THE EFFECTS OF MALPRACTICE INSURANCE ON CERTIFIED NURSE-MIDWIVES: The Case of Rural Arizona

Authors

  • Rena J. Gordon PhD

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    • Rena J. Gordon, assistant research professor and director of the Phoenix branch of the Rural Health Office of the University of Arizona's College of Medicine, 1983–89, has been involved in administration, research, and teaching. Gordon holds a doctorate and master's degree in medical geography from Arizona State University, as well as a master's degree in historical, social, and philosophical foundations of education. She holds a bachelor's degree in education from Wayne State University. Her areas of interest and teaching fields include health workforce supply and distribution, health professions education, health policy, research methods, and access to care for vulnerable populations.


  • Gordon is a current member of the American Public Health Association and the Arizona Public Health Association, having served on its board 1986–88. She is among the founding members of Arizona's primary care working partnership, a statewide coalition of professionals working in primary care. She was elected to serve to 1990 on the medical geography specialty group board of the Association of American Geographers and was selected in 1984 and continues to serve on the national steering committee of the annual Applied Geography Conference. She also is a member of the New York Academy of Sciences.

  • Her community affiliation include membership on the high-risk subcommittee of the March of Dimes Birth Defects Foundation 1988; St. Luke's Behavioral Health Center current trustee and member of the medical center's finance and audit committee, 1988–89; Camelback Hospitals' Counseling Center board 1982–88 and chair 1983–84. She has published a number of articles in scholarly Journals and has contributed chapters to four edited books and numerous state reports. Gordon has also published two health atlases.

5262 N. Woodmere Fairway, Scottsdale, AZ 85250.

ABSTRACT

This study of CNMs in rural Arizona indicated malpractice insurance has had a negative effect on the practice of nurse-midwifery. In 1987 a telephone survey was conducted to assess the effects on the practice patterns of Arizona's 21 rural CNMs, four of whom had had previous experience as licensed midwives. Results indicated 24% had been refused medical back-up by a physician. Although 10% were personally responsible for paying malpractice insurance premiums, they were not able to afford the cost and were going “bare.” Nearly 30% had changed their employment status from private practitioner to salaried employee, suffering a decrease in professional autonomy, flexibility of hours, quality of lifestyle, benefits, and income. Unless there are changes that result in lower malpractice insurance premiums or greater compensation and benefits, there likely will be a diminishing number of entries into an increasingly stressed profession.

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