Malpractice -A reality ? (An Opinion)

While most ,if not all of us would like to believe and behave  to be best doctors , statistics speak otherwise . Reality check  is worth  , to help the future  decision makings/ advices  This article is submitted by Dr MGK Murthy on litigation scenario in India on malpractise.

1. 400 Percent  increase in medical   litigations have occurred in the country (India) over the last decade , with few reasons cited  by many ,such as  increased awareness  of patient community,  Increasingly favourable outcomes in consumer forums  / courts  and their wide publicity by media /press  ,Rise in  cost of medicare,   litigant societal  nature of our country,   Inadequate communicative skills  of doctors of both oral/ written varieties  etc

2.Radiology stands 4 th in the list of "most vulnerable for suing " categories , behind Obs/ Gynae/ Surgery  &orthopaedics.

3. More men Radiologists get sued than women, and the chances of getting sued rise  proportionately with age (Irony considering  we tend to think with  we learn with age).  "The older you get, the more you have to lose."

4.In the 2011 JAMA study, lawsuits in the outpatient settings were more likely to be due to diagnostic issues and in the inpatient setting from surgical errors. Failure to treat at 12% was in third place and far behind the first two. Less than 5% cited poor documentation or medication errors (both 4%) or failure to follow safety procedures or obtain informed consent (both 3%). 

I personally feel this is different for India , with lack of proper documentation / communicative skills / consent taking etc representing the FIRST category

5. All physicians report  feeling humiliated at being lied about by colleagues/ patents/ lawyers etc and profound  change in personality over time  in the form of lack of trust .

6. Most would say  "It is a very bizarre situation. Each word that you say has to be measured and thought about, and it is a very strange way to have a conversation with someone."

7.Doctors (of America) do win the vast majority of lawsuits (only 16% on average result in awards), but they fear entering the world of the lawyer," said Marc Siegel, MD, an internist, author, professor of medicine at NYU Langone Medical Center, and a senior Fox News medical contributor. "Courts are unpredictable, and the stress of being sued—with years of depositions, worry, and damage to your reputation—is a devastating experience, even if there's no payment to the patient."

8.  While the world  debates about  how to fix these dysfunctional systems ,  great majority  of physicians believe  that malpractice cases should be screened for merit by a medical panel before they can proceed and losing side should be made to pay to avoid fraudulent claims

9.The current system of compensating patients for medical errors is not working and is leading to profound disillusionment among those in the medical profession. 

US is aggressively addressing it with various measures and has actually reduced trust deficit between medical professionals and  patient community  , with Paid claims decreasing  from 18.6 per thousand physicians in 2002 to 9.9 in 2013. Of these claims, 96.6% were from settlements and only 3.4% from verdicts.

10.Unfortunately there  are no steps at present in our society/ community to address this single most  factor ( trust deficit)  responsible  for  rising medicare costs , with Doctor  vs  Society approach , rather than doctor in society approach