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"MEDICAL MALPRACTICE"
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Medical malpractice stress syndrome in theory and practice – a narrative review
Accusations of medical malpractice, increasingly common among healthcare professionals, are a massive source of stress which can lead to the development of medical malpractice stress syndrome (MMSS). The symptoms of this syndrome are often compared to those in post-traumatic stress syndrome (PTSD), and the doctors are referred to as “second victims” of medical mistakes. The aim of the publication is to highlight MMSS, its symptoms, its similarity to PTSD, its consequences, and methods of prevention and management. In addition, attention was paid to the number of medical malpractice lawsuits among medical specialties mostly affected by this problem to illustrate the scale of the phenomenon. The publication is a narrative review. Medical databases (PubMed, ResearchGate, Biblioteka Nauki), termedia and Jurnals.viamedica service from the years 1988–2023 were reviewed. The MMSS manifests itself with symptoms such as anger, frustration, anxiety, guilt, sleeping disorders, loss of self-confidence, and depression. Later, somatic symptoms, such as cardiovascular, also appear. The MMSS may lead to unnecessary ordered examinations, delayed therapeutic processes, or premature retirement from the profession. Recently, patients have become more aware of their rights, resulting in an increase in malpractice lawsuits, particularly in specialties such as gynecology and obstetrics, neurosurgery, and radiology. Concerns about the legal consequences of medical errors may affect future specialization choices. Graduates tend to avoid specialties with a high risk of medical malpractice. Coping with MMSS requires social support and cooperation between doctors and lawyers or psychiatrists. Prevention of MMSS includes awareness of stress reactions and procedures decreasing the risk of committing medical malpractice. The prevalence of MMSS among physicians and the impact of the risk of medical malpractice lawsuits on the choice of medical specialty in Poland require further examinations. Med Pr Work Health Saf. 2023;74(6):513–26.
Journal Article
Legal aspects of health care administration
\"The most trusted resource in healthcare law is this classic text from George Pozgar, now completely revised. With new case studies and news clippings in each chapter, the 13th edition continues to serve as an ideal introduction to the legal and ethical issues in the healthcare workplace. This authoritative guide presents a wide range of health care topics in a comprehensible and engaging manner that will carefully guide your students through the complex maze of the legal system. This is a book they will hold on to throughout their careers. Healthcare administrators face an increasingly complex maze of legal issues as government regulation and health care reform evolves and corporate structures adapt to meet the changing demands of their constituencies. With a continued emphasis on the ethical challenges of providing quality care amidst these powerful and often chaotic industry forces, the 13th Edition helps future administrators navigate the core industry issues of patient centered care, the future workforce and the culture of compassion. With over 40 years of experience as an administrator, consultant, and surveyor across 650 hospitals, author George D. Pozgar provides a uniquely accessible tool for grasping the legal complexities of health care through an array or real-life case studies, precedent-making court cases, and key statistical data. In the 13th Edition, Mr. Pozgar once again invites the reader to explore the comprehensive range of legal issues--from tort reform and healthcare fraud to reporting requirements and patient rights. Legal Aspects of health Care Administration, 13th Edition is an indispensable text for future healthcare administrators and one that will serve them throughout their professional lives. The 13th edition presents a wide range of health care topics in a comprehensible and engaging manner that will carefully guide your students through the complex maze of the legal system. This is a book they will hold on to throughout their careers.\"-- Provided by publisher.
Book
The status of medical malpractice litigations in Saudi Arabia: Analysis of the annual report
Context:
Medical malpractice is a leading cause of morbidity and mortality worldwide. Analyzing the current number of lawsuits and comparing it to previous years will help assess the status of medical malpractice litigations in Saudi Arabia.
Subjects and Methods:
A review and analysis of the annual statistics book of the Medico-Legal Committees (MLCs) in Saudi Arabia over the years (1437-1439 H) was conducted.
Results:
Over the 3-year study period, the total number of lawsuits was 3,684. The percentage of increase of malpractice lawsuits from 1437 until 1439 Hijri (2016-2018) was 26% (1,097-1,379 lawsuits). Obstetrics and Gynecology consistently had the highest number lawsuits compared to other specialties (25.6%), followed by dentistry (13.5%). Similarly, the rate of compensation after a lawsuit was highest in Obstetrics and Gynecology claims (62.7%), followed by dentistry (60%). The private healthcare sector consistently showed the highest number of lawsuits when compared to other healthcare providers, with a 73% increase over 3 years. The Ministry of Health showed an overall reduction in the number of lawsuits by 6.6% over the course of the study period.
Conclusions:
The number of lawsuits in Saudi Arabia is increasing rapidly. Understanding the reason for this is very important especially given the high rates of lawsuits for certain specialties and healthcare sectors. A root cause analysis cannot be conducted without a detailed reporting system for malpractice lawsuits; the development of which would help in research and the generation of solutions in this field.
Journal Article
Medical Malpractice Stress Syndrome and Defensive Medicine in Obstetricians and Gynecologists in Turkey
Background: Medical malpractice is a significant global issue affecting various aspects of healthcare, including ethical, legal, and managerial perspectives. Defensive medicine, where physicians engage in excessive practices to avoid malpractice lawsuits, is prevalent. In Turkey, the impact of malpractice fears on obstetricians and gynecologists (OB/GYNs) has not been extensively studied. This study aims to investigate the frequency of medical malpractice lawsuits, defensive medicine practices, the prevalence of medical malpractice stress syndrome (MMSS), and potential preventive measures among OB/GYNs in Turkey. Methods: A cross‐sectional survey was conducted with 212 OB/GYNs in Turkey, following ethical approval. Participants completed a questionnaire on their experiences with malpractice, defensive practices, and MMSS. The survey included sociodemographic questions, standardized scales for defensive medicine practices, and MMSS‐related questions. Data were analyzed using SPSS 18 with a 95% confidence level. Results: The majority of participants were experienced professionals aged 30–39, predominantly female, and working in the public sector with limited subspecialty training. Defensive medicine was widespread, with 95.5% of participants engaging in such practices, and 79.2% reported altering their practice due to malpractice fears. Older age, female gender, extensive experience, private sector employment, and specific subspecialties were associated with higher defensive practices and MMSS. Conclusion: Defensive medicine is common among Turkish OB/GYNs, driven by malpractice fears. The study highlights the need for improved support systems, better legal protections, and educational interventions to address defensive practices and reduce malpractice‐related stress.
Journal Article
Structures of indifference : an indigenous life and death in a Canadian city
\"Structures of Indifference examines an Indigenous life and death in a Canadian city, and what it reveals about the ongoing history of colonialism. At the heart of this story is a thirty-four-hour period in September 2008. During that day and half, Brian Sinclair, a middle-aged, non-Status Anishinaabeg resident of Manitoba's capital city, arrived in the emergency room of the Health Sciences Centre, Winnipeg's major downtown hospital, was left untreated and unattended to, and ultimately died from an easily treatable infection. His death reflects a particular structure of indifference born of and maintained by colonialism. McCallum and Perry present the ways in which Sinclair, once erased and ignored, came to represent diffuse, yet singular and largely dehumanized ideas about Indigenous people, modernity, and decline in cities. This story tells us about ordinary indigeneity in the City of Winnipeg through Sinclair's experience and restores the complex humanity denied him in his interactions with Canadian health and legal systems, both before and after his death. Structures of Indifference completes the story left untold by the inquiry into Sinclair's death, the 2014 report of which omitted any consideration of underlying factors, including racism and systemic discrimination.\"--Provided by publisher.
Book
Medical judicial expertise: the real decision-maker in Chinese medical dispute litigation
PurposeThis article attempts to contribute to medical dispute resolution by examining the adoption of medical judicial expertise opinions in determining medical malpractice responsibility and its coordination with the judge’s legal opinions.Design/methodology/approachThis article examines the legal basis and empirical data to demonstrate the decisive effect of medical judicial experts’ opinions in allocating medical malpractice responsibility and corresponding dispute resolution effectiveness.FindingsHigh reliance on medical judicial expertise in medical dispute litigation not only unifies the judicial standards but also limits judges’ discretion, which brings the risk of contradiction between factual and legal findings, which currently ends in judges’ compromise.Originality/valueThe current medical malpractice provisions neglect the divergence of medical judicial expertise and judges’ opinions in determining medical malpractice responsibility, which produces difficulties in harmonizing awarded compensations and parties’ expectations, leading to problematic medical dispute litigation in Mainland China.
Journal Article
An Analysis of the Number of Medical Malpractice Claims and Their Amounts
Starting from an extensive database, pooling 9 years of data from the top three insurance brokers in Italy, and containing 38125 reported claims due to alleged cases of medical malpractice, we use an inhomogeneous Poisson process to model the number of medical malpractice claims in Italy. The intensity of the process is allowed to vary over time, and it depends on a set of covariates, like the size of the hospital, the medical department and the complexity of the medical operations performed. We choose the combination medical department by hospital as the unit of analysis. Together with the number of claims, we also model the associated amounts paid by insurance companies, using a two-stage regression model. In particular, we use logistic regression for the probability that a claim is closed with a zero payment, whereas, conditionally on the fact that an amount is strictly positive, we make use of lognormal regression to model it as a function of several covariates. The model produces estimates and forecasts that are relevant to both insurance companies and hospitals, for quality assurance, service improvement and cost reduction.
Journal Article
Evaluating the Medical Malpractice System and Options for Reform
The U.S. medical malpractice liability system has two principal objectives: to compensate patients who are injured through the negligence of healthcare providers and to deter providers from practicing negligently. In practice, however, the system is slow and costly to administer. It both fails to compensate patients who have suffered from bad medical care and compensates those who haven't. According to opinion surveys of physicians, the system creates incentives to undertake cost-ineffective treatments based on fear of legal liability—to practice “defensive medicine.” The failures of the liability system and the high cost of health care in the United States have led to an important debate over tort policy. How well does malpractice law achieve its intended goals? How large of a problem is defensive medicine and can reforms to malpractice law reduce its impact on healthcare spending? The flaws of the existing system have led a number of states to change their laws in a way that would reduce malpractice liability—to adopt “tort reforms.” Evidence from several studies suggests that wisely chosen reforms have the potential to reduce healthcare spending significantly with no adverse impact on patient health outcomes.
Journal Article