Liability Concerns: A View From the American College of Nurse‐Midwives

Abstract

The national office of the American College of Nurse-Midwives (ACNM) is the center of day-to-day administration for the professional organization. Staff members respond to requests for information and assistance from certified nurse-midwives or certified midwives and facilitate the work of the Board, Divisions, and Committees. This article reviews the questions most frequently asked of the Professional Services department about risk management and professional liability issues and summarizes the most important lessons learned from the calls received. The focus is on 5 topic areas: 1) collaboration confusion, 2) systems needed to implement and effectively track diagnostic tests and referrals, 3) expansion of services beyond the core competencies, 4) patient satisfaction and patient complaints, and 5) maintaining medical malpractice coverage.

The Role of Litigation in Midwifery Practice in the United States: Results from a Nationwide Survey of Certified Nurse‐Midwives/Certified Midwives

“… There are no significant differences between the distributions of the two samples in columns A and C (χ 2 = 5.14; P = .40). …”

“…Based on self‐reported ACNM‐designated regions of practice, the geographic distribution of respondents also was closely representative of the distribution of ACNM‐registered CNMs/CMs across the country in 2004 at the time of the survey's distribution (χ 2 = 5.14; P = .40). Columns A and C of Table 1 provide a comparison of this geographic distribution across the six ACNM regions for survey participants and ACNM members nationwide.…”

“…In fact, the rate of attrition from obstetric practice has reached crisis proportions in many regions of the country 1 . Malpractice premiums for obstetricians are among the highest of any health care specialty, while the cost of liability insurance for midwives has risen considerably over the past decade 2 . This increasing role of legal matters in the practice of women's health care influences not only employment opportunities and work environments, but also the access to and quality of care for childbearing women.…”

The American Association of Birth Centers: History, Membership, and Current Initiatives

“…In many cases, the companies kept premium rates below the levels of losses and even below the level of inflation 13,14 . After September 11, 2001, the insurance industry faced large investment losses in the stock market and was no longer able to use investment income to support claims payment, so they increased premiums dramatically to remain financially stable 14,15 …”

“…13,14 After September 11, 2001, the insurance industry faced large investment losses in the stock market and was no longer able to use investment income to support claims payment, so they increased premiums dramatically to remain financially stable. 14,15 It is difficult to estimate overall increases in malpractice insurance rates because insurance rates vary with many factors, including region, practitioner type, experience, and previous claim history. 13 A 30% increase in premiums to match premium prices to the rate of inflation was expected in 2001 as the stock market fell.…”