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At least 1,369 records · Page 76Linked to original sources
PubMed1982

Pharmacists as a liability-reducing factor.

The potential for clinical pharmacy services to reduce the liability of institutions and the personnel who practice in them is presented. Several studies are reviewed that identify the characteristics of patients who are at a high risk of developing complications. Based on these data and data gathered on drug-related malpractice claims, pharmacists can concentrate their efforts on those patients who have the greatest liability implications to the institution. Pharmacists' efforts to reduce the liability of their institutions can also provide a justification for their clinical services.

Drug-Related Side Effects and Adverse Reactions↗
PubMedDate not supplied

Disease and cure: the professional liability crisis.

Many of the issues surrounding the so-called liability crisis are not in dispute. However, the parties involved to differ significantly in their approaches to solutions to the problem.

American Hospital Association↗
PubMed2005

Malpractice crisis and reform.

Medical liability coverage has become increasingly expensive and scarce since 2001, especially for obstetrics and other high-risk specialties. Physicians, whose own fees are constrained, see this as a crisis needing tort reform to cap payouts. Plaintiffs' lawyers fight caps; they blame insurance trends and call for stronger regulation of insurers and physicians. Doctors' arguments are somewhat better than lawyers' about insurance developments, but the huge tort reform battle wholly ignores the biggest problems--the medical system has too many preventable medical injuries, and the legal system fails to prevent them. It is time to try out better approaches, three of which are discussed in this paper.

Compensation and Redress↗
PubMed1991

Medical malpractice in California: recent trends and future prospects.

For many years, California court decisions and legislation have often presaged national trends. The expected debate over medical malpractice should be no exception. Thus, the court decisions on third party liability and the outcome of the MICRA negotiations are important both for California and as a harbinger of future national trends.

California↗
PubMed1998

Managed care organization liabilities.

While certain efficiencies and cost savings have been achieved, Managed Care Organizations (MCOs) have risk exposures never before considered. MCOs provide a number of services for their clients. Specifically, they are involved in credentialing, network development, utilization review, and the hiring and firing of physicians and other allied medical professionals subject to rather complex and detailed contractual arrangements. The insurance industry has responded to the increase in claim exposure associated with the aforementioned activities by providing any number of insurance products. Depending on the insurance provider, a number of different coverages are available. The final decision as to which coverage to purchase will be governed by the risks associated with a particular MCO, contractual protections, available cash flow, protections under federal and state laws. The point of this article is to apprise MCOs of the claims now starting to develop against MCOs as well as alternative insurance products that can be purchased in order to protect both the firm's assets as well as those of individual directors and officers.

Allied Health Personnel↗
PubMedDate not supplied

Introducing herbal medicine into conventional health care settings.

Herbal therapy is one of several holistic therapies gaining recognition within the health care community in the United States. As a discipline, herbal medicine is in its infancy regarding educational standards for credentialling, standardization, and regulation of products and clinical applications within this health care system. This article discusses professional considerations for midwives who are interested in integrating herbal healing into their clinical practices, and offers examples of how to incorporate herbal medicine into midwifery care. Resources for practitioners including books, newsletters, journals, courses, computer sites, and databases are presented. The author offers guidance for creating an herbal practice manual for the midwifery office as well as the hospital setting and for documenting herbal healing in the medical record. Collegial support, barriers to practice, liability, and insurance issues are discussed. A clinical applications section includes specific herbal formulas for preconception health, pregnancy-induced hypertension, gestational diabetes, and postdates pregnancy.

Certification↗
PubMed1996

Frustrating patient visits.

OBJECTIVES: This study, part of a national mail survey of dentist malpractice liability claims, reports the reliability and validity of a new 22-item instrument measuring frustrating patient visits. METHODS: The items were subjected to factor analysis and subscales constructed. Reliability was assessed using Cronbach's alpha. Validity was assessed by comparing subscale scores to self-reports of satisfaction and liability claims. RESULTS: Factor analysis revealed four subscales representing unpleasant feelings, lack of communication, compliance, and practice organization (alpha = 0.60-0.86). Compliance was the most important factor. Subscale scores were related to satisfaction with practice and the proportion of patient visits in the practice that were frustrating to the dentist. Dentists who reported frustrating patient visits as quite typical of their practices were more likely to have had a malpractice liability claim within the last five years. CONCLUSION: This instrument may be of value in detecting patient-dentist communication difficulties that are the precursor to liability claims.

Communication↗
PubMed1977

Recommendations for a national policy on poliomyelitis vaccination.

Declining numbers of adequately vaccinated persons, new data about the comparative safety and effectiveness of live, attenuated and killed poliomyelitis-virus vaccines, increased consumer awareness of adverse reactions and pressure from manufacturers seeking protection from liability were factors leading the Institute of Medicine to re-examine poliomyelitis vaccination programs. The relative merits of live and killed virus vaccines as immunizing agents were reviewed within the context of the 60 to 70 per cent level of poliomyelitis vaccination now reached in the United States. Until about 90 per cent of persons are adequately immunized, the continued use of live-virus vaccines for infants is recommended, with provision that certain categories of persons receive killed-virus vaccine. Vaccination with attenuated live virus of children 11 to 12 years old is suggested to reduce vaccine-associated disease when they become parents of vaccinated infants. Recommendations are made on education, research, liability and informed consent as they pertain to prevention of polyomyelitis.

Adult↗
PubMedDate not supplied

The patients' complaints system in New Zealand.

Since 1996 New Zealand has had a Code of Patients' Rights enforceable by complaints to an independent ombudsman. Patients are entitled to receive health care of an appropriate standard, to give informed consent, and to complain to a health commissioner about perceived malpractice. The commissioner investigates and reports on complaints, recommends practice changes by providers, is a gatekeeper to discipline by professional boards, and acts as a public advocate for patient safety. In this paper the current commissioner describes New Zealand's experience with the patients' complaints system and discusses the implications for the quality of health care.

Administrative Personnel↗
PubMed2007

[Evaluation of 157 arbitration procedures against maxillofacial surgeons handled by the arbitration office of the North German Medical Associations from 2000 to 2005].

Medical work is, just like any other profession, not always without error and even when no mistake has been made the patient may suffer health damages, because such are the unavoidable risks. Arbitration procedures of medical liability disputes can in particular cases resolve the individual conflict between physician and patient. The results of these arbitration procedures can point towards the main focus of diagnosis, patient accusations (patient dissatisfaction) and treatment errors. In the space of 6 years from 2000 until 2005 the North-German arbitration office handled 157 arbitration procedures against Maxillofacial surgeons. The decisions were statistically and casuistically analysed with regard to patient accusations, type of treatment error, frequency of treatment error, health damages that were caused and not caused by errors. Liability claims against a physician result only from those errors that have caused health damages to a patient. Not all errors cause damage automatically. Patient claims were found to be justified in 28% of all procedures and a recommendation for regulation was made to the physician's insurance. Maxillofacial surgery, with reference to the 20.4% of cases analysed, clearly represents less than the total average. The main focus of accusations raised by patients and also the main focus of the observed treatment errors are operative errors as a cause of sensitivity defects of the lower lip and the tongue, also of tongue damages and their associated taste defects. Parallel to the 20.4% of cases, which showed iatrogenic health damages caused by errors, 60.9% of cases showed patients had also suffered iatrogenic damages even though no medical errors had caused them.

Cross-Sectional Studies↗
PubMed1997

Liability issues in managed care.

The explosive growth in Managed Care Organizations as a mechanism for providing health care in the United States has generated an equal explosion in litigation and new legislation related to problems within this delivery system. Abuses have included the "gagging" of physicians from providing full disclosure of medical options for their patients, inappropriate denial of care, denial of specialty referral, false claims data, insurer insolvency, economic credentialling, deselection, financial disincentives to render care, and lack of appeal or grievance mechanisms. These issues and others have resulted in injuries to patients and damage to the patient/physician relationship. This article discusses some of the more dramatic litigated cases and endeavors to alert both physicians and patients to potential legal matters that should be considered before becoming involved within this structure.

Confidentiality↗
PubMed1999

Neurologic malpractice: the perspective of a patient's lawyer.

The definition of professional negligence is clearer than is commonly believed. Trials rarely involve lack of informed consent. In fact, the main dispute at a trial usually concerns what really happened. Causation, however, is the prime area of disagreement between the experts. The trial judge and the appeals court are required to set aside a jury verdict that is without proper legal basis, either regarding liability or the amount awarded. The best screen against unjustified lawsuits is a knowledgeable plaintiff's attorney aided by a competent expert review.

Causality↗
PubMed1986

Assessing your personal liability.

In days gone by, trustees of nonprofit corporations were unlikely to be sued. Today, however, trustees are no longer immune from such actions. Prudent trustees must be able to assess their personal liability as interpreted within their twin fiduciary duties of care and loyalty, and take appropriate steps to minimize their risks.

Financial Management↗
PubMed2000

Risk management: how doctors, hospitals and MDOs can limit the costs of malpractice litigation.

The concerns of doctors regarding their risk of malpractice litigation and the costs of indemnity premiums are resulting in calls for legal reforms to limit their liability. We do not believe these returns will be successful either practically or politically. Medical defence organisations often attempt to vindicate the doctor rather than settle the dispute--a strategy that might be morally satisfying to doctors but which is also more expensive than the approach taken by commercial insurers. Risk management--the activities required to minimise financial loss for hospitals and the doctors who work in them--is disorganised or absent in most hospitals. Hospital managers lack incentives for risk management because the costs of litigation do not come out of their budgets. The five mainstays of effective risk management are credentialling of medical staff, incident monitoring and tracking, complaints monitoring and tracking, infection control, and documentation in the medical record. The implementation of risk management activities in hospitals is the immediate responsibility of hospital management, not doctors.

Australia↗
PubMed1988

Professional liability: epidemiology and demography.

Because of increasing numbers of claims, professional liability for obstetrician-gynecologists carries an ever-increasing cost in dollars, emotions and time. The tort system in medicine is slow and inefficient in time and dollars going to injured patients compared to dollars supporting courts and lawyers. As a result of medical liability costs and a rising number of claims, patients are losing basic access to care, especially for pregnancy and are treated defensively when the receive care.

Defensive Medicine↗
PubMed1994

The value of liability in medical malpractice.

In this paper I estimate the strength of medical providers' incentive to avoid negligent medical care, taking account of the facts that many victims of medical malpractice do not file claims, many nonvictims do file claims, legal costs are high, and the legal system makes errors. Despite these problems, the negligence system creates a strong financial incentive for medical providers to avoid substandard care: The average cost of negligence is $135,000 per malpractice claim involving negligence and $3,500 per occurrence of negligent medical care. These substantial penalties suggest that if liability were abolished without adopting effective alternative sanctions for negligent medical care, the number and cost of medically caused injuries and deaths could rise sharply.

Consumer Advocacy↗
PubMed2005

Legal. Sharing the bill.

Beset by liability costs, doctors are asking patients to chip in and help pay for premiums. Critics of the maneuver worry that it crosses ethical boundaries and violates business practices.

Ethics, Medical↗