Well, one indication of how little the rate affects my decisions is that I have absolutely not the vaguest idea how much my INSTITUTION pays for my malpractice insurance. In academic neonatology, we are generally covered via the institution so it is relatively invisible to us. In private practice, this is variable, Doc-Hollywood would know more. If anyone on the forum works for the largest private group Pediatrix, they could comment although I suspect it is also fairly invisible to the Pediatrix doctors as well.
Now then, my ignorance about the rates paid for me does not mean I am ignorant about the issue of malpractice in neonatology 🙄. In general, this is an increasing problem. It used to be that the OB would be sued but not the pedi/neos so as to get them to testify against the OB, such as in birth trauma/asphyxia cases. This has changed considerably as lawsuits become more blanket ("everyone failed the baby") and malpractice lawyers have become much more sophisticated in evaluating neonatal care practices.
I don't know any numbers on this, but I am sure the frequency of malpractice claims against neonatologists is on the rise as are the $$ amounts being paid out. A quick lit search showed a marked increase in neonatologists sued comparing 1987 to 1995, but no more recent data. Still, I think we are generally not considered an extremely high risk group.
To answer the question you asked, although there are some data (See: Fear of litigation may increase resuscitation of infants born near the limits of viability. The Journal of Pediatrics, Volume 140, Issue 6, Pages 713-718) that neonatologists affect their clinical practice based on malpractice concerns, I don't think it is a major aspect of our day-to-day thinking or the decision to go into the field. Effect on job satisfaction probably depends on ones personal experience with being on the end of a subpoena.
Regards
OBP
