DO - Ohio University College of Osteopathic Medicine

WWhen Mary Kruszewski, D.O. (‘88), began her practice in 1993, she paid $6,000 for insurance. This
year, her total malpractice insurance premiums exceed $107,000. Money, however, has not been
the only cost.
Skyrocketing costs of medical malpractice insurance spell ominous warnings for the future of
health care and physicians’ practices. Kruszewski is feeling it firsthand like so many
physicians, including other graduates of Ohio University’s College of Osteopathic
Medicine, who are speaking up.
Recent studies, surveys, papers and reports reveal in ever-increasing frequency how
the issue is impacting decisions physicians make, not only about how they treat patients
but where and even if they practice. The field of obstetrics remains especially hard hit.
An Ohio Department of Insurance report issued in February 2005 from a survey of
Ohio physicians concluded that the rising cost of malpractice insurance has significantly
impacted physician behavior and their future plans in the state. The survey included
answers from 1,359 physicians from across Ohio, 10 percent of whom were osteopathic
physicians.
Nearly four out of 10 respondents surveyed say they have retired or plan to retire by
2008 because of rising insurance expenses. “This finding is all the more sobering since
just 9 percent of the respondents were over the age of 64,” the report says.
Among osteopathic physicians, 11 percent say they planned to retire during 2005, and
15 percent say they planned to seek employment outside patient care.
Kruszewski, who practices in Du Bois, Pa.–a rural town in a state considered in crisis because of
high premiums–has been affiliated with several insurance companies and named a defendant in
lawsuits. “I’ve gone to two trials, both of which turned out in my favor,” she says. But her hefty
insurance premiums have affected how she practices, including ordering more tests, but as of
yet, she has not considered moving her practice or leaving patient care. “I’m not ready to
give it up because I like what I do,” she says.
A paper issued by the University of Michigan Health System warned that increasing
premiums are forcing many physicians to rethink how they practice, from reducing
staff to quitting patient care altogether.
“The hard cost of malpractice premiums is beginning to lead providers to drop or reduce
obstetrical services,” says Scott B. Ransom, D.O., senior author of a research paper published
in the June 2005 issue of the journal Obstetrics & Gynecology. “Our study shows that there
is legitimate reason for concern about patients’ access to obstetric care and prenatal care in
the future,” he warned.
“It is frustrating,” says Michelle Wright, D.O. (‘95), who moved her obstetrics practice
from Athens in rural Ohio to Sharon, Pa., for a variety of reasons, not the
least of which was yearly double-digit rate increases for her malpractice
insurance. Before relocating from Athens, Wright saw her premiums
jump from $18,000 to $65,000 in just two years.
“I can’t work without it; it’s a necessary evil.”
The primary breadwinner in her household, Wright took a job at a federally funded clinic in
western Pennsylvania mainly for economic reasons. Although Pennsylvania ranks close to
Ohio for some of the highest medical malpractice insurance rates in the country, her clinic is
covered under the federal court and tort system, keeping Wright’s insurance rates–and
any possible malpractice claims–somewhat moderated. With family ties and roots in western
Pennsylvania, the professional change made more sense.
Did malpractice insurance rates drive her out? Certainly in part. “Leaving Athens
was difficult, but I had to find a stable climate and not worry about a paycheck at the end
of the day,” Wright says.
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