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Danes’ different approach to medical malpractice

danishhealthcard

Danish health card. All  adults citizens have them.

København (Copenhagen), Sjælland (Zealand), Danmark (Denmark) Photo: News Øresund - Johan Wessman © News Øresund Detta verk av News Øresund är licensierat under en Creative Commons Erkännande 3.0 Unported-licens (CC BY 3.0). Bilden får fritt publiceras under förutsättning att källa anges (Foto: News Øresund - Johan Wessman). The picture can be used freely under the prerequisite that the source is given (Photo: News Øresund - Johan Wessman). News Øresund, Malmö, Sweden. www.newsoresund.org. News Øresund är en oberoende regional nyhetsbyrå som ingår i projektet Øresund Media Platform som drivs av Øresundsinstituttet i partnerskap med Lunds universitet och Roskilde Universitet och med delfinansiering från EU (Interreg IV A Öresund) och 14 regionala; icke kommersiella aktörer.

The Little Mermaid Stature in Copenhagen.

This ProPublica investigative piece looks at how Denmark got rid of the traditional medical-malpractice civil law and improved patient safety.

The article notes:

“The U.S. system for compensating injured patients — medical malpractice lawsuits — effectively shuts out patients when the potential damages are small. Proving negligence, the usual standard for winning compensation, is difficult. There are scant incentives for doctors and hospitals to apologize, reveal details about what happened, or report errors that might unveil a pattern.

“Denmark offers a radically different alternative, as do similar programs in other Scandinavian countries and New Zealand. To be sure, these countries have nationalized health care systems. …”

“Common to all these programs is a commitment to provide information and compensation to patients regardless of whether negligence is involved. That lowers the bar of entry for patients and doesn’t pit doctors against them, enabling providers to be open about what happened.”

“Denmark’s compensation program has been in place since 1992, replacing a lawsuit-based approach much like that in the U.S.”

“Today, medical injury claims aren’t handled by the Danish court system but by medical and legal experts who review cases at no charge to patients. Patients get answers and can participate in the process whether or not they ultimately receive a monetary award.

“Filing a claim is free. Patients are assigned a caseworker to shepherd them through the process. The hospital or doctor is required to file a detailed response, which patients may rebut. Patients have access to their complete medical record and a detailed explanation of the medical reviewers’ decisions. All of this is available for patients and their families through an online portal, which alerts them when there are developments in their claims process.

“Compensation is awarded if reviewers determine the care could have been better, or if the patient experienced a rare and severe complication that was ‘more extensive than the patient should reasonably have to endure.”’


Bold plan to reform malpractice-tort system in Georgia

courtroom

Charles R. Evans, retired president of Hospital Corporation of America and current president of International Health Services Group, endorses an effort to reform Georgia’s medical-malpractice system.

Becker’s Hospital Review reports that “A proposal before the state Senate Health and Human Services Committee calls for repealing Georgia’s medical malpractice system and replacing it with an administrative model. Under the proposed Patients’ Compensation System, medical malpractice cases would be brought before an administrative panel of healthcare experts and an administrative law judge rather than the court.”

“During my 40 years of leading hospitals, I can say that the majority of physicians I met have been sued — many under frivolous circumstances. As a result, doctors have changed their behavior to practice wasteful defensive medicine to protect themselves,” wrote Mr. Evans in a recent Gwinnett Daily Post opinion piece.

Mr. Evans argues that physicians would no longer need to practice defensive medicine under the PCS model.

“Patients would be compensated in an amount similar to what they would receive after years in the legal system. This no-blame, administrative model would eliminate the adversarial relationship between patient and doctor and allow physicians to acknowledge their errors without fear of litigation,”  he wrote.


Video: Report finds ‘culture of secrecy’ that hides medical malpractice

 

Video and text: A TV station alleges a culture of secrecy that lets hospitals hide medical malpractice.

 


4 steps to reduce unnecessary care

 

Robert Pearl, M.D., writes in Forbes on how to cut back on unneeded healthcare.

He offers four steps:

1. “Empower patient decision-making. New tools, including interactive videos, can help patients objectively evaluate the pros and cons of procedures and treatments. ”

2. “Shift to value-based pay practices. Paying for the value of care, rather than for the volume of services, would eliminate the perverse incentives in the current fee-for- service reimbursement system. A major step in that direction was the announcement from the U.S. Department of Health and Human Services to shift 50 percent of Medicare reimbursements to reward higher quality and pay based on clinical outcomes by 2018. ”

3. “Determine when new approaches are really better. To help accomplish this, every medical journal should require authors to compare new procedures, devices and drugs to current, often lower-cost alternatives. In a similar vein, the FDA should revise its charter to enable it to require that existing therapies be compared to new drugs and devices prior to approval.”

4. “Reform medical malpractice. Changes to litigation for medical malpractice would lessen the burden of unnecessary care associated with defensive medicine. What motivates many doctors to do too much for patients, including much they would never choose to do for themselves, is fear of missing an extremely unlikely problem and being sued.”

 


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