Obstetricians in Bermuda have faced some of the highest malpractice insurance premiums in order to offer their services.In fact obstetric care was in jeopardy of becoming exorbitantly expensive had the Bermuda Hospitals Board (BHB) not come to the rescue. Body & Soul has learned that premiums for private obstetricians have steadily increased from about $28,000 12 years ago to about $200,000 today.While we tend not to consider ourselves a litigious community, medical professionals do face lawsuits in Bermuda. Malpractice insurance is therefore a must and all practising local physicians do have at least one policy to cover them in this area.Many use the Medical Protection Society (MPS) in the UK for this purpose. MPS is not an insurance company. It is described on its website as “a discretionary, mutual, non-profit organisation”. It has no shareholders, which it says enables it to make decisions which support good practice in the medical and dental professions, and are not simply made for “financial expediency”.About four years ago, malpractice insurance with MPS rose significantly for local obstetricians causing them to actively seek alternatives. MPS was charging over $100,000 a year for a premium with plans to increase that premium over four or five years to a whopping $350,000 to $400,000 a year.That’s significantly higher than most other medical professionals have to pay (although cosmetic surgeons pay a premium of $110,420 a year). The MPS rates for 2012 reveal physicians in “super-high risk” categories of neurosurgery, plastic and reconstructive surgery and spinal surgery, pay a yearly premium of $44,180. Doctors in the “very high risk category” which includes bariatric surgery, gynaecology, hand surgery, trauma and orthopaedic surgery, pay a yearly premium of $31,960.Part of the reason premiums are so high for obstetricians is that people can sue up to the age of 21 for problems that may have happened during pregnancy and/or delivery. This long-time period increases the risk of a suit happening.On average 800 babies are delivered on Island each year. But local obstetricians have said this volume is not enough for them to have been able to absorb the increased cost.“Local obstetricians were seriously having to consider ceasing their local service,” said Dale Wilmot chief of obstetrics for the BHB. “The only other alternative would have been to increase fees to a level that would be prohibitive for most people.”Practitioners said they contacted insurance companies locally and overseas in a bid to find a new provider, but this was not fruitful. Talks with Government and former Health Minister Nelson Bascome were undertaken in an effort to satisfy MPS on a reduction of risk. Local practitioners said they encouraged Government to amend some laws in an effort to meet demands of MPS.In the end, King Edward VII Memorial Hospital’s chief of staff, Donald Thomas, offered the best solution. Local obstetricians became employees of KEMH and received malpractice insurance under their umbrella through local insurer, Kitson & Company.Dr Wilmot explained further: “Local obstetricians joined BHB as employees so that we could maintain an obstetric service in Bermuda. Although this development was driven by the malpractice insurance, there are benefits to service consistency and patient safety possible with local obstetricians working as an employed team.”