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Tuesday, May 07, 2002
Copyright © Las Vegas Review-Journal

MEDICAL MALPRACTICE CRISIS: Pregnant women turned away

OB/GYNs say they cannot afford to take on new cases

Las Vegas obstetricians are turning away newly pregnant women, including existing patients who become pregnant, because they say they cannot afford to deliver more babies.

The doctors are trying to reduce their number of annual deliveries to keep their already skyrocketing medical malpractice rates from jumping any higher.

Most of the 93 doctors who deliver babies in Clark County began turning women away Monday, said Dr. John Nowins, president of the Clark County OB/GYN Society. An exact number wasn't available late Monday.

"The insurance companies are scared to death of us delivering babies, and now we're scared to death of delivering babies," Nowins said. "I'm telling patients that to make my malpractice insurance even remotely affordable, I have to severely restrict my OB practice."

Several other doctors and doctors groups stopped taking new patients Monday, including West Valley Women's Care, Las Vegas OB/GYN Associates and Green Valley OB/GYN.

Most of the doctors are insured by American Physicians Assurance, a company that recently began charging doctors even more for delivering what it considers too many babies, said Dennis Coffin, an insurance agent representing the company.

"The company doesn't like to insure OBs. It's risky," Coffin said. "They won't let me insure any more because the risk is too high."

Doctors say that if they deliver less than 125 babies a year, they face annual malpractice premiums that jump from about $40,000 to $80,000. Those who deliver between 125 and 175 babies will have to pay more than $100,000 per year in medical malpractice premiums. The prices continue to rise for doctors who deliver more than 175 babies a year.

Clark County obstetricians delivered more than 23,000 babies last year, about 250 babies each.

"I do about 20 to 25 babies a month to keep my head above water," said Dr. Shelby Wilbourn. "How am I supposed to afford an insurance increase from $33,000 to $80,000 and do half as many deliveries?"

Wilbourn began turning away new patients Monday. He said he might lose his contracts with managed care companies because he has not notified them that he will no longer take new pregnant patients. His notification letters were mailed Monday.

"We've been trying to call around and find other doctors to send our patients to," Wilbourn said. "I've called over 50 doctors who told me they are not taking any new OB patients."

The doctors say Gov. Kenny Guinn's emergency insurance plan isn't helping because it's too expensive. Although premiums might be lower the first year, doctors still have to pay more than $100,000 in tail coverage. Tail coverage is a one-time fee doctors often pay when switching insurance companies.

Guinn created a plan in April to help stem the exodus of Las Vegas doctors.

Area physicians, especially obstetricians and speciality surgeons, say they've been forced to retire early, close their practices or limit their services because of tripling and quadrupling malpractice insurance rates.

The region's medical malpractice insurance crisis started when the St. Paul Cos., the largest medical malpractice insurer in the state, stopped offering coverage in December. Frivolous lawsuits, large jury awards and the pullout of St. Paul forced remaining insurance companies to raise rates, doctors and insurance company officials have said.

About 100 Las Vegas doctors already have left Nevada to practice elsewhere, have announced they will close or have retired early, said Larry Matheis, executive director of the Nevada State Medical Association.

Nine of the 140 obstetricians and gynecologists in Clark County already have shut down their practices and at least 30 more are preparing to leave, according to a survey commissioned by the Clark County OB/GYN Society.

The obstetricians trying to remain in practice are cutting their deliveries as a last resort before leaving the state.

"My office has been turning away patients all day today (Monday)," said Dr. Brent Bartholomew. "We've turned away 15 to 20 patients. This is the last thing I wanted to do, but it's either make drastic changes or look elsewhere."

If newly pregnant women cannot find care in Las Vegas, their choices include moving elsewhere, traveling out of state for care or going without prenatal care and delivering in area emergency rooms.