Physicians Demand Action

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Physicians Demand Action
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Severity Damage Awards are Rising Rapidly
Average amount paid, excluding claims paid with
no indemnity
400,000
342,000
267,000
300,000
160,000
200,000
150,000
100,000
0
0
1995
2001
1989
Source TMA
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Noneconomic Damages Growing Fastest
Source TDI
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Frequency Claims Against Texas Doctors Double
Every Five Years
Source TDI
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Average Annual Liability Premiums Ob/Gyn
Surgeons in Dallas pay more than twice as much
for liability coverage as San Francisco
surgeons. Psychiatrists in the Rio Grande Valley
pay five times as much as their peers in
Sacramento.
Source TDI
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Texas Physicians Plan Early Retirement
Source TMA Survey
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Crisis Threatens Access to Care ??Doctors leave
or refuse to come to Texas ??Fall to 48thof 50
states in physician manpower ??Texas 152
MDs/100,000 population ??US average 196
MDs/100,000 population ??158 counties have no
obstetricians ??Medical malpractice insurance
companies flee the state as underwriting
losses explode.Annual industry profit,
negative56.6. ??17 medical liability insurance
companies fall to 4??8 nursing home liability
carriers fall to 1Source
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Costs of medical liability

• Insurance premiums
• Defensive medicine
• Physician time in litigation
• Medical care costs
• Practice changes
• Changed relationships

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Risk Factor
The first is to never see a patient. The second
is to keep all patients deliriously happy,
because happy patients do not sue.
Over Expectation
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??????????????????????? (Professional Act)

• Malpractice
• Medical error

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Caption Johns Hopkins intensivist Dr. Peter
Pronovost is helping to lead the effort to make
American medicine safer. Dr. Pronovost works on
improving communication between physicians,
nurses, other care providers and families.
Communication breakdowns are the leading cause of
medical error. Medical errors kill between 44,000
and 98,000 patients in U.S. hospitals every year,
more than AIDS, breast cancer or motor vehicle
accidents.
Medical errors
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Negotiation Conciliation Arbitration Restorative
Justice

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REAL TIME
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MAN MATERIAL MANAGEMENT
CONCILATION
HELP
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REAL TIME
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REAL TIME
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CPG vs Standard

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(Matter Of Fact)
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Humanized Doctor

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• COMMUNICATION
• COORDINATION

HEALTH CARE
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??????????????????????? (Professional Act)

• Malpractice
• Medical error

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TO ERR IS HUMAN
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• COMMUNICATION
• COORDINATION

HEALTH CARE
QUALITY MANAGEMENT PATIENT SAFTY SYSTEM
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3.????????????????????????????????????????????????
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??????????????? (Professionalism)

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GOOD MEDICAL PRACTICE
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GOOD MEDICAL PRACTICE

• Make the care of your patient your first concern
• Protect and promote the health of patients and
  the public
• Provide a good standard of practice and care
• - Keep your professional knowledge and skills up
  to date
• - Recognise and work within the limits of your
  competence
• - Work with colleagues in the ways that best
  serve patients interests

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• Treat patients as individuals and respect their
  dignity
• - Treat patients politely and considerately
• - Respect patients right to confidentiality
• Work in partnership with patients
• - Listen to patients and respond to their
  concerns and preferences
• - Give patients the information they want or need
  in a way they can understand
• - Respect patients right to reach decisions with
  you about their treatment
• and care
• - Support patients in caring for themselves to
  improve and maintain their health

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• Be honest and open and act with integrity
• - Act without delay if you have good reason to
  believe that you or a
• colleague may be putting patients at risk
• - Never discriminate unfairly against patients or
  colleagues
• - Never abuse your patients trust in you or the
  publics trust in the profession.

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??????????????????????? (Professional Act)

• Malpractice
• Medical error

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TO ERR IS HUMAN
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Caption Johns Hopkins intensivist Dr. Peter
Pronovost is helping to lead the effort to make
American medicine safer. Dr. Pronovost works on
improving communication between physicians,
nurses, other care providers and families.
Communication breakdowns are the leading cause of
medical error. Medical errors kill between 44,000
and 98,000 patients in U.S. hospitals every year,
more than AIDS, breast cancer or motor vehicle
accidents.
Medical errors
79
????????
?????
???????
?????
QUALITY MANAGEMENT PATIENT SAFTY SYSTEM
error
???????
80
?????
???????
???????? ???? ???
???? ??????? ?????

• COMMUNICATION
• COORDINATION

???????
???????????
81
Risk Factor
The first is to never see a patient. The second
is to keep all patients deliriously happy,
because happy patients do not sue.
Over Expectation
82
????????????

• ????????
• ????????
• ????????????
• ?????????

83
???????????????????? ??????? ?? 2534-2550
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Health Care Lawsuit AbuseCrisis
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Physicians Demand Action
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??????????????? 80(2)
CPG vs Standard

• ???????
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94
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