Profiles in leadership. Liability reform ... for physicians, it's the issue. David Selby, MD.
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This article examines the relationship between measures of severity of the professional liability "crisis" and physicians' responses, which may affect both costs of medical care and availability of care. Data from the American Medical Association's Periodic Surveys of Physicians are stratified by Census Region and specialty category. Claim frequencies, premiums and increases in premiums are calculated as indicators of the professional liability environment. Responses of physicians in each Region to questions on refusal cases, additional testing and fee increases due to liability considerations are then examined and compared with the liability environment to determine if there appears to be an association between liability environment severity factors and physicians' responses.
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The incidence of drug-related liability claims is discussed, and data from a number of studies in this area are reviewed. Drug categories that appear to cause the greatest problems are hormones, anticoagulants, adrenal steroids, and antibiotics. Focusing attention on these categories may enable the pharmacist to function as a liability-reducing factor in the institutional setting.
The President of The American Association of Neurological Surgeons discusses the three major problems of his year in office -- medical education, neurosurgical manpower, and professional medical liability -- and the attempts that are being made to solve them.
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The end of the last century saw the development in the United Kingdom of medical protection and defense societies. Their history, objects, growth, and scope are outlined. Reference is made to leading cases of medical malpractice and to the relevant statutes. The relationship between the protection societies and the National Health Service authorities is dealt with and a comparison made of the relative situations in the United States and United Kingdom. Finally, recent trends are examined and views expressed about possible future developments in this field which will be the subject of recommendations by a Royal Commission on Civil Liability and Compensation for Personal Injury which is now sitting.
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The past 15 years have not been easy for the doctors who manage Medical Liability Mutual. There have been many frustrations and setbacks, and at times the predictors of doom for MLMIC seemed to be correct. Despite all the difficulties, the board of directors has never deviated from its original basic principles: (1) to attempt to settle meritorious claims rapidly and to resist totally those claims without merit; (2) to invest funds with caution and prudence, while achieving the best possible return on that investment; (3) to reduce medical injury and enhance patient safety; and (4) to make every effort to change a system that does not serve the public and threatens our health care system. The next five years may well be even more hectic than the past 15 have been. We do not know the reasons for the recent apparent improvement, and the situation may well deteriorate again. It is to be hoped that major changes that will benefit the public as a whole will occur, and that in the future the concerns of professional liability will not consume as much of our time and resources as they do at present.