OAKLAND — The state Department of Health and Mental Hygiene has given its blessing to Garrett County’s possible short- and long-term solutions to its OB/GYN crisis.
Currently four general practitioners provide all OB/GYN services in the county, including delivering babies. But they deliver so many babies — an average of 273 per year from 2006-08 — that they’re required by medical malpractice insurance guidelines to pay the higher insurance rates of OB/GYNs.
Until Jan. 1, the doctors received state subsidies to make up most of the difference between the general practitioner and OB/GYN insurance rates. But when that provision expired, officials were left scrambling for a new solution to ensure that obstetric services remain available to county residents.
In a letter to Sen. George Edwards, DHMH Secretary John Colmers said his department will assist the Garrett County Health Department if it becomes necessary for the county to set up its own maternity clinic in fiscal 2011, which begins July 1.
Officials have been looking into that option for months, according to Garrett County Health Officer Rodney Glotfelty. If that plan goes into effect, the county clinic would serve women whose primary or secondary health coverage comes from Maryland Medicaid. In recent years, about 59 percent of in-county deliveries were to women in that category.
Under the plan, as employees of the clinic, the four doctors could continue to provide care to those women and would therefore be eligible for the same liability protections as state employees. That would in turn allow the doctors to carry only the malpractice insurance required of general practitioners.
The doctors could also continue caring for women with private insurance through their private practices, as long as their numbers of privately insured deliveries don’t exceed the OB/GYN insurance threshold of 30 per year.
But Glotfelty said the county clinic option has several shortcomings, one being the cost to the county, and another the restrictions it would place on the doctors.
“It really limits the doctor’s practice, because they can only see 30 patients per physician,” he said. “Ultimately the better solution is to have Mountain Laurel establish an obstetrics program.”
That seems to be the DHMH perspective as well. The letter acknowledged that negotiations are under way between the doctors and Mountain Laurel Medical Center, a federally qualified health center in Oakland, to establish a permanent relationship that would extend federal tort protections to the doctors. But it stated that a possible arrangement “will take some time to implement, as it will require federal approval.”
Glotfelty said he doesn’t have any idea of a timeframe for those negotiations, and isn’t sure of what the end result will be. But he said he’s hopeful that a permanent solution can be worked out with Mountain Laurel soon enough that the county won’t need to open its own clinic.
Both Edwards and Delegate Wendell Beitzel plan to meet soon with representatives of Mountain Laurel on the issue. In a prepared statement, Beitzel praised the four doctors for continuing to perform admirably in an uncertain situation.
“Though this may be a solution on the horizon, both Senator Edwards and I will work hard to ensure that there is no disruption in the services provided to the mothers of Garrett County,” he said.
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