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The Journal of the American Board of Family Practice 16:471-477 (2003)
© 2003 American Board of Family Practice

Risk Management in Obstetric Care for Family Physicians: Results of a 10-Year Project

Thomas S. Nesbitt, MD, MPH, Allen Hixon, MD, Jeffrey L. Tanji, MD, Joseph E. Scherger, MD, MPH and Dana Abbott

From Outreach, TeleHealth and CME (TSN), University of California, Davis (JLT, DA), University of Connecticut (AH); School of Medicine, Florida State University (JES), and University of California, Davis

Correspondence: Address correspondence to Thomas S. Nesbitt, MD, MPH, Center for Health and Technology, UC Davis Health System, 2300 Stockton Blvd., Sacramento, CA 95817

Background: Malpractice issues within the United States remain a critical factor for family physicians providing obstetric care. Although tort reform is being widely discussed, little has been written regarding the malpractice crisis from a risk management perspective.

Methods: Between 1989 and 1998, a 10-year risk management study at the UC Davis Health System provided a unique collaboration between researchers, a mutual insurance carrier and family physicians practicing obstetrics. Physicians were asked to comply with standardized clinical guidelines, attend continuing medical education (CME) seminars, and submit obstetric medical records for review. Feedback analysis was provided to each physician on their records, and the insurance carrier tracked interim malpractice claims.

Results: One hundred and ninety-four physicians participated, attending to 32,831 births. Compliance with project guidelines was 91%. Five closed obstetric cases were reported with only one settlement reported to the National Provider Data Bank. Physicians believed the project was beneficial to their practices.

Conclusions: Family physicians practicing obstetrics are willing to participate in a collaborative risk management program and are compliant with standardized clinical guidelines. The monetary award for successful malpractice claims was relatively low. This collaborative risk management model may offer a potential solution to the current malpractice crisis.






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Copyright © 2003 by the American Board of Family Medicine.