Doctor’s liability is a big issue

Extracts from the encyclopedia compiled

By

DR. MRS. Meenal Kumar, M.D. senior gynecologist and menopause consultant, sector 20 civil dispensary, Chandigarh

&

DR.R.KUMAR M.S., OPHTHALMOLOGIST AND HEALTH COLUMNIST, 232, SECTOR 16, CHANDIGARH

Five reforms are essential to solve the medical liability crisis. The following proposals have come from USA.

•  First, a new medical tort and liability insurance system modeled after the one enacted in California, which has stabilized that state's system and maintained open access to courts for all patients.

1. Liability rates up 168 percent in California compared to national average of 420 percent.
2. Cost of settlements in California 53% lower than national average.
1. California cases settled in average of three years vs. national average of four.
2. Injured patients compensated more quickly in California than in any other state but Minnesota.
3. California reforms have lowered health care costs by estimated six percent - saving patients $6 BILLION every year on health care.
4. California now has a system working for benefit of patients - not trial lawyers.

B.  The second major reform is; It is Not fair for a doctor not in same specialty to be an expert witness in a malpractice case - just as it does not make sense for a plumber to evaluate the work of an electrician. Expert witnesses should be:

• Practicing same specialty in Maryland;
• Board certified;
• Specially licensed by State;
• Subject to peer review and subject to sanctions in the event of false testimony.
• Court brings witnesses to eliminate bias or incentives to give certain testimonies.

C. Third, stronger "Good Samaritan" protections are called for.
Don't punish doctors for donating care to critically ill, often uninsured patients.
Make volunteer care economically feasible to keep retiring doctors practicing.
Establish immunity for ER/trauma care officials who cannot get patient consent.

4. Fourth, a Health Care Court can block frivolous lawsuits from making it to court and further cut down on legal costs.

1 This reform is already working in Indiana.
2 System evaluates merits of malpractice claims before they go into the legal system.

2. One attorney and three health care professionals define standard of care and decide whether it has been violated.

5. Fifth, medical liability insurance reform that includes accountability, transparency and a healthy respect for competition among providers of malpractice coverage to Maryland doctors.
   1. Accountability means requiring Med Mutual to disclose its rate setting practices to doctors - because it's "doctor-owned."
   2. Transparency means letting doctors know about Med Mutual's practices, full investigatory authority for the Maryland Insurance Commissioner and full disclosure to any legislative body that seeks oversight without throwing up protections that information is proprietary, etc.
   3. Competition means looking into the potential or actual conflict of interest of MedChi and Med Mutual in allowing commissions to be paid to Med Mutual. Competition also means possible changes in the criteria at the Maryland Insurance Administration to allow more companies full access.

"Why should I care if doctors get a pay cut or loses his job or is hauled up in a court of law?" a patient recently asked me. Therein lies the delicate dilemma physicians face today.

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