Malpractice Costs Leading To Closings Of Maternity Wards

Bradley Vasoli

Media – Hospital officials and health care experts from southeast Pennsylvania told the state House Republican Policy Committee yesterday that many maternity wards find it difficult to stay open due to malpractice insurance costs.

Since 1995, 36 of the state’s hospital obstetrical units have closed, 14 of them in the southeast. But as these wards dwindle in number, demand for care for Pennsylvania’s 147,000 annual births doesn’t seem likely to subside. At Riddle Memorial Hospital, where the committee held the hearing, doctors, administrators and patients have felt the pressure of tort liability.

Three years ago, the hospital had 12 obstetricians on staff. Today, seven still practice obstetrics, while the other five work only as gynecologists. Demand for obstetrical care, meanwhile, has grown. Births in the hospital have increased from 800 to 1,200 per year in the past decade.

Dan Kennedy, president of Riddle, said that the hospital’s problems arise from two major causes. Medicaid and other government programs have provided inadequate reimbursements for maternity care, he said, and malpractice insurance costs have stayed too high.

“The crisis in malpractice insurance and the need for tort reform is exacerbating the problem and making it very difficult to recruit obstetricians,” he said. He noted that the state of Texas used to have a judicial system friendly to medical tort claims. But after 1995, when a number of reforms were made to the state’s system of litigation, over 7,000 physicians from out of state came in to practice.

Joseph Nixon, a former Texas state legislator, has written that doctors have saved well over $200 million in malpractice insurance costs.

Perry Pepper, president of Chester County Hospital, noted that the impact malpractice lawsuits have on the medical community does not only manifest itself in dollar amounts.

“There isn’t just the cost of insurance,” he said. “Those times you get sued are psychologically traumatic.”

“It’s devastating,” agreed Jeffrey Komins, chief medical officer of Mercy Health Systems, further observing that such experiences take heavy tolls on doctors’ families. Some health facilities have set up support groups to help physicians through these ordeals.

Members of the legal community also testified at the hearing, focusing heavily on the issue of insufficient government reimbursements for low-income patients. Mark Tanner, president of the Philadelphia Trial Lawyers Association, pushed strongly for increasing subsidies for care in order to ease the burden on doctors. He did not offer any proposals purported to curb frivolous lawsuits.

“I was encouraged this afternoon to see such broad agreement among testifiers,” he said, referring to the reimbursement issue.

Bradley Vasoli can be reached at

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