John H. Niles Jr. has wanted to be a doctor in his hometown since his senior year at Spingarn High School in Northeast, but rising medical-malpractice insurance rates have forced him to leave the city, he said.
"My thrust was always to practice in the inner city," said Dr. Niles, 67, chairman of the Medical Society of the District of Columbia's Medical Liability Reform Task Force. "That is where I grew up, and you have so many high-risk people, and I thought that is where I could use my skills."
Dr. Niles, who will have been an obstetrician/gynecologist for 34 years in July, said he referred more than two dozen pregnant patients to his colleagues in the District before he moved to Greenbelt last May.
His patients "weren't very pleased," he said. "Many of them asked, 'Can't you just wait until you deliver my baby?'"
The District has lost about 60 practicing obstetricians over the past two years, the medical society said. Doctors say rising medical-malpractice insurance costs are driving them out of business.
President Bush has made medical-malpractice reform a top priority, and Maryland and Virginia enacted reforms this year.
Last week, Mayor Anthony A. Williams submitted legislation that would limit jury awards in malpractice lawsuits. The Health Care Reform Act of 2005 would not cap economic damages but would limit most pain-and-suffering payouts to $250,000 against physicians and $500,000 against hospitals.
Dr. Niles said he saved 50 percent in malpractice insurance premiums by dropping his obstetrics practice and relocating .
The National Capital Reciprocal Insurance Co., the largest insurer of D.C. physicians, said premiums for many obstetricians rose from $122,323 last year to $139,528 this year.
The Medical Society of the District of Columbia projects that insurance premiums will increase to $235,113 in 2010.
Dr. Niles would not say how much he pays for malpractice protection and how much he earns from his gynecological practice, saying trial lawyers find such information useful in planning lawsuits.
He has faced three medical-malpractice lawsuits, which his insurance company settled even though he thinks he could have won them in court, Dr. Niles said.
He said 78 percent of obstetricians average 2.6 lawsuits over a 15-year period, adding, "It has just been shown that urban juries are more financially sympathetic."
The District needs malpractice insurance reform to protect the remaining 80 obstetricians who are practicing in the city, said K. Edward Shanbacker, executive vice president of the Medical Society of the District of Columbia.
As a part of the American Medical Association, the Medical Society of the District of Columbia has more than 2,400 member physicians and advocates for health-related issues in the city.