Lack of malpractice insurance is threatening to close the only obstetrics practice in Virginia’s rural and economically depressed Northern Neck region. The closure of Rappahannock General Hospital’s OB unit, which delivers about 250 babies a year, would be “absolutely devastating” to community health, says Albert C. Pollard Jr., who represents the region in the Virginia House of Delegates: “we’d lose a lot of babies if somebody has to drive to Richmond or Newport News.” (Frank Delano, “Crisis presses OB docs”, Fredericksburg (Va.) Free Lance-Star, Dec. 21). “While the governor and Legislature dither over fixing the state’s medical malpractice system, the [Philadelphia] region’s doctors have been voting with their feet,” reports the Philadelphia Daily News. “And they are choosing states that cap damages in malpractice lawsuits — or have other strong reforms to keep malpractice insurance premiums low.” (Michael Hinkelman, “Pa. docs are moving to ‘cap’ states”, Philadelphia Daily News, Dec. 8). Hard numbers on malpractice payouts are often in short supply, but the Missouri state department of insurance has some: it says insurance companies operating in the state “reported paying $135 million to cover 524 claims closed last year”. Self-insured entities, mostly hospitals, “reported paying $6.6 million to close 42 claims, but the actual number of claims and the amount paid may be understated in the data, department spokesman Randy McConnell said. … The average malpractice claim takes more than four years to reach resolution, so the 2002 claims data capture injuries sustained over a period of years. Only 15 of the 566 claims went to a court verdict.” Most of the paid cases involved claims that medical misadventure led to permanent injury or death. (Judith Vandewater, “566 medical malpractice claims were settled in Missouri in 2002”, St. Louis Post-Dispatch, Dec. 4). The American Medical Association rates Missouri a “crisis” state. (M. Steele Brown, “Malpractice ‘crisis’ drives docs from Missouri”, Kansas City Business Journal, May 5).

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