Many Mississippi doctors giving up obstetrics

JACKSON, Miss. -- When Kim Smith went into labor in Holly Ridge on Sept. 9, 1993, she had every intention of driving the two hours south to her doctor in Jackson.

But Smith and her family ended up instead in a hospital in nearby Indianola, where family practice physician Dr. Edgar Donahoe Jr. delivered her son.

"We barely got in the car and it was time to have the baby," said the 40-year-old mother of three.

If Smith were in the same predicament today, she may not have found a doctor in time.

Physicians who specialize in family medicine and obstetrics/gynecology in Indianola and other rural areas of Mississippi are increasingly dropping obstetrics because of skyrocketing costs for malpractice insurance.

Medical liability insurance rates for doctors who deliver babies have risen anywhere from 20 percent to 400 percent this year depending on the carrier, according to Mississippi State Medical Association.

Annual premiums range from $40,000 to $110,000, the association said.

"They're passing the load to every physician they cover," said Liz Caroll, the medical association's government affairs representative. "Good doctors are being forced to ante up for the jackpot justice mentality in this state. In the end, patients have fewer options."

Rural areas hit hard

The Delta has been particularly hard hit because of the already-limited choices for care in the rural, impoverished region.

Three of the six doctors in Cleveland who deliver babies ended that part of their practice in October because of the hike in premiums. Greenwood soon will go from four to two. Yazoo City, which has 14,550 residents, has no one practicing obstetrics.

Dr. Waldemar "Lanny" Prichard, one of Donahoe's partners in Indianola, says he'll have to stop delivering babies next year unless he gets a break on his current malpractice insurance bill, which he pays for himself.

Prichard's premium for the coming year: $70,000. His gross salary last year: $72,000.

"Rural family doctors don't make a lot of money, contrary to popular belief," said Prichard, 57. "My whole raison d'etre is I wanted to be a doctor -- not for the money but for the sheer pleasure and satisfaction of making a difference in people's lives. But you still have bills to pay."

Insurance companies say they've had no choice but to raise rates because of increasing health care costs and the rising number of high-dollar lawsuits and claims in Mississippi and other states.

Mississippi has gained a national reputation for multimillion-dollar verdicts and settlements and attracted high-profile lawsuits involving tobacco, asbestos, HMOs and drug companies.

"The legal climate is one of several factors that has us where we are," said Mississippi Insurance Commissioner George Dale.