Medical Law – Risks associated with practising Obstetrics

Doctors are reluctant to specialise in Obstetrics due to the constant threat of being sued and the exorbitant cost of insurance premiums for medical malpractice cover.

Professional Indemnity Insurers indemnifying obstetricians in private practice should take note that the Sunday Times reports that these risks are regarded as falling in the “super high risk” category and pay the highest insurance premiums of the medical fraternity.

According to Health Minister Aaron Motsoaledi the problem has become so serious that he has commissioned a study to investigate reasons for this spike in litigation, which he hopes will report by the end of the year. Motsoaledi told the Sunday Times that while doctors should not be exempt from litigation “the manner in which it is happening is unacceptable”.

He is further quoted as saying “it’s overburdening gynaecologists more than any other profession … Why will you go and specialise in a profession where everybody is targeting you?”

Obstetricians who are members of the Medical Protection Society (MPS) – a non-profit organisation offering indemnity to nearly 30 000 health professionals in the country – pay an annual subscription fee of R220 700 while gynaecologists pay R111 130. In contrast, their counterparts in public hospitals who are members of MPS pay only R7020 because the State is liable to pay out negligence claims.

Professor Bhaskar Goolab, the president of the South African Society of Obstetrics and Gynaecology is quoted as saying that the average gynaecologist is “significantly fearful of litigation and it is something that affects his quality of practice”.  According to Professor Goolab the profession is being tainted by the legal profession as a “profession that is out there to harm mothers”.

Dr Chris Archer, an obstetrician in private practice, says that some of his colleagues are considering giving up their practice because of the steep cost of malpractice insurance. Dr Archer himself is reportedly paying just under R250 000 a year for cover through a commercial insurer. Dr Archer states that this amount is “enormous, especially when you consider that, 15 years ago, we were paying about R3000. Each time one reads of being sued, it makes us think that we are actually in a very dangerous profession and we wonder whether it’s worth it to carry on doing this”.

According to Dr Archer a possible reason for the increase in legal action against medical specialists could be the demise of the Road Accident Fund. He states that “it has forced a lot of lawyers who did this sort of work to look at the medical profession as a source of income because we are the only insured party”.

Dr Graham Howarth, MPS’s head of medical services for Africa, said in a statement that the organisation is aware of the issue. He is quoted as saying that “anecdotally, we are aware that some obstetrician members who have considered making the move into private obstetric practice have been apprehensive given the adverse claims environment”.

Although he refused to divulge the amount paid out by the MPS in claims in the past year, he said it had seen an increasing number of multi-million rand clinical negligence claims.

AM Theron Inc have developed a specialist Medical Law defence practice focussed on assisting Insurers of Medical Malpractice claims.