Professional Liability And Medical Malpractice 3-5pgs Not Including Title
The Medical Staff Coordinator has again called upon your expertise in the area of healthcare law. You have been asked to provide a written discussion on professional liability and medical malpractice. You are asked to provide the information outlined below and use research (at least two sources) to substantiate your discussion.
- Define liability and malpractice.
- Summarize the three areas of general liability for which a physician/employer is responsible.
- Discuss the role and purpose of risk management.
Use APA 7 formatting and citation standards. Use at least two (2) scholarly references published within the last 5 years to substantiate your work.
Malpractice Influence on Health Care
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Question 1: What is written about the history of malpractice litigation?
Answer 1:
Very little has been written about the history of malpractice insurance.
However, according to James Mohr (2000) at the University of Oregon, medical
malpractice litigation appeared in the United States around 1840. It appears
that the reason medical malpractice came about was related to the lack of
quality control toward medical practitioners at that time. Mohr contends there
are several factors contributing to why medical malpractice litigation has
sustained itself, including the pressures for innovation on American medicine and the spread of uniform standards.
Question 2: Who is required to purchase medical malpractice insurance?
Answer 2: Individual licensed practitioners and licensed health care facilities
are required by law to maintain a minimum level of insurance. States require
practitioners and facilities to obtain insurance for the welfare of patients;
however, rather than settling for the minimum legal standard of the law,
practitioners and facilities should assess and purchase the insurance they truly
need. Medical malpractice insurance purchased by facilities is obtained for the
purpose of covering all those who perform services within the facility (e.g., social workers and technicians) in addition to the licensed professionals.
Question 3: Is malpractice insurance provided for a practitioner by the organization or facility sufficient coverage?
Answer 3: This depends on the individual. All practitioners should consult with
a risk manager to learn their medical malpractice health insurance’s coverage
and limitations. The practitioner should carefully evaluate if the insurance is
sufficient and, if not, purchase additional insurance. If the individual performs
any medical practice not associated with the facility, he or she should have
separate insurance to cover those services because those services will not be covered under the facility insurance.
Question 4: How is malpractice insurance purchased?
Answer 4: Most often, individual practitioners access insurance through
national associations like the American Medical Association or American
Psychiatric Association. Facilities generally utilize insurance brokers to obtain
insurance. The broker is responsible for representing the facility to the
insurance company. An insurance broker can assemble all the necessary
FAQs: Malpractice Influence on Health Care
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information regarding an organization to present to the insurance company.
Question 5: What impacts the costs of malpractice insurance?
Answer 5: Several factors impact the cost of acquiring medical malpractice
insurance. First, the amount of previously paid claims impacts the cost of future
insurance. The higher the amount of past claims paid out, the higher the
increase in future premiums. Another factor that impacts the cost of medical
malpractice insurance is the insurance company’s ability to make a profit with
its investments. If investment profits are down, costs of insurance will rise, and if profits are up, the cost of insurance will level or reduce.
Question 6: What is the current debate about the rising costs of malpractice insurance?
Answer 6: Many attribute the rising trends in medical malpractice to the surge
in the number of claims filed and the astronomical rise in the amount of claims
paid. Others contend that insurers had to increase premiums because of the
lack of profitability of their investments in the stock market over the past several years.
Question 7: How is insurance regulated?
Answer 7: All states have laws regulating the insurance industry and
insurance departments to perform regulatory functions. Insurance agents or
brokers must be licensed and are required to pass an examination and obtain ongoing education.
Question 8: Do insurance companies have to insure any health care provider that requests malpractice health care insurance?
Answer 8: Individual state laws determine this. Some states require that an
insurance company insure all individuals who request to be insured, while other
state laws are silent about this and allow insurance companies to select the individuals they will cover.
Question 9: Is an insurance company obligated to make payments to individuals who file medical malpractice insurance claims?
Answer 9: No, an insurance company is not obligated to make a payment to
all individuals who file medical malpractice insurance claims. Claims depend on
policy specifics and legal considerations. In most cases, a claimant must prove
FAQs: Malpractice Influence on Health Care
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that a mistake was made, that an injury occurred, and that damages were
sustained (e.g., lost wages, medical bills, or agony). Generally, the claimant
will need a lawyer or another expert to calculate and present these damages in court.
Question 10: What is tort reform?
Answer 10: Tort reform pertains to the enactment of laws to limit the amount
of payment that could be made on a medical malpractice claim. Some states
have enacted such legislation. Many maintain that these tort reform laws are
solving the malpractice insurance cost crisis by reducing the cost of medical
malpractice insurance. Others argue that there is no crisis and reform efforts
are just a way for large companies to further their own agenda of reducing
their financial risk. There are many health care think tanks studying both sides of this issue.
References
Medical malpractice: Quick reference. (n.d.). Retrieved from Consumer Action
and Information Center of Hawaii Web site:
http://www.consumerlaw.com/medical.html#prove
Mohr, J. C. (2000). American medical malpractice litigation in a historical
perspective. The Journal of American Medical Association, 283(13), 1731–1737.
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