Obstetrician crisis in New Jersey. This is what’s happening in the real world, whether there is evidence to support OB’s actions or not:
Schulze recently received her malpractice premium for 2006. For gynecology only, it was $16,214. If she’d stuck with obstetrics, it would have been $51,349.
Others are paying much more. Clachko, who has practiced in River Edge for 30 years, said his malpractice premium was about $40,000 three years ago. In 2005, it climbed to about $73,000. Next year, he said, he’ll pay about $140,000.
Most businesses would pass on the additional costs to their customers, but doctors can’t. Managed care companies, they say, pay them between $2,300 and $2,800 for nine-plus months of perinatal care. That reimbursement rate, adjusted for inflation, was the same in 1978.
Some OB-GYNs have opted out of managed care entirely and ask patients to pay them directly out of their pockets. Dr. John Marcus, director of OB-GYN at The Valley Hospital in Ridgewood, said he charges $4,500 for perinatal care. In Manhattan, he said, OB-GYNs get $6,000.
Schulze said she tried and tried to justify the money she was losing – approximately $75 on every delivery and $175 on Caesarean sections . . .
. . . OB-GYNs pay the second-highest liability insurance in the medical field, topped only by neurosurgeons, who earn much more. They pay higher rates because their errors, real or as perceived by juries, potentially bring higher damage awards.
Juries calculate awards based on the cost of medical care and lost income over the remainder of the plaintiff’s life. Babies harmed during childbirth can be compensated for a lifetime’s worth. Lawyers can play a jury’s heartstrings by showcasing an injured child, and the jury will loosen the purse strings.
Insurance companies bemoan high jury settlements, some of which have topped the $20 million mark. Critics of malpractice reform say those are rare. In fact, payouts by New Jersey malpractice insurers actually decreased 21 percent from 2001 to 2003 – even as malpractice rates were rising.
As for frivolous claims, experts say only 4 percent of the people who’ve been harmed by medical malpractice file suit. Plaintiff’s attorneys, who aren’t paid unless they win, weed out the other 96 percent, says Jillian Aldebron of Public Citizen’s Congress Watch, a Washington advocacy group.
Schulze, whose malpractice record is clean – she was sued twice, but won both cases – says the expectation of “perfect health care” is at the root of the problem.
“When people don’t get the perfect result they feel American medicine is capable of, then they feel they deserve economic compensation,” she said.
It’s not only about the high cost of premiums, Schulze said. It’s also a question of liability. If a judge ever orders Schulze to pay damages that exceed the amount for which she’s insured, she could lose her house in Upper Saddle River.
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