Medical dispute resolution, patient safety and the doctor-patient relationship | SMJ
The first thing medical malpractice lawyers establish to build a case is the existence of a doctor-patient relationship. This is a prerequisite to. "A doctor/patient relationship is established by informal advice at a duty is established, and that duty is the first element of a malpractice case. One of the elements that the person has to prove in order to succeed in this kind of lawsuit is that there was a doctor-patient relationship.
Is it to prevent physical injury, psychological harm, emotional distress, pure economic loss, expectations loss, loss of chance, or loss of autonomy? How is the standard of care to be determined? The relationship between doctor and patient is not like the relationship between pedestrian and motorist. There is a prior relationship of trust, vulnerability and expectation. Causation in medical negligence is especially complex.
The trial process, which is adversarial, bound by strict rules of evidence and usually takes place years after the event, is not the best mechanism to determine liability, let alone understand what actually happened. In Montgomery, the infant child suffered from cerebral palsy during childbirth. The mother, who was diabetic, was carrying a child that was larger than normal.
The risk materialised with tragic consequences.
Medical Malpractice Lawyers Establish Doctor-Patient Relationships
It was alleged that the doctor was negligent in failing to inform the mother of the risk of vaginal delivery and in failing to perform an emergency Caesarean. In finding the doctor liable, Lady Hale, in her concurring opinion, emphasised the significance of patient autonomy: The plaintiffs husband and wife had a child through IVF. The question is whether the parents are entitled to claim damages for the cost of raising the child.
This raises complex legal and moral questions with the international jurisprudence divided: However, even in the UK, which denies such claims, the House of Lords recognised that in these cases, the autonomy interests of the parents have been adversely affected, meriting some compensation.
Medical Malpractice Lawyers: Proving the Existence of Doctor-Patient Relationship Is Essential
Again, although from a different perspective, patient autonomy is central to medical negligence discourse. The Singapore Medical Council, in its revised guidelines issued earlier this year, highlights the importance of patient autonomy both in its foreword and within the guidelines.
Patient autonomy is a recurrent theme affecting medical malpractice today and it has to be taken into account both in resolving medical disputes and in developing patient safety protocols. There is no evidence to support an unequivocal affirmative answer. What is clear is that medical litigation is costly and ineffective.Why Doctors Get Sued: Malpractice Claims Trends (Episode 1)
Often, unmeritorious claims were pursued by disgruntled patients while clear-cut claims were vigorously defended by medical insurers.
The Woolf Report further noted that the success rate for medical negligence litigation was lower than in other personal injury litigation. The answer to the question of whether litigation raises professional standards and patient safety is that it most likely does not. Anecdotal evidence suggests that doctors either settle claims with a non-disclosure agreement, or if they do not believe they are personally at fault, take their chances with litigation where they have a high chance of successfully defending the action.
This does not encourage a culture of sharing information and learning from mistakes. Litigation is a compensation lottery with no proven impact on patient safety, but with increasing evidence that it contributes to defensive medicine and prevents reporting of adverse incidents.
Separate strategies are required to improve patient safety and to resolve medical disputes. Patient safety is improved through systemic intervention rather than by identifying individual instances of negligence.
Building a Safer Health System. It estimated the occurrence of preventable deaths at between a conservative estimate of 44, and an outer estimate of 98, per year, far exceeding annual deaths due to traffic accidents. These eye-catching figures have, however, been doubted and a recent British study suggests that many of these early studies overestimated the number of preventable deaths.
This is not to say that doctors should never be held personally responsible, but a greater distinction should be drawn between medical errors and medical negligence. If litigation does not contribute to improving patient safety, why is it necessary? It remains necessary because it is vital that individuals have access to courts to seek justice; the trial process, for all its weaknesses, does provide procedural fairness and legitimacy. Most importantly, it is open and transparent. However, for the most part, litigation probably does more harm than good in resolving medical disputes and alternative resolution for the majority of disputes is preferable.
Litigation is designed to result in a win-lose outcome, as one medical negligence litigator graphically illustrates using a war metaphor: Recently, it was reported that one in five complaints against doctors in Singapore arises out of poor communication. Litigation does not encourage open communication or disclosure. Would ADR mechanisms fare any better? ADR refers to resolving disputes without resorting to litigation.
It includes negotiation, mediation and arbitration. Historically seen as an alternative to litigation, ADR is increasingly being used in conjunction with litigation as a screening or settlement device. Chief Justice Menon, in his opening address at the Global Pound Conference Series held in Singapore in March this year, outlined a holistic approach to dispute resolution.
Rather than viewing ADR as an alternative to litigation, courts should promote a combination or hybrid mechanism that works best for the particular dispute. Four primary reasons emerged: At the root cause of many of these malpractice claims is a breakdown in the relationship between the physician and the patient—typically due to problems with communication. The unifying theme that emerges from these dissatisfied patients is communication—the most crucial aspect of the interaction and relationship between doctor and patient.
The first step toward improving communication between doctors and patients is to determine which barriers might stand in the way.
One such barrier is the challenge many doctors face in navigating cultural and societal differences among their patient populations. Michigan, like the rest of the United States, is rapidly diversifying.
And a recent Gallup poll indicates that 10 million Americans, or 4. So what can physicians do to strengthen their doctor-patient relationships and avoid malpractice claims?
Medical dispute resolution, patient safety and the doctor-patient relationship
A starting point is to develop cultural competence, often defined as a set of knowledge, behaviors, attitudes, and policies that enable effective work in a cross-cultural environment. Here, culture is defined broadly to include the customs, beliefs, language, and perspectives of racial, ethnic, social, and religious groups. Prioritizing the development of cultural competence can improve communication across cultures.
Research by the Commonwealth Fund and the Office of Minority Health demonstrates that training and education in cultural competence increases the quality of care provided to diverse populations.
These outcomes show that a commitment to cultural competence training is well worth the investment. Taking initial steps toward developing or enhancing cultural competence does not have be overwhelming or intimidating.
The following are a few ways that practitioners can begin to develop these skills:
- The doctor-patient relationship and malpractice. Lessons from plaintiff depositions.