Published May 4, 2004
Well, an L and D unit I used to work in closed, despite loud protest from the surrounding community. The fact is this: Most of the time, OB is a big money-loser in most hospitals and if they can get away with it, they will shut the OB unit down to stop the hemorrhage of profits. It's sad this is happening, but believe me, it will continue as long as ob units lose money for hospitals, especially smaller ones that cannot so easily make up for these losses.
I don't know if it sort of works on supply and demand also. We have 3 or 4 hospitals within 20 miles of each other that all have very nice units. One closed last year due to a decrease in number of births. Stated in paper that if they didn't have 50 births a month they would have to close. (they did) Well boy did the other two pick up the slack probably doubling the smallest hospitals births. The hosptial I am currently working stated that the emergency room, maternity and radiology department are the big money makers and we probably average 20-30 births a month. July and August are going to be big according to the midwives with two groups saying they each have 20-30 and that is without the MD's pts, so I will be sure to have a busy summer.
tntrn, ASN, RN
You hear stories of the OB's getting out of doing OB from a number of states, due to rising malpractice costs. In the recent months, I've about Arizona, Illinois, now Florida and I know the costs of our OB group is getting to that point also in Washington. Question is: where will they go where the costs aren't as high?
dawngloves, BSN, RN
I'm in PA and my OB had to stop doing deliveries when she could no longer afford the insurance. Of course this was half way through my pregnancy. She could do PNC, but it's never a given she'd deliver my baby anyway.
And my neighborhood hospital closed it's labor floor two years ago. This after 85 years of delivering babies.
Many OBs here are retiring, just doing GYN or moving their practice to NJ, as my first OB did. Very scary when you consider how hard it is to get women to get PNC when it is readily available. What will happen when it's harder to come by?
I agree, dawngloves.
It's strange, because just over 1.5 years ago, my OB/GYN left VA to go to AZ where he said prices were cheaper. Now, he's being driven out again, I guess. So what are we to do??
In my hospital, OB is where the $$ is. We are also the dept. that has the highest customer satisfaction scores.
*sigh* reconsidering midwifery even more.....
This is very bad news. I'm really sad to hear about this in your area. A woman should have a choice in where she delivers. We have 3-4 big hospitals in our area and each is different in it's childbirth philosophy. One is more laid back while the other is more technology dependent. I believe a woman should have a choice - if she wants a more natural approach, she should have the option of going to Hospital A. If natural isn't her cup of tea, then she should have the choice of going to Hospital B, or C, or D.
This is just very sad, and unfortunately it's even worse for the midwives because only 2 hospitals allow midwifery privileges.
BTW, this is in a city of ~1,000,000 in the metro area. :uhoh21:
In Frederick, MD the midwives employed by a very large OB practice lost their jobs in January 2004. The reason cited was rising malpractice costs. I am not sure if they are still out of work (I live about 40 miles away from there), but they were a real fixture in that community and many, many women were very upset. It was even carried in my local newspaper. When will it end. I also saw that the 2003 graduating class of the U of MD School of Medicine had no graduates going into OB. We are in for some real problems w/ access to care a few years down the road (we think it's bad now). I know all of our FP docs gave up OB several years ago. I used to think of being a CNM, but I have pretty much given that idea up. I just don't want to be sued and take on all of that responsibility.
I live in Pittsburgh, PA and can say that yes, my state has been loosing OB/GYN's to sky rocketing insurance and malpractice verdicts.
It can take 6 months to get in to see an OB/GYN if you are not a previous client and even if you have an emergency. A co-worker of mine had to wait 5 months to get in to see an OB/GYN for endometriosis. Other doctor's offices told her she could end up waiting as long as 8 months. While she waited she spent a lot of money and time in the ER. Her first OB/GYN left the state due to insurance costs.
It takes me 3 months to get a "check up" appt. with my OB/GYN of many years, I think I could get in in relatively quickly though if I had an emergency.
A few years ago a local hospital closed down it's midwifery service. Luckily, with much gusto and public out cry they were able to open up their own practice outside of the hospital.
I agree with Dawn Gloves.
Seems we spend a lot of time, money and public education on female health issues and disease prevention like breast cancer screening and STD's in the young at risk population but when the doctors aren't there to see the patient's what more can you do?
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