Effect of perceived malpractice insurance costs on the family practice career goals of medical students.

A questionnaire regarding perceived training and practice goals was distributed to 185 consecutive medical students interviewing for a 1986-87 internship at a community hospital in Southern California. Students were asked to estimate the dollar cost of professional liability insurance for a hypothetical family physician in the first year in practice performing low-risk obstetrics in Southern California. Family physician applicants who planned to do obstetrics estimated an initial average yearly premium cost of $16,406, whereas those not planning to do obstetrics estimated costs of $25,710 per year. Non-OB directed family practice applicants had a statistically significant (P = .0018) higher estimate of professional liability insurance costs. Average premium costs were obtained from three separate professional liability insurance carriers. Cost estimates of mature rates were not necessarily unrealistic, but student ignorance of significantly lower initial rates was widespread. The broad ranges of estimates suggested that subsets of students may be dramatically overestimating these costs. The data and direct questioning of students suggest that perceived insurance costs may affect training goals and career choices of medical students.