Impact of the Medical Liability Crisis on Postresidency Training and Practice Decisions in Obstetrics-Gynecology

Abstract

Concerns about medical malpractice and the medical liability crisis are not new. Their impact on the field of obstetrics and gynecology has been discussed since the 1970s and 1980s.1 Evaluations of the specific bearing of the liability crisis on obstetricians and gynecologists have demonstrated regional influence on providers.2,3 Nationally, more than 60% of obstetricians and gynecologists have made one or more changes to their practices as a result of the affordability or availability (or both) of professional liability insurance or because of the perceived risk or fear of professional liability claims or litigation. 4 To date, few studies have investigated the influence of the liability crisis on the decision patterns of residents. Mello and Kelly 5 surveyed Pennsylvania residency program directors and senior residents in anesthesiology, general surgery, emergency medicine, obstetrics and gynecology,The authors wish to recognize Mary Behneman, BS, Christine Himes, and LaShawn Jordan, BS, for administrative assistance in the production, tracking, and collection of the surveys. Special thanks to Andrea M. Carpentieri, MA, for assistance in data collection and analysis, and to Sterling Williams, MD, MS, for aid in the creation and conceptual development of the project. Mss Behneman, Himes, Jordan, and Carpentieri and Dr Williams received no compensation for their contributions.Corresponding author: May Hsieh Blanchard, MD, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, 11 South Paca Street, Suite 400, Baltimore, MD 21201, 410.328.5964, mblanchard@fpi.umaryland.edu Received June 20, 2011; revision received November 6, 2011 and December 6, 2011; accepted January 9, 2012. DOI: http://dx.doi.org/10.4300/JGME-D-11-00135.1 AbstractIntroduction The liability crisis may affect residency graduates' practice decisions, yet structured liability education during residency is still inadequate. The objective of this study was to determine the influence of medical liability on practice decisions and to evaluate the adequacy of current medical liability curricula.

Major problems, current characteristics and future career plans of obstetrics and gynecology residents in Turkey

“…Current data suggest that medico-legal training during OBGYN residency is inadequate (15) . A large survey study showed that more than 20% of the fourth-year OBGYN residents had already been in a lawsuit (16) and more than half of those indicated that they had not received adequate training on legal matters. In a prospective survey study, 35% of residents stated that they had been planning for a fellowship program only because of malpractice concerns.…”

Strategies for Cost Optimization in Minimally Invasive Gynecologic Surgery

“… 10 The Accreditation Council for Graduate Medical Education requires a minimum of 15 TVH out of a total of 70 minimally invasive hysterectomies. 25 The small proportion of required TVH cases compared with the total minimally invasive hysterectomies created the potential for potentially choosing laparoscopic routes over vaginal hysterectomy in future practice.…”

“… 25 Half of graduating residents receive no formal training in risk management when it comes to medical liability, yet more than 20% of residents are already involved in a lawsuit by graduation. 25 According to a nationwide survey of residency program directors in 2005, the average number of medicolegal didactic sessions for residents is only four per year. 25 This did not improve after 15 years according to another survey in 2020.…”

Medical Malpractice Lawsuits Involving Trainees in Obstetrics and Gynecology in the USA

“…Studies show that residents and medical students identify liability-related issues as a major factor in considering post-residency work [ 4 , 5 , 6 ]. However, residency training lacks sufficient medicolegal education, exacerbating trainee fear [ 7 ].…”