Liability crisis drives away Obs. (ACOG Issues Red Alert).

LOS ANGELES -- While Dr. Gloria Martin and Dr. Basia Yakaitis hunted for leads on new jobs at the annual meeting of the American College of Obstetricians and Gynecologists, their office staff back home in Las Vegas turned away 31 frantic callers a day--women seeking obstetricians as their physicians flee a city at the grim forefront of the nation's liability insurance crisis.

Half of the obstetricians in Las Vegas have their homes up for sale. Several have gone bankrupt; several more have retired early. Nearly all are considering leaving or restricting their practices to gynecology or infertility.

Las Vegas is one more hard-luck story in a worsening industry-wide losing streak. ACOG President Thomas F. Purdon issued a "red alert" on the condition of the nation's obstetrical care during the annual meeting.

In nine "hot states" the situation is dire, putting women and infants at risk because of obstetricians' difficulty finding affordable or available liability insurance. Hospitals are closing obstetrical units and physicians are moving away In three additional states, "a crisis is brewing," according to Dr. Purdon of the University of Arizona, Tucson, and four more need to be watched since conditions are worsening fast. (See box.)

Nevada, for one, may be facing a catastrophe.

Last year, there were 23,000 deliveries in Las Vegas, and the number is expected to be higher in 2002. Currently, there are only 93 obstetricians still delivering babies, and at least 8 more will be gone by year's end, predicted Dr. John M. Nowins, president of the Clark County Ob.Gyn. Society, Las Vegas. Complicating matters, the state's few remaining malpractice carriers are offering a 20% premium discount to obstetricians who agree to deliver fewer than 125 babies a year. If they deliver 125-175 babies, their premiums will be the standard, vastly increased rate. If they deliver more than 175 babies, they will be charged a 25% penalty over and above the new rates.

"There are more than 10,000 babies in Las Vegas who won't be delivered by doctors next year," he said.