Ob-Gyn doctors consider leaving the speciality over litigation fears

Almost three-quarters of doctors in training in the areas of obstetrics and gynaecology would consider leaving the speciality because of the risk of litigation and negative media coverage, according to a new study. Picture: Pexels

Almost three-quarters of doctors in training in the areas of obstetrics and gynaecology would consider leaving the speciality because of the risk of litigation and negative media coverage, according to a new study.

A survey of 151 doctors in training said they felt the media did not have a positive impact on patients receiving care and unfairly represented the speciality, with the threat of litigation affecting retention and recruitment in the area.

The research, published in the European Journal of Obstetrics & Gynecology and Reproductive Biology, was carried out by medics and experts based in Cork University Maternity Hospital, the Rotunda, University College Cork and the Royal College of Physicians in Ireland. It was led by Dr Suzanne O'Sullivan, national director of Education and Training at the RCPI, and Claire McCarthy of the Department of Obstetrics and Gynaecology in CUMH.

Dr O'Sullivan said she undertook the research as she knew morale was being "hammered" and while she loves her work, she said: "Would I let my daughters do this? Realistically, I would not encourage them."

According to the study: 

Over the past decade, attrition rates among trainees in the speciality of obstetrics and gynaecology have reached up to 30%, with low morale, poor job satisfaction and the perception as a 'lifestyle unfriendly' speciality dominating the rationale."

It said there were "countless newspaper articles and social media content on medical cases visible at every juncture", with the speciality of obstetrics and gynaecology having "one of the highest rates of litigation of all medical specialities".

"On average, by the time an obstetrician/gynaecologist is over the age of 55, 76.5% will have had a medico-legal claim made against them," it said, adding that this was in the context of "the increasing patient expectation of a perfect outcome".

It is also a lengthy career pathway, with a minimum training time of 14 years required to achieve specialist certification in obstetrics and gynaecology.

As for the survey, the majority of respondents were women and had worked in obstetrics and gynaecology for less than five years.

"Media was perceived to have a negative impact on those receiving care by 86.7%," it said. 

The majority of respondents (94.1%) felt that the media representation of the speciality of obstetrics and gynaecology was unfair, with a large number also believing that midwives and nurses (72.6%) were negatively impacted by media."

"Additionally, 70.3 % of respondents felt that other medical specialities were represented in a more balanced way.

"The media was also perceived to have a role in propagating trainees’ fears of litigation and adverse outcomes (82.3 %)."

It found that just over one-third of trainees had been involved in a medico-legal case, with 54.8 % being named in a legal complaint. One interviewee said: 

The current litigation heavy, fear-inducing, undermining system makes me reconsider my life choice almost every day. Especially since I’m only starting, and I can see that worse is yet to come."

It found that nearly three-quarters of respondents regretted choosing the speciality to some extent and 71.5 % had considered leaving the speciality, with a third considering this option on a monthly basis.

Dr O'Sullivan said there were no easy answers to the issues but added: "A recognition of it is important. If we don't address this we will not have good doctors working in women's health any more."

The report is available here