— More than 22,000 babies were born in Nevada hospitals last year, but the odds are about 10,000 pregnant women in the state will not be able to see an obstetrician before their babies are born.
Candice Sansonetti is more than five months pregnant. She has taken time off from her job as a cigarette girl at a Las Vegas casino hoping to enjoy her pregnancy, but she spends most days on the phone, anxiously looking for a doctor.
"I opened up the phone book and started going in alphabetical order. And every single doctor that I had called said that they weren't taking anybody that was pregnant," said Sansonetti, balancing a telephone book on her ample lap.
The crisis began when St. Paul Cos., the country's leading provider of malpractice coverage, quit the business in December 2000.
The company insured 60 percent of Nevada doctors. Citing falling profits because of high jury awards in medical malpractice law suits, St. Paul did not renew policies. The insurance policies run out this summer.
Scrambling for Coverage
As Nevada's doctors scrambled for alternative coverage, they were hit with rate rises of 100 percent to 400 percent, a staggering increase. So, some doctors retired early, others stopped seeing new patients, and still others left the state.
Dr. Mark Turner has been delivering Nevada babies for 13 years, but he recently dropped obstetrics from his practice.
Obstetricians, such as Turner, pay some of the highest rates because a mistake in their profession brings some of the biggest jury awards.
"When there's no limit on what can be awarded and with a jury system that seemingly has a perception that insurance companies as well as physicians have money trees in their back yards, it's an untenable situation," Turner said.
"It's a business decision on their part. If it's not a fruitful field and market to work in, then you limit your losses and you get out of it," he said, referring to the insurance companies.
So it appears that Turner also made a business decision "to get out of it." He dumped obstetrics from his practice to reduce insurance costs.
Trauma Center Shut Down
It is the same decision that surgeons made at the only trauma center in Las Vegas. The facility serves a four-state area, but doctors walked off the job for 11 days, including the Fourth of July holiday weekend.
Dr. John Fildes, head of the trauma team, says doctors had to walk because of insurance costs.
"At first, they were unable to find companies that would offer them insurance, and when they did, they had their rates increase two and three times, and as a way of trying to control their personal risk, they had to eliminate some of the highest risk activities they were involved in," Fildes said. "And, unfortunately, the trauma center is one of those situations."
The trauma center reopened only when the state agreed to provide temporary medical liability coverage.
Now, doctors are demanding a cap on all jury awards in Nevada for pain and suffering in medical malpractice suits.
But Timothy C. Williams, head of the Nevada Trial Lawyers Association, says that the decision to close the trauma center was a strategic one. He called it a "scare" tactic to force the state to institute caps.
"There's certain individuals out there, including the doctors and the insurance companies, that want to penalize the victims and the citizens and take away their rights to bring civil jury trials," Williams said.
The Nevada Legislature is holding a special session next week to consider caps on jury awards.
A recent poll shows a large majority in the state now agrees with the doctors for the need for caps.
But there are no guarantees that the cap will reduce doctor's insurance or that more doctors will quit the state and look for work elsewhere.