New pregnancies could create crisis

By Emily Richmond (contact)

Tuesday, May 7, 2002 | 10:59 a.m.

The executive director of the Nevada State Medical Association has a message for Southern Nevada women who may become pregnant: There may not be an obstetrician available.

Many of Las Vegas obstetricians, one of the hardest-hit specialities in the medical malpractice insurance crisis plaguing the region, say they have to refuse new patients to afford their soaring medical malpractice insurance premiums.

"It's a terrible day for the entire community when a doctor cannot afford to deliver a baby," said Larry Matheis, executive director of the state medical association.

Matheis said he has heard from many obstetricians who say they are either cutting back on delivering babies or eliminating the speciality entirely from their practice.

The move is the latest development in the state's medical malpractice crisis. Soaring insurance rates have some doctors saying they will close their practices and leave the state. Other doctors say they will scale back their practices to try to cut the increase in their premiums.

Doctors are looking for affordable malpractice insurance, which went up in Nevada because a major insurance provider pulled out last year. A state plan and some privately funded plans are trying to make up the difference.

Matheis said one of the most serious concerns regarding OB/GYNs not taking new patients is that some women may not get prenatal care and wind up in the emergency room to deliver. If a woman doesn't receive adequate prenatal care, the chances of serious complications during delivery soar, Matheis said.

"The infant mortality rate 100 years ago was one out of every three babies, and one out of every four mothers died giving birth," Matheis said. "If we don't want to go back to the old days, we have to solve the crisis we're facing today."

Dale Carrison, director of University Medical Center's emergency room, said while it's not uncommon for his staff to deliver babies, they are not prepared for a deluge of pregnant women.

In addition, the University of Nevada School of Medicine is also searching for malpractice insurance coverage and without it will not be able to supply UMC with the residents and interns who staff the ER, Carrison said.

Obstetricians are liable until the children they deliver turn 18, which makes it one of the most expensive specialities to insure, said Dennis Coffin, a Las Vegas insurance agent with American Physicians Assurance. Because of Nevada's high rate of malpractice claims, Coffin said his company has put a moratorium on any new obstetrician applications for coverage.

"It's ugly out there," said Coffin, whose current clients include about 60 of the 93 obstetricians in Clark County. "Until the state gets some sort of tort reform going, it's not going to get any better."

Since December, when the state's largest insurer of physicians announced it would no longer offer malpractice coverage, more than 100 Las Vegas doctors have left the state, retired or closed their offices, Matheis said.