Obstetricians call it quits

Obstetricians are leaving private practice in droves, citing stress and the threat of legal action as reasons for the move.

Fellows of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists carried out a survey of more than three-quarters of college fellows earlier this year.

Within five years, it was expected that only 8 per cent of New Zealand's 188 specialist obstetricians and gynaecologists would be running a full-time private practice. Today's figure is 18 per cent.

"The drift away from private obstetrics appears to have two principal reasons - the need to reduce the stress on these doctors' lifestyles, and the ever-present threat of legal action if there is not a perfect outcome," the college said.

College president Dr Andrew Child said the survey showed that, in general, Australian and New Zealand gynaecology and other sub-specialty services provided by college fellows were in good shape.

But many doctors were working long hours and the long-term picture for obstetrics was "troubling".

Just 18 per cent of those surveyed practised private-only obstetrics, with a further 31 per cent practising both private and public obstetrics.

Fifty specialists had quit private practice in the past three years. But some of those had a mixed private-public practice before they abandoned private deliveries.

Dr Child said expectant mothers would have to rely increasingly on strained public hospital services, private midwives, general practitioners or a dwindling number of private specialists.

College vice-president Kenneth Clark said lifestyle issues appeared to be the most significant factor.

"The stress of being on call 24 hours a day, seven days a week, is not appealing to the emerging generation of specialist obstetricians, and the older ones have had enough," he said.

"It seems many doctors can no longer tolerate making great personal sacrifices, but still practice under the growing threat of being sued and tied up in the courts for years when the outcome is anything less than ideal."

Thirty-four per cent of college fellows were female and needed time to devote to their own children and families.

It was becoming increasingly difficult to attract trainee obstetricians and a significant number of trainees came from overseas. And Dr Clark said those obstetricians were not necessarily looking for long-term careers in New Zealand.

"So while we have significant numbers abandoning private practice, we have a real problem producing new specialists from the trainee systems."

Dr Clark was concerned what services would take over from private-practice obstetricians. He questioned whether public hospitals would be able to cope with the extra demand.

"Is there a plan for more services in public hospitals?"

Dr Clark said more group practices, where several specialists shared responsibility for coverage and care, were needed. Many of those who were quitting had been working at sole-practices.

The median number of hours worked in a week by those surveyed was 51, while more than half the specialists had at least one night's sleep interrupted by the needs of a patient.

Survey findings

Faced with long hours and legal threats, many obstetricians are quitting private practice.

A survey found that in five years as few as 8 per cent of New Zealand's 188 specialist obstetricians and gynaecologists would be running a full-time private practice.

The trend has implications for expectant mothers, who will need to rely increasingly on strained public hospital services, private midwives, GPs or a dwindling number of private specialists.

- NZPA