Durban - The fear of being sued for medical negligence and the high cost of indemnity from legal claims has resulted in a countrywide trend of obstetricians leaving the child delivery profession.
In the past six months, five obstetricians practising privately in the northern areas of Durban gave up the speciality in medicine.
Doctors believe the number leaving will be significantly higher, nationally, in 2017.
By the end of this year, the majority of South African obstetricians in private practise would have paid R650 000 for indemnity cover, as members of popular UK-based non-profit organisation Medical Protection Society (MPS).
However, MPS’s fees for protection cover in 2017 is set to cost approximately R1-million, paid in 10 monthly instalments.
The average cost of cover for obstetricians was almost R4 000 a year in 2000, said Dr Siva Moodley, a council member of the Durban Obstetrics and Gynaecological Society.
“Obstetrics is in a state of crisis. More doctors will leave this profession,” Moodley said.
He said that while experienced obstetricians were bowing out, at the same time, fewer registrars at universities were choosing obstetrics as their field of speciality.
Moodley said he had heard rumours that 58 registrars had filled posts at the University of KwaZulu-Naral in 2014, but only 24 were specialising in obstetrics at present.
However, UKZN’s executive director, Lesiba Sheshoka, said their numbers of registrar applications remained consistent.
Moodley claimed that lawyers were largely to blame for obstetrics becoming unpopular, as well as the sharp increase in insurance costs.
“Medical malpractice is now the niche market lawyers are focused on because of the large lump sum payouts that could be collected.
“Claims against obstetricians averaged around R30m and were usually made when babies were born with abnormalities, or patients sustained surgical injuries or the death of some.” Moodley said lawyers marketed their services for medical malpractice claims aggressively through many mediums.
They offered to do legal work on a contingency basis and usually pocketed as much as a third of the payout.
“Lawyers even have touts at hospitals and medical centres to alert them to potential clients.”
He said the greater number of claims against obstetricians had caused the steep rise in indemnity costs. “Doctors can’t afford the cover that is why they prefer to specialise in other fields.’
But Dr Graham Howarth, head of MPS Africa, said their tariff increases were justified.
“As a responsible, not-for-profit organisation, we need to reflect the increasing cost of negligence claims in our membership subscriptions.
“The estimation of the long-term average claim frequency for doctors in 2015 is around 27 percent higher than in 2009. Our concern is that this trend may continue, with increasing claim sizes forcing us to raise subscription costs,” explained Howarth.