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PubMed2005

Medical professional liability insurance and its relation to medical error and healthcare risk management for the practicing physician.

PURPOSE: To review the history and current issues surrounding medical professional liability insurance and its relationship to medical error and healthcare risk management. DESIGN: Focused literature review and authors' experience. METHODS: Medical professional liability insurance issues are reviewed in association with the occurrence of medical error and the role of healthcare risk management. RESULTS: The rising frequency and severity of claims and lawsuits incurred by physicians, as well as escalating defense costs, have dramatically increased over the past several years and have resulted in accelerated efforts to reduce medical errors and control practice risk for physicians. Medical error reduction and improved patient outcomes are closely linked to the goals of the medical risk manager by reducing exposure to adverse medical events. Management of professional liability risk by the physician-led malpractice insurance company not only protects the economic viability of physicians, but also addresses patient safety concerns. CONCLUSIONS: Physician-owned malpractice liability insurance companies will continue to be the dominant providers of insurance for practicing physicians and will serve as the primary source for loss prevention and risk management services. To succeed in the marketplace, the emergence and importance of the risk manager and incorporation of risk management principles throughout the professional liability company has become crucial to the financial stability and success of the insurance company. The risk manager provides the necessary advice and support requested by physicians to minimize medical liability risk in their daily practice.

Delivery of Health Care↗
PubMed1995

[Telemedicine and medical responsibility].

Dealing with telemedicine including telediagnosis and teleassistance, we have to assess the legal and ethical components of medical liability. With medical telediagnosis, the dispersion of medical liabilities is the main risk: how can we ensure a clear identification of the medical liabilities involved in case of damage? From a legal point of view, the dispersion of the liabilities is not authorized and the use of telediagnosis must ensure a total transparence. As we cannot presently establish a separate amount for a medical act based on the cost of the image records and the cost of image interpretation, it is necessary to establish a contract. Today the most convenient is a contract similar to the usual contract between laboratories which implies that the liability belongs to the practitioner who has received the sample. In the future, other legal obligations may appear when telediagnosis develops. Indeed, the increase in reliability due to telediagnosis could be normally required as a part of the medical obligation to use the latest technology. On the opposite, the excessive use of teleassistance, when there is neither emergency nor medical isolation, is dangerous because it affects the integrity and the quality of the medical act. A medical practice without any clinical examination of the patient is contrary to medical ethics.

Computer Communication Networks↗
PubMed2005

Expert witness malfeasance: how should specialty societies respond?

There is little doubt that severe distortions are present in the legal adjudication of professional medical liability. The medical expert witness plays an important, often crucial, role in the medical liability cases. The expert assesses medical information, interprets and explains medical uncertainty, medical research, and customary practice for a nonscientific jury, and offers an expert level opinion as to whether the standard of medical care was met. When expert witnesses not merely disagree, but misrepresent data, misrepresent their background credentials and expertise, and offer egregiously false testimony, the legal process is violated and verdicts may be distorted. Many medical and surgical professional organizations, including the American Medical Association, have adopted programs that provide guidelines for members who serve as medical expert witnesses in professional liability cases. The American Association of Neurological Surgeons (AANS) was the first to develop a program to deal with irresponsible expert witness testimony. That program involves a published code of conduct, which outlines the expectations of society regarding expert witness testimony, and potential consequences for noncompliance. To date, the AANS program has withstood court challenge, in fact, has received judicial praise. Other medical societies, including the American College of Gastroenterology (ACG), have reviewed efforts by others and are considering developing their own programs.

American Medical Association↗
PubMedDate not supplied

The cost of medical professional liability.

The high cost of medical professional liability is a source of growing concern among policymakers, health care consumers, and the medical profession. While the concern is widespread, to date there has been little quantitative evidence on the overall economic impact of the problem. Utilizing data from the American Medical Association's Socioeconomic Monitoring System, the impact of medical professional liability (PL) on the cost of physicians' services has been estimated employing two different methods. Both estimates indicate that the costs of PL are substantial. In particular, the two methods yield estimates of the total cost of PL in 1984 of $13.7 and $12.1 billion, respectively--or approximately 15% of the total expenditures on physicians' services. Furthermore, increased costs associated with PL from 1983 to 1984 alone are estimated under the two methods to have accounted for 63% and 57%, respectively, of the increase in expenditures on physicians' services. These costs include PL insurance premiums, costs of practice changes made in response to increasing PL risk, and costs of incurring claims that are not covered by PL insurance.

American Medical Association↗