Patient-held Medical Malpractice Insurance

his_dudeness

http://www.irishtimes.com/news/health/government-urged-to-postpone-extension-free-gp-care-to-under-6s-1.2002779

Buried at the bottom of this article from the Irish Times is some comments from Jimmy Sheahan, founder of the Blackrock Clinic. He said similar at the Sir Peter Freyer Surgical Symposium in Galway in September. Essentially, he's suggesting that patients should be the ones to hold medical malpractice insurance, not the doctors exclusively.

Personally, I find it quite an interesting idea, wondering what the boards.ie community feel about it.

Harold Finchs Machine

The Patient has insurance incase hurt by Doctor?

Did he buy shares in Aviva or something?

ravima

This make no sense at all. The one who causes the injury should have the insurance, not the injured one.

Harold Finchs Machine

Yea, it's bullsh1t.

I'm lost as to how anyone but the Insurer wins.

Get hurt through no fault of your own, claim off yourself, pay 3 times as much for the privilege next year.

Ryder

Harold Finchs Machine wrote: »

Yea, it's bullsh1t.

I'm lost as to how anyone but the Insurer wins.

Get hurt through no fault of your own, claim off yourself, pay 3 times as much for the privilege next year.

It's not terribly far off. Taking traffic as an example., if you cause an accident, you pay. In medical malpractice, if you cause injury by act or ommission, you pay. What is currently happening though is that if a patient suffers a known potential complication, they still sue even though it's not the fault of the surgeon. Even if the case looses money is spent on a costly defence. This drives insurance up and is currently restricting the access of patients to care.

Broadening the insurance vase may help to drop premiums......not terribly far off an idea

Harold Finchs Machine

Ryder wrote: »

Broadening the insurance vase may help to drop premiums......not terribly far off an idea

Better odds of winning euromillions than this happening.

Not a chance.

Only 1 winner - insurance companies.

drkpower

Does the insurance cover against an adverse outcome after medical treatment or an adverse outcome as a consequence of negligence?

Harold Finchs Machine

drkpower wrote: »

Does the insurance cover against an adverse outcome after medical treatment or an adverse outcome as a consequence of negligence?

Negligence.

Xeyn

Surely the logic is shared insurance might lead to decreased premiums on medical protection which leads to reduced prices for patients as insurance premiums are a driving factor in at least private practice charges? Or am I being naive?

Harold Finchs Machine

Xeyn wrote: »

Surely the logic is shared insurance might lead to decreased premiums on medical protection which leads to reduced prices for patients as insurance premiums are a driving factor in at least private practice charges? Or am I being naive?

You think Doctors will lower their prices if their premiums were lower?

Xeyn

Yes.

Harold Finchs Machine

Who would force that change? Cuz it sure as hell wouldn't be voluntary.

drkpower

If medical negligence is a pre requisite, this proposal would present a few difficulties.

What if the patient wants, in addition to compensation, an admission by the doctor that they are liable/in the wrong. Presumably the patients own insurer can't make an admission of liability on behalf of the doctor. By separating wrongdoing and financial accountability, this system would lose what is considered to be one of the benefits of litigation. That the risk of litigation encourages a doctor/hospital to improve their practice and manage risk.

The position of the doctor would be unusual.They would have absolutely no say whatsoever as to the outcome of the case. Reputational factors would go out the window. What if a doctor argued that what happened was not negligent? Presumably that will have no influence on an insurer. Does an insurers acceptance of a settlement mean that there has been an admission of liability?

But the biggest problem as I see it is that it will be impossible to defend any claim. How does the insurer secure the evidence of the doctor involved when there is no relationship between them at all? Unless there is some mechanism to address this issue, then every medical negligence claim will be effectively indefensible. You may as well just have some form of no fault system in place.

Ryder

Harold Finchs Machine wrote: »

Negligence.

The article dosent state that and unless you were at the conference or are Jimmy sheahan, you don't know.

Would make sense for malpractice to be covered by patient or general insurance and negligence by gp.....exactly like car insurance

drkpower

Ryder wrote: »

The article dosent state that and unless you were at the conference or are Jimmy sheahan, you don't know.

Would make sense for malpractice to be covered by patient or general insurance and negligence by gp.....exactly like car insurance

Have u considered the issues I raised above?

Ryder

drkpower wrote: »

Have u considered the issues I raised above?

im

Ultimately no fault would be best. This might not be an unreasonable alternative. The doctor only suffers if negligence is proven and then premiums will rise. Patient can prove it then there is no payout or reputational damage.

If the patient suffers ill from an accepted side effect they can apply for compensation through their own insurance. I'm presuming this option would be on the basis that there was no negligence. It's in the insurance companies interests to defend 5 his and to insist on hospital disclosure etc as per normal in any other legal situation.

Again no fault would be best or at least a compensation cap but in the prese t situation where the practitioner needs insurance to defend against everything then it's not an unreasonable suggestion

drkpower

Ryder wrote: »

im

Ultimately no fault would be best. This might not be an unreasonable alternative. The doctor only suffers if negligence is proven and then premiums will rise. Patient can prove it then there is no payout or reputational damage.

If the patient suffers ill from an accepted side effect they can apply for compensation through their own insurance. I'm presuming this option would be on the basis that there was no negligence. It's in the insurance companies interests to defend 5 his and to insist on hospital disclosure etc as per normal in any other legal situation.

Again no fault would be best or at least a compensation cap but in the prese t situation where the practitioner needs insurance to defend against everything then it's not an unreasonable suggestion

I'm not quite sure I follow. Are you suggesting that

- where medical negligence is proven, the patient claims from the doctors insurer (the system we have now); and

- Where there is no negligence, the patient claims off his own 'bad outcome' insurance (which insurers effectively offer already).

If so, I don't disagree, but it doesn't really differ massively to what we already have now.

Ryder

drkpower wrote: »

I'm not quite sure I follow. Are you suggesting that

- where medical negligence is proven, the patient claims from the doctors insurer (the system we have now); and

- Where there is no negligence, the patient claims off his own 'bad outcome' insurance (which insurers effectively offer already).

If so, I don't disagree, but it doesn't really differ massively to what we already have now.

Well that's my interpretation of the suggestion. It differs in terms of where injury is suffered but there is no fault. For example a patient undergoes a thyroidectomy and suffers nerve injury causing loss of earnings....maybe a singer. The surgeon took all steps necessary to prevent this and detailed the risk precisely om the notes.

The patient has an injury and wants compensation. Not really fair to blame the surgeon for this as it was a recognised and accepted complication. Currently that is the only recourse the patient has. With this suggestion, the patient buys complication insurance preop and uses that for compensation. Everyone is a winner especially the patient as they don't have to prove the doctor was negligent or worry about him blocking a settlement. They will get a fixed cash sum just like if you lose your bags on a flight

drkpower

Ryder wrote: »

Well that's my interpretation of the suggestion. It differs in terms of where injury is suffered but there is no fault. For example a patient undergoes a thyroidectomy and suffers nerve injury causing loss of earnings....maybe a singer. The surgeon took all steps necessary to prevent this and detailed the risk precisely om the notes.

The patient has an injury and wants compensation. Not really fair to blame the surgeon for this as it was a recognised and accepted complication. Currently that is the only recourse the patient has. With this suggestion, the patient buys complication insurance preop and uses that for compensation. Everyone is a winner especially the patient as they don't have to prove the doctor was negligent or worry about him blocking a settlement. They will get a fixed cash sum just like if you lose your bags on a flight

I don't disagree with that approach, but 2 points:

1. We basically have that already (insurers offer optional coverage of this type), yet very few people choose it (because we don't think that we will be suffer that 1% complication)

2. At least from what the article says, it seems that Sheehan is suggesting that patients carry insurance that covers medical negligence, so back to the problems I identified above.

Patients should have to carry their own insurance against medical malpractice, in the same way as they have house and car insurance, Mr Sheehan suggested.

Ryder

drkpower wrote: »

I don't disagree with that approach, but 2 points:

1. We basically have that already (insurers offer optional coverage of this type), yet very few people choose it (because we don't think that we will be suffer that 1% complication)

2. At least from what the article says, it seems that Sheehan is suggesting that patients carry insurance that covers medical negligence, so back to the problems I identified above.

My understanding of malpractice is that it covers both negligence and accidentally suffering. I would disagree with the patient having to insure against negligence. .....should be entirely the doctors responsibility if only to act as an additional layer of security

drkpower

Ryder wrote: »

My understanding of malpractice is that it covers both negligence and accidentally suffering. I would disagree with the patient having to insure against negligence. .....should be entirely the doctors responsibility if only to act as an additional layer of security

Malpractice typically refers to negligence only.

Xeyn

Have to agree with drkpower after his reasoning. Would be far too messy to say the least.