The effect of malpractice insurance costs on family physicians' hospital practices.

One hundred fifty-two family physicians responded to a questionnaire about malpractice insurance from the Arizona Academy of Family Physicians. Physicians were asked whether they had limited their hospital privileges, by choice, because of the cost of malpractice insurance. One hundred thirty-eight (90.8 percent) of the physicians had a hospital practice. Of these, 36 (26.1 percent) reported that they had restricted their hospital practice because of the cost of insurance. Most commonly, restricted activities involved the discontinuation (38.7 percent of the 36 physicians) or limitation (22.2 percent) of obstetrical activities. Other physicians had eliminated general abdominal surgery (24.9 percent) and other surgical and radiologic procedures. The tendency of family physicians to limit their practices because of the cost of insurance premiums has important implications for health care in rural areas. It also may affect the scope and practice patterns of family physicians and other primary care physicians.