In Bronx, Obstetricians May Find Work Inspiring, and Careers Hindered

New York Times
Friday, December 15, 2017

By Vivian Wang

Dr. Mark Rosing, the chairman of obstetrics and gynecology at St. Barnabas Hospital in the Bronx, is clear with every job candidate he interviews: Once they join his department, they may have trouble leaving.

That’s partly because, he tells them, it is an inspiring place to work. The staff is passionate, the benefit to patients in the city’s poorest borough visible.

But it’s also because they may not be able to get hired anywhere else.

“Providers are very, very resistant or hesitant to come practice here, because in many cases, it can literally destroy their careers,” Dr. Rosing said.

The difficulties of being an expectant mother in the Bronx are well known: A 2016 report found that the borough consistently had the city’s highest rates of life-threatening complications during childbirth, with those dangers arising there in 296 of every 10,000 deliveries between 2008 and 2012, compared to 230 citywide.

Less frequently discussed are the effects on obstetricians practicing in the Bronx. High-risk pregnancies are by definition more taxing for physicians. And the heightened likelihood of something going wrong may in turn increase the likelihood of a malpractice lawsuit. …

Patient advocates defended lawsuits as a crucial tool for holding doctors accountable. Joanne Doroshow, the executive director of the Center for Justice and Democracy at New York Law School, which opposes efforts to limit malpractice claims, said the state had already erected “enormous obstacles” to malpractice suits, even without payment caps. She said the number of claims originating in New York suggested an inordinate amount of subpar care, not a more litigious patient base.

Michael Kaplen, a New York City malpractice lawyer and member of the American Board of Professional Liability Attorneys, said that if doctors were choosing not to practice in the Bronx, financial considerations, not malpractice claims, were most likely the reason.

The high numbers of patients in the Bronx who rely on Medicare and Medicaid might drive some physicians away, Mr. Kaplen said.

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