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Hospital leaders, OBGYNs warn call burden, malpractice risk and low volumes make rural labor & delivery fragile
Summary
Banner Wyoming Medical Center and practicing OBGYNs described operational steps (night laborist programs, locum tenens) taken to maintain obstetric coverage, noting high fixed costs and malpractice exposure reduce willingness of providers to practice in Wyoming, and urged recruitment and liability reforms.
Lance Porter, chief executive officer of Banner Wyoming Medical Center, and Dr. Susan Sheridan, a Casper OBGYN, told the committee that labor‑and‑delivery capacity is constrained by livability, spouse employment, call burdens and malpractice exposure.
Porter said hospitals use multiple costly strategies — locum tenens, rotating provider models and a night laborist program — to reduce on‑call burnout. "We spend a little over $3 million a year in establishing a night laborist program," Porter said, describing overnight staffing paid to protect local clinicians from continuous on‑call duty.
Dr. Sheridan, a private‑practice OBGYN, said malpractice risk and the lack of tort protections are a significant deterrent to recruiting and retaining specialists. She described how specialists frequently become the “backstop” when complications arise regardless of prior care, sometimes exposing their personal assets to litigation risk; that exposure, she said, makes physicians reluctant to cover mid‑level providers without clear training and supervision.
Committee members and panelists discussed potential levers — higher Medicaid reimbursement, loan‑repayment incentives, regionalized specialty centers and tort‑reform options — as part of a package to stabilize services and reduce the cost pressures that push hospitals to discontinue labor & delivery services.
Next steps: Hospital and clinician witnesses offered to provide quantitative estimates of locum tenens usage, night‑laborist costs and local malpractice premiums to help the committee weigh targeted incentives and whether regionalization of specialty services is appropriate.
