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PubMed2006

Bleeding Kentucky: unjust tort laws cause a hemorrhage of physicians to other states.

Access to medical care in Kentucky is increasingly being lost due to the unjust tort climate created by the state constitution and Jural Rights Doctrine. The primary mechanism underlying this loss of access is migration of physicians to other states with more reasonable tort statutes and lower liability premiums. Access to care in rural settings is particularly impaired. The dimensions of this effect are explored and other harmful effects on access to care in Kentucky are presented in this analysis.

Costs and Cost Analysis↗
PubMed1990

Tort reform recommendations for West Virginia.

Tort reform is central to resolution of the malpractice issue in West Virginia. This article examines tort law and malpractice as viewed from federal and state levels and compares general liability costs in states. The article also looks at national trends in malpractice awards; at state initiatives in tort reform; and finally extracts what works and what doesn't. It presents strategies for legislative approaches to tort reform.

Insurance, Liability↗
PubMed1990

Hospital complaints procedures and no fault liability.

This article considers the extent to which it would be feasible to introduce 'no fault liability' for medical accidents, while the present system for dealing with complaints procedures remains in force. What is needed, it is argued, is a genuinely independent review process for dealing with complaints about clinical judgments.

Defensive Medicine↗
PubMed2005

Professional liability claims and Central Association of Obstetricians and Gynecologists members: myth versus reality.

OBJECTIVE: The purpose of this study was to survey members of the Central Association of Obstetricians and Gynecologists about professional liability claims. STUDY DESIGN: A survey was mailed to Central Association of Obstetricians and Gynecologists members regarding medical liability experience. RESULTS: Of the 897 surveys mailed, 73% were completed. The responding 658 clinicians had been in practice for 17,136 years and had 1507 closed claims. The respondents had a claim every 11 years of practice and a trial every 69 years. Matched for years of practice, a case control comparison indicated that the litigation is significantly lower for female physicians (1.5 +/- 1.8) than for male physicians (2.2 +/- 2.0; P = .019) although the mean cases that were dropped or dismissed were higher for men (1.3 +/- 1.7 vs 0.8 +/- 1.4; P = .022). However, the mean number of trials, defense trial verdicts, and the settlement amounts were similar for both genders. CONCLUSION: We found that professional liability claims are uncommon and that the gender of the obstetrician-gynecologist influences the litigation profile.

Adult↗
PubMed1987

Malpractice in Pennsylvania.

The author presents facts about professional liability. Although the article discusses professional liability of physicians in Pennsylvania, its scope is larger and offers general legal principles germane to dental practitioners throughout the United States. The author stresses that the advice of counsel should always be sought whenever legal problems arise.

Dentistry↗
PubMed2001

Medical malpractice liability and its effect on prenatal care utilization and infant health.

In this paper we conduct the first national evaluation of the effect of malpractice liability pressure, as measured by malpractice premiums, on prenatal care utilization and infant health. Our results indicate that a decrease in malpractice premiums that would result from a feasible policy reform would lead to a decrease in the incidence of late prenatal care by between 3.0 and 5.9% for black women and between 2.2 and 4.7% for white women. Although, we found evidence that malpractice liability pressure was associated with greater prenatal care delay and fewer prenatal care visits, we did not find evidence that such pressure negatively affected infant health.

Black or African American↗
PubMed1979

[Liability claims for prosthetic treatment].

Liability claims of 153 patients receiving prosthetic treatment were organized according to damage and were discussed on the basis of the known decisions and judgements of the courts.

Crowns↗
PubMed1991

Malpractice in physical medicine and rehabilitation. A review and analysis of existing data.

Malpractice issues are a concern for physiatrists, but little information specific to the field is readily available. Medical, legal and economic literature provide profiles of physicians involved in malpractice claims and the types of clinical situations in which suits are brought in general but no specifics on physiatry before 1973. Nine malpractice studies were examined to characterize malpractice claims in the field. The physiatrist's risk relative to other specialties could be studied specifically in three studies of 197,230 claims reported from 182 liability carriers. The number of claims brought was one-third of that predicted relative to the size of the specialty. The number of paid claims was one-fourth of that predicted, and the total dollar indemnity was one-fifth of that predicted. The average indemnity per claim rose 770% over a decade, from $12,000 in 1978 to $92,000 by 1988. Dollar losses were significantly lower than expected compared with other specialties classified by insurance carriers to be of similar risk such as neurology, pediatrics and general/family practice and one specialty considered to be very low, dermatology. Losses for physiatry were more similar to that of the very low risk category specialties such as psychiatry and pathology. One-fourth of successful claims resulting in one-third of the total dollar losses were associated with physical therapy. Cases involving femoral fracture comprised 14% of paid claims accounting for 34% of the total losses. Conditions of the vertebral column accounted for 35% of monetary losses and medication error accounted for 14% of monetary losses. The claim incidence was very low as one study of 71,130 claims identified none against physiatrists, with no more than 110 claims in any single study.

Insurance, Liability↗
PubMed1994

Medical liability, product liability, and the question of tort reform.

Physicians have identified malpractice reform as their first priority during the recent flurry of national reform initiatives. Their focus on malpractice, however, tends to obscure the relationship between malpractice and the systemic problems wracking our healthcare delivery system. Because malpractice has an impact on all three foci of comprehensive reform--quality, cost, and access--it is reasonable to expect healthcare reform to include some manner of tort reform. However, it is important to realize the tangential nature of the relationship and keep the focus of reform on the underlying issues of system reform. The authors define the areas of physician liability under tort law (both malpractice and product liability), point out the misperceptions that inform physician behavior, and review the individual reforms proposed. They identify the stakeholders and their positions on each proposal, while imploring a cooperative, systemwide approach to tort reform.

Health Care Costs↗
PubMedDate not supplied

Risk management: an analysis of technologist liability.

Should radiologic technologists be concerned about the risk they may or may not have in being named as a defendant in a medical negligence suit? The risk is analyzed in terms of possibility and probability of suit. Suggestions are made concerning the management of that risk in the light of court decisions, trial tactics, and legal doctrines.

Allied Health Personnel↗
PubMed1996

Drafting a sound physician employment agreement.

Group practices that employ physicians on a contractual basis face a number of risks. Among these risks are the possibility of employee-physicians engaging in competitive activities; the practice's potential liability for outside services its physicians may perform; and the possibility of breaches of patient and practice confidentiality. By drafting employment agreements that include provisions that minimize such risks, practices can strengthen their market position and protect themselves from potential losses.

Catchment Area, Health↗
PubMed1987

Tort versus no-fault: compensation and injury prevention.

The tort system, as a means of compensating the victims of injury, no longer fulfills the purpose for which it was intended. The attempt to achieve a fair and rational method of compensation, especially in the areas of medical malpractice and products liability, has been displaced by a form of litigation lottery which permits attorney's fees to divert great amounts of money from victims in needs. A reform of this system is much in need and long overdue. Following a discussion of these and other problems with the tort system, this paper will present a method for ensuring the prompt settlement of most personal injury claims through payment of the victim's net economic losses. The parallels to no-fault auto insurance and workers' compensation are examined and attention is given to the likely impact of this proposal on the conduct of potential injurers and victims.

Consumer Product Safety↗
PubMed1992

Creating outcomes-based systems for quality and malpractice reform: methodology of accelerated compensation events (ACEs).

Today's unduly erratic and expensive payment system for medical malpractice undercuts its own goal of compensating victims. Its lack of scientific legitimacy hampers its other main goal of deterring injury. Reform is needed, but most "tort reform" fails to make fundamental changes and does not promote quality of care. Alternative systems using "Accelerated Compensation Events" (ACEs) offer a better way to replace or improve judicial resolution of liability claims as well as independent, quality-oriented reform. ACEs do not cover all injuries, just classes of adverse outcomes that are normally avoidable, given good care. This article explains the scientific methodology of ACE development and the benefits of ACE-based reforms.

Humans↗
PubMed1995

The legal status of clinical practice parameters: an updated annotated bibliography.

In response to extensive speculation about the probable liability implications for health care providers of the formal creation and dissemination of explicit practice parameters of guidelines, I prepared several years ago an annotated bibliography of emerging literature on that topic (1). Since preparation of that catalogue, little meaningful clarification of these issues has emerged from the courts, legislatures, or regulatory agencies.

Insurance, Liability↗
PubMedDate not supplied

Tort reform and medical malpractice: a risk management leader's analysis.

In summary, the United States Tort System, with malpractice actions based upon the law of negligence, remains a driving force in affecting health care delivery costs. The reforms and attempted reforms under consideration by legislative branches nationwide also play a key role in this endeavor. Yet, tort reform alone is not the answer. Reducing the initial occurrence of medical injury remains the ultimate method of easing the current liability crisis. Health care providers must assure the delivery of quality care to their patients or face consequences in areas of licensure qualifications, license renewal, professional discipline, suspensions, probations and fines. An effective quality assurance program that provides measurable results should be a priority for all health care providers. Administration, medical staffs and all departments within a health provider's facility must work together to achieve quality patient care. Proven risk management programs, combined with similar cooperative efforts by health care companies, physicians, attorneys, insurance companies, state regulatory agencies and the federal government, will prove extremely effective in controlling future health care delivery costs.

Hospitals, Proprietary↗
PubMed2002

[General medicine malpractice cases].

During the last five years legal proceedings about alleged treatment mistakes in Germany more than doubled. Using a standardized questionnaire about legal proceedings in general medicine, involving liability, an anonymous survey with the members of the workgroup law medicine of the Deutsche Anwaltsverein (DAV) was carried out. The questions included among other things the number and reasons of legal proceedings involving liability. Of 322 questioned lawyers who focused on medicine law 122 (38%) answered. 69.9% of the lawyers think poor information is the main reason for legal proceedings involving liability in general medicine. Three disease groups were mentioned more frequently: diseases of the digestive system (22 mentions), diseases of the circulatory system (21) and diseases of the muscles, skeleton and connective tissue (15). 40 mentions of injections as treatment mistakes build the most frequent therapeutic reason for legal proceedings involving liability. Most of the lawyers think that guidelines do not reduce legal proceedings involving liability. The most common reasons for legal proceedings involving liability such as poor information and insufficient medical examination may point out that the budgetary standards for consultation cannot guarantee enough time for firstly giving a sufficient individual information to the patient and secondly for developing a decision satisfactory for both sides.

Family Practice↗
PubMed1982

The use of prescribed medication in the schools: a status report on the state policies and guidelines.

The increased use of medication in school systems and the broadened responsibility of educators for the medical/health related needs of students have created a number of concerns. Examples of issues facing school personnel include liability risks, designation of persons to administer medication and drug management procedures to safeguard students receiving drugs during the school day. A review of the literature indicates a paucity of legal documents and policies regarding the use of medication in schools. This study investigates existing state laws, regulations, attorneys general opinions and guidelines concerning the management of medication in the school system. The results show that: (a) the majority of states do not have legislation, regulations or other directives with force of law; (b) major policy statements found most often in legal documents were designated persons permitted to administer drugs, physician's approval, parent's authorization and liability; and (c) many states have apparently deferred policy making to the schools, and have developed state department guidelines to assist local school officials. The major policy and guideline statements may be considered as recommendations for adoption by states wanting to establish responsibility for policy making at the state and local school level.

Drug Prescriptions↗
PubMed1998

Understanding managed care organizations' liability exposure.

Managed care organizations can minimize their liability exposures by staying informed about industry changes and by implementing a comprehensive risk management program. Typically, managed care organizations face three general exposure areas: directors and officers liability (e.g., exposures associated with nonclinical aspects of an organization); errors and omissions (e.g., exposures involving the day-to-day operations of managing the health care received by an organization's members); and financial loss, or provider excess (e.g., exposures that occur when certain catastrophic events expose the organization to financial peril).

Credentialing↗