Las Vegas Sun

April 18, 2019

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Southern Nevada called worst place for pregnant women

Southern Nevada has become the worst place in the country for a woman to deliver a baby, the president of a national group of medical doctors said Wednesday in a letter presented to Gov. Kenny Guinn.

As many as 35 percent of Clark County's obstetricians have left the state in the past nine months because of the state's medical malpractice insurance crisis and more are packing their bags, according to the Clark County Medical Association. That leaves 86 obstetricians to deliver an estimated 23,000 babies annually for an average of 22 deliveries per doctor each month, according to the medical association.

"Nowhere else in the country has such a profound loss occurred. Southern Nevada has become the worst place in the country for women to find OB/GYN care," said Charles Hammond, president of the American College of Obstetricians and Gynecologists, a 44,000-member national organization.

"The word is out -- Las Vegas, Henderson, and surrounding areas may not be the place to move or visit if you are a woman."

Despite a new law passed in a special session of the state Legislature this summer, which for the first time will place caps on jury awards in medical malpractice cases, there has been no immediate relief from high insurance premiums, a group of nine Clark County obstetricians told Guinn on Wednesday.

Guinn's chief of staff, Marybel Batjer, said the state cannot help doctors until it has a clearer grasp of the extent of the crisis. According to the state Board of Medical Examiners, Batjer said, just two obstetricians have left the state.

Obstetricians say while many of their colleagues have not yet filed with the state board, they have left the state.

To keep more from leaving, doctors asked Guinn to consider increasing pay by reimbursing Clark County doctors for Medicaid services as the state does elsewhere in Nevada, on a fee-for-service basis rather than through a managed care provider.

That shift in payments for the 62,000 Medicaid patients in Clark County would cost the state from $6 million to $30 million annually, Batjer said, at a time when it is already facing a budget shortfall of $294 million.

"Anything that puts further pressure on the general fund is of concern right now," Batjer said, "But that doesn't mean the governor isn't concerned. He doesn't want one doctor to leave the state."

In Las Vegas, lawyers, doctors and insurers who in July helped draft a law to address Southern Nevada's medical malpractice insurance crisis also met Wednesday in a separate attempt to stem the exodus of Clark County obstetricians and gynecologists.

Members of the Clark County OB/GYN Task Force said the crisis is no longer limited to medical care, but has mushroomed into a public relations liability as well, due to national media coverage of the crisis.

"This issue has long-term implications, not only for the health of women and families, but for the for the health and well-being of the whole economy," said County Commissioner Erin Kenny, chairwoman of the University Medical Center board.

"If we close our eyes to this, it will close down Nevada."

OB/GYNs have been the group of doctors hardest hit by the medical liability crisis because they are considered the highest risk pool by the insurance industry. Premiums for most obstetricians have jumped more than 250 percent this year,according to doctors. But how to help them remained unclear.

Legislators convened a special session in July in an attempt to rein in rising rates, but insurers say they will not be able to drop rates for more than a year.

The new state law, effective Oct. 1, caps jury awards in malpractice cases at $350,000. But exceptions allow awards of up to $1 million and lawyers are expected to challenge the constitutionality of the law, possibly leading to further delays before rates decrease.

State Sen. Ray Rawson, a member of the task force, suggested putting up $4 million in state aid to cut in half the approximately $8 million in premiums that the OB/GYNs pay. The average OB/GYN pays $80,000 a year in premiums, according to the insurance industry.

"Not doing something on this is an unacceptable alternative," Rawson said.

But that offer fell far short of the request obstetricians made of Gov. Guinn earlier in the day.

Dr. Rhonda Robbins, a Las Vegas OB/GYN, said she's not waiting any longer for relief from the state. Despite having no claims filed against her, she said her premium jumped from $29,000 to $108,000 this year, an increase of 270 percent.

So after she delivers her last baby Dec. 19, she will provide only gynecological care in hopes of qualifying for reduced rates. She said she wouldn't resume obstetrics until there are drastic changes, either in liability rates or compensation for services.

Overlooked for comment at the Las Vegas meeting, she left in frustration. She was going to a farewell party for another obstetrician at the T-Bird Lounge in Henderson, she said.

"He's been working in Las Vegas since 1988 and now he's headed to Enid, Oklahoma, the armpit of the U.S.," Robbins said. "But right now, it's better than Las Vegas."

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