In NYC, a crisis in women's health care
by Daniel Bush
Jun 23, 2009 | 4276 views | 1 1 comments | 660 660 recommendations | email to a friend | print
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Dr. David Friedman delivered babies for years in Manhattan, and loved the work he did, before malpractice insurance rates became so high he was forced to stop.

In Brooklyn, Dr. Judith Weinstock, who practices at Brooklyn Women's Health Care, is set to lose her malpractice insurance July 1st.

Non-doctors more worried over their own rising health care costs might stop to consider a startling fact: Weinstock and Friedman are just two among scores of doctors across the city who are finding it harder than ever to afford delivering care, and especially women's care, to city residents due to skyrocketing malpractice insurance rates.

In the past three decades, malpractice rates have grown exponentially. NYU Medical Dr. Mitch Essig said when he began practicing in 1981, he paid roughly $8,000 a year in malpractice rates. That number has now risen to $155,000, a common figure for private practitioners like Essig and Weinstock.

According to the American College of Obstetricians (ACOG) District II, which represents more than 4,000 women's health care providers in New York, insurance premium rates for New York-based obstetricians/gynecologists are among the highest in the country.

Despite this, they now face yet another scheduled rate hike unless Governor Paterson, who froze the increase last year, does so again by the start of next month.

At a June 17th City Hall press conference, Queens Councilwoman Elizabeth Crowley and two dozen doctors urged the governor to enact immediate malpractice insurance reform.

If Paterson does not do so, said Crowley, at least 28 obstetricians affiliated with eight hospitals in Queens, Brooklyn, and Manhattan would be forced to stop delivering babies. Countless others, in giving up malpractice insurance they can no longer afford, would stop administering additional women's health services.

Crowley said overburdened doctors would be forced to follow their colleagues out of state, where rates are lower, in a growing exodus that could very well jeopardize women's health care in the city in years to come.

"The current medical malpractice insurance system, which is regulated by our government, is driving doctors out of New York, and the first doctors to go are the ones who provide women's health care," said Crowley.

She said obstetricians are leaving the city at a faster rate than any other place nationwide; her office pointed to statistics showing that between 2002 and 2008, 160 obstetricians/gynecologists reduced their coverage to uncomplicated obstetrics; 99 dropped their obstetrician coverage; and 36 more were non-renewed.

"If we continue in this direction, who will care for pregnant women?" Crowley asked. "Who will deliver babies in New York?"

A handful of leading doctors spoke alongside Crowley for the need for malpractice reform.

They included Dr. Friedman, from Manhattan, who said while Paterson's decision last year to block malpractice insurance increases would be welcomed again this year, a more permanent solution to the problem was needed.

"Expenses are going up, up, up and reimbursements are going down," Dr. Paul Aaronson, president of the Queens County Medical Society, told this paper after the press conference. "Its impacting places like Queens, Brooklyn, and the Bronx."

Aaronson, an urologist, said his own malpractice insurance, though lower than for most obstetricians, has risen from $25,000 to $55,000 in the past six years alone.

He said unless more elected officials take notice, and pass legislation to reform the system, it would just continue getting worse.

"This might be the kind of thing where it has to get worse before it gets a little better," Aaronson said.

But then he voiced a note of cautious optimism, saying efforts like the one now led by Crowley were drawing attention to the issue. Aaronson said the Queens County Medical Society has successfully encouraged doctors to begin lobbying for change, if not now than for the future.

"We're trying to get doctors to be more engaged," said Aaronson. "It's a grassroots process."

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October 26, 2009
you should size the images to be the same size, as they switch the text moves about the page... i could only read one paragraph before becoming too dizzy to finish