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Sunday, February 09, 2014


Malpractice Prevention

For years I have been of the opinion that the problem with medical malpractice was that there was too much of it and that prevention efforts would be more effective as a remedy than attempts to reform the legal system.

I now sense a slight movement in my direction.  The January issue of Health Affairs featured several articles on the subject.  The introductory column by founding editor John Inglehart reported that the designers of Obamacare considered including medical malpractice reform but decided that the political risks involved in getting in between the personal injury bar and the medical profession were too great.  They punted by including an appropriation of $25 million to fund a search for new approaches to medical liability and demonstrations of evidence-based patient safety programs.

Judging from the articles, most of the effort has been focused in the area known as Communication-and-Resolution.  Under this approach, medical errors are reported to the patient as soon as they become known and compensation offered for damages.  This is in contrast to past practices of sitting tight and fighting the matter out in court.

One article dealt with “safe harbor” legislation, which limits liability if the physician can demonstrate that “designated guidelines” have been followed.  In other words, if there is an established protocol for a procedure and it has been followed, the legal liability for adverse results will be reduced.  The authors doubted that the “safe harbor” approach would have much effect on malpractice settlements but speculated that following protocols could improve patient safety and, thereby, the number of adverse events leading to malpractice claims.

Prevention may not yet be popular but perhaps some people are starting to think about it.

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