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Malpractice premiums and the supply of obstetricians

Daniel Polsky1, Steven C Marcus, Rachel M Werner

  • 1Division of General Internal Medicine, University of Pennsylvania School of Medicine, Blockley Hall, Rm. 1204, 423 Guardian Drive, Philadelphia, PA 19104, USA. polsky@mail.med.upenn.edu

Inquiry : a Journal of Medical Care Organization, Provision and Financing
|May 15, 2010
PubMed

Insights

Rising medical malpractice insurance premiums are forcing obstetricians out of practice and deterring new ones from entering. This trend led to a 5.3% decline in the obstetrical workforce in some states.

Area of Science:

  • Health Economics
  • Medical Workforce Studies
  • Public Health Policy

Background:

  • Medical malpractice insurance premiums represent a significant operational cost for obstetricians.
  • Fluctuations in these premiums can impact physician practice decisions and workforce dynamics.
  • Understanding the relationship between malpractice costs and physician supply is crucial for healthcare planning.

Purpose of the Study:

  • To investigate the association between rising malpractice insurance premiums and the supply of practicing obstetricians.
  • To quantify the impact of premium increases on obstetrician entry and exit rates.
  • To determine the net effect on the obstetrical labor supply in specific US states.

Main Methods:

  • Utilized longitudinal data from hospital discharge records in Pennsylvania, Florida, and New York (1998-2004).
  • Analyzed trends in practicing obstetricians, focusing on entry and exit rates.
  • Correlated changes in malpractice premium costs with observed shifts in obstetrician supply.

Main Results:

  • Increasing malpractice premiums were significantly associated with higher obstetrician exit rates.
  • Rising premiums correlated with reduced entry rates for new obstetricians.
  • In Pennsylvania and Florida, a 20% annual premium increase over four years resulted in an 80-physician (5.3%) reduction in obstetrical labor supply.

Conclusions:

  • Malpractice insurance costs are a key determinant of obstetrician workforce stability and availability.
  • Policy interventions addressing malpractice premium trends may be necessary to ensure adequate obstetrical care access.
  • The findings highlight the economic pressures influencing physician supply in specialized medical fields.

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