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Re: IUFD ( long)From: RModugno@aol.comWed Apr 26 10:05:54 2000
Rick writes: Just to play the devil's advocate, suppose an OB or FP agreed to do the NST. Significant late decelerations are noted; emergent c-section is performed and a significantly injured baby is born (say with CP.) Who becomes the responsible party? Who is going to get sued? Ashley writes: Fear of a multimillion dollar lawsuit, including inclusion in the national malpractice data bank with subsequent damage to one's reputation and ability to make a living, has causes many of our colleagues to refuse to see patients later in pregnancy or when they have certain high-risk complications. It has also caused many fine ob/gyns to leave obstetrics. It is easy to say that taking care of every ill patient is part of being a doctor, until one has been the victim of a frivolous lawsuit for doing just that. Our international colleagues likely have no idea about the oppressive malpractice situation in the United States, and I imagine it is hard for them to understand why we are so concerned about lawsuits. In the US when a doctor is successfully sued his or her name is entered into a national data bank, which is accessible by hospitals, state medical societies, and other entities. Some states are publishing legal information on the Internet for patient access. And, some HMOs will drop doctors if they have been sued. I recall that about 80% of US ob/gyns have been sued at least once, so this is a problem that affects most of us. Although I have mixed feelings about obstetricians refusing care for high-risk obstetric patients such as those with no fetal movement, I acknowledge that until the malpractice burden is eased that many of our colleagues will continue to hide from high-risk cases, rather than expose themselves to potential lawsuits. Both makes excellent points regarding the psyche of OB physicians in the US ( having had my fair share of frivolous lawsuits - all of which have gone to summary judgment). But I feel their comments amplify my statement that this is why the US healthcare system is in chaos. Physicians can be paralyzed into inactivity by the fear of lawsuits. My feeling is that is why we have malpractice insurance. If an HMO has the audacity to drop us because of lawsuits filed against us - then use the system! Sue them! Or at least fight to change the system! Sorry, the 2cents has multiplied! Robert Modugno MD MBA FACOG Marietta, GA
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