would be easier to shoot the lawyers than virtually everyone besides the lawyers ;)

[lbnurse]

Sir,

Please be careful how you throw terms such as "midwife" out there. There are many different kinds of midwives, and certified nurse midwives are most certainly trained in neonatal resuscitation. You must also remember that the parents in these transfer-in situations have chosen to try home birth. A small amount of home labors need to be transferred in, and a great many of these are transferred to hospitals in a timely manner when they are managed by competent CNM's.

I also disagree with you on the need for a neonatalogist at every birth. You just need someone who can provide competent initial resuscitative efforts until a more specialized provider arrives. If we were to apply your belief to other fields, then we would have to have a cardiologist and anesthesiologist at every healthcare gym - after all, even though it is normal for middle-aged people to exercise, hey, they might just have an MI at the gym, and we wouldn't have competent individuals to respond to their healthcare crisis unless we have the most specialized person available.