dejerine

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A while back I was flying and the person sitting next to me revealed he was a professional expert witness/consultant economist. His job was to help companies compute the litigation costs for a given product so they could include that in the cost of the product.

His neighbor, an OBG had asked him to do this for delivery of a baby. He told me the very least OB's should charge is 25,000 per baby if they followed the industry standards. He said the situation is so bad that OB's should unionize and demand higher reimbursement.

If you get two bad babies in your practice, it will cost you 20 million on the average, which is four times what you can plan to make. To make up for it, you would have to charge much higher costs.

He said the other alternative was for the federal govt to insure OB's. He said this would lead to tort reform nationally. He made me think soberly about the whole business.
 

BBCatcherVA

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I'm so glad to hear someone comment on this. I will be starting residency in June and I cannot tell you the number of times that the "What will you be specializing in?" question is followed up by "What are you going to do about malpractice?". I did not pick this field because I thought that it would be easy work or to get rich, but I do think that we need to re-examine the cost of providing OB care.
I know that Ob/Gyns are not alone in paltry reimbursement for evaluation and management services; however, most other fields of medicine have returned to some form of fee-for-service payment structure while OB still functions largely on a global fee reimbursable after delivery. I have seen billing "gymnastics" where providers include very specific phrases to insure that they can bill for OB clinic services outside of these global fees.
I think the question that I have as a newbie is how to get involved with organizations that are seeking to change these reimbursement practices. I am a member of ACOG and the AMA, but I don't know exactly how to get involved in any meaningful way. Any recommendations would be very welcome!
 

Global Disrobal

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Points well taken but where do you get your conclusions from with respect to "FMG Club" and OB having the highest FMG rate. Correct me if I'm wrong, but I was under the impression that Internal Medicine and Family Practice had a significantly higher proportion of FMG's that OB/GYN.

I don't want to turn this into a typical "FMG" shouting match as unfortunately many threads become; especially since this is a very interesting topic and deserves discussion. However, you may want to leave out the comments like "girls club" and "FMG club" as they dilute your points and take away from the true discussion.

Now getting back to the point at hand. There is definitely a need for tort reform as litigation-avoidance practice is now-a-days dictating the way many obstetricians practice their trades. I've often heard the phrase "you'll likely not get sued for doing a section too early, but god help you if you sit on the decels too long and do the section too late." Read some of the articles by Charles Lockwood (from Yale) as he provides interesting insights into tort reform and today's political scene with respect to OB/GYN.

Thanks for your post.
 

nykka3

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Read some of the articles by Charles Lockwood (from Yale) as he provides interesting insights into tort reform and today's political scene with respect to OB/GYN.

Thanks for your post.
Are there any free reprints or web links about Dr. Lockwood's insights? This is a very important and interesting topic I would like to get more information for.
 

Global Disrobal

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Yea look up the archives of Contemporary OB-GYN. He generally writes an editorial in the front. Just recently, he spent two issues reviewing the top candidates in the election and how their stance on issues will impact the practice of reproductive medicine.

Have a good weekend.
 

nykka3

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Yea look up the archives of Contemporary OB-GYN. He generally writes an editorial in the front. Just recently, he spent two issues reviewing the top candidates in the election and how their stance on issues will impact the practice of reproductive medicine.

Have a good weekend.
Yes, I have seen some of his articles from this journal but I am not a paying subscriber. I was hoping to see some of the articles for free. I signed up via modernmedicine.com which displays some of contempory obgyn articles for free in the meantime. Thanks!
 
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dejerine

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Bundling is fraud in other medical professions, but the standard in OB. (see the fraud case settled by five big insurers who were trying to bundle EKG's etc with office visits).