What is Medical Malpractice Insurance?

• Medical malpractice insurance is a financial-based instrument available only to physicians or those individuals involved in healthcare. By purchasing a medical malpractice policy, the physician or medical professional is protected in the event of a judgment against them for medical negligence, malfeasance, or in general malpractice.

• The majority of states in America require that physicians have some form of medical malpractice insurance to protect them from a faulty or negligent action. In addition to a state mandate, the majority of hospitals or medical institutions will require physicians to be obtain a form of coverage—institutions will require the obtainment of a policy to protect them against costly settlements.

How Medical Malpractice Insurance Works

• A physician will purchase a medical malpractice policy from either a commercial insurance company or a mutual insurance company that is operated by a health care provider or medical professional. The physician can either choose individual coverage or be a part of a policy that incorporates the underlying practice or institution in which the doctor is employed.

• The form of coverage purchased is dictated by the individual physician’s employer. Those doctors or medical professionals employed by the United States Federal Government will not be required to purchase a medical malpractice insurance policy—any lawsuit against the federal government is self-insured.

How is the Medical Malpractice Premium Determined?

• The majority of physicians are rarely sued or sued infrequently. As a result, the data attached to a premium calculation is actuarially unsound. This characteristic makes it impossible for a physician to be “rated” or “classified” based on past history. In addition, the claims filed against a doctor are based on circumstance, making the issues concerning with a premium determinant difficult to gauge.

• As oppose to past histories, the premiums associated with medical malpractice insurance are determined based on specialty. All physicians are classified based on their medical field or their specialty.  Each classification is attached to a rate based on the probability of an occurrence of a medical malpractice issue. For example, orthopedic surgeons are more susceptible (as a result of the skill required to perform surgery) to negligent actions or mistakes, and as a result, are more likely to face a medical malpractice suit. As a result of this general susceptibility, orthopedic surgeons will face higher premiums for their medical malpractice insurance policies. In addition, the location of the physicians or medical professionals practice, will affect the premium level.

• As a result of the rising number of medical malpractice cases, insurance companies are realizing that the business of offering medical malpractice insurance is not indisputably profitable. This realization has increased premiums and placed a strain on the medical field.

What is a Medical Negligence Claim?

• A medical negligence claim is a direct legal action taken by a patient who falls victim to the negligent or wrongful actions of a medical provider or medical professional. All medical professionals work under a code of ethics. Considering the importance of their role, all physicians and medical professionals are required to provide suitable support and medical advice to their patients. These actions must be delivered in the patient’s best interest to accurately treat, diagnosis, or rehabilitate the individual. A failure to deliver this expected course of conduct may result in the filing of a medical negligence claim.

• To be considered medical negligence, the patient in question must suffer from an injury or some form of damage that arose from the medical professional’s actions.  These actions are not always direct; a misdiagnosis or a faulty prescription can result in long-term effects. Regardless of the specifics, all medical negligent claims are filed because the patient (who expected to receive suitable care) was injured, harmed, or suffered some form of loss as a result of the doctor’s negligent or wrongful actions.

• Medical negligent claims are filed through the civil court system of the particular jurisdiction in which the negligent or wrongful action took place. A medical negligent claim is filed by the patient to recoup finances from their injury. When an individual falls victim to a negligent or fraudulent medical action they will invariably suffer from sort of pain—emotional or physical pain must be present which results in the loss of wages or emotional distress.

• The laws associated with medical negligence claims–meaning the grounds for what constitute a medical negligent action—are dictated through state interpretation. Medical negligence is not always a direct issue; similar to other personal injury claims the negligent actions must be directly linked to the patient’s suffering.

• In addition to the varying interpretations, all states possess different statues of limitations that regulate when a medical negligence suit can be filed.

How to File a Medical Negligence Case

• To recoup finances lost from an injury or emotional distress caused by a doctor’s actions, you must gather all information regarding your particular case. A list of the doctor’s actions, all appointments with the underlying medical provider, prescriptions, diagnoses, and a proof of wages or time lost due to the injury must be presented at the medical negligence trial.

• After all information has been gathered and you understand your particular state’s interpretive laws regarding medical negligence, you must hire a medical malpractice attorney to facilitate your claim. Utilize all resources (the yellow pages, the Internet, word of mouth) before hiring a medical malpractice attorney.

• When an attorney is hired, develop a strategy that will give your case the best opportunity to reach a favorable settlement. The most important aspect of developing a strong case is the obtainment of information and evidence.

What is a Misdiagnosis?

• A misdiagnosis is an inaccurate diagnosis of a medical ailment. Medical professionals can misdiagnose an individual depending on a number of factors; however, in most instances a misdiagnosis is delivered through a negligent action taken by the medical provider or physician. An erroneous diagnosis can take on a number of forms—sometimes a medical problem is identified when the patient has no such ailments, or a diagnosis can be classified incorrectly. Examples of the latter include a doctor who diagnoses a tumor as benign when it is in fact malignant.

• A misdiagnosis is a medical error, and although it may be difficult to gauge given varying symptoms or the presence of inaccurate statistics, all forms of misdiagnoses will portray some form of externalities or adverse side effect.
 

Contact a medical-malpractice-lawyer to acquire legal advice and assistance.

Reasons for a Misdiagnosis?

• There are a number of reasons that will cause a misdiagnosis. People often times blame negligent actions or laziness for an inaccurate diagnosis; however, a misdiagnosis can arise for a number of medical reasons. That being said, the presence of a misdiagnosis may award an individual the right to file a medical malpractice suit.

• Reasons that would not necessitate or warrant a medical malpractice suit for a misdiagnosis include: faulty or malfunctioning medical equipment, a patient’s discretion to conceal critical information, a language barrier between the medical professional and the patient, or a situation in which the symptoms of the ailment did not match the universal diagnosis.

• Reasons that would necessitate or warrant a medical malpractice suit for a misdiagnosis: a negligent action taken by a doctor, a failure to adhere to the code of conduct necessary for all doctors to abide by, or a blatant wrongdoing that stems from laziness or the doctor’s inability to deliver a routine medical action.

Consequences of a Misdiagnosis

• The consequences of a misdiagnosis are variable; for example if a patient’s biopsied tumor is misdiagnosed as malignant when it is in fact benign, he or she will undergo unnecessary medical operations. This obviously would adversely affect the individual’s health and would invariably result in a medical malpractice suit.

• In order for the misdiagnosis to be considered malpractice, the individual must suffer a direct loss through a physical damage. Undergoing unnecessary surgery or chemotherapy will inevitably result in a negative effect in the form of unwarranted scars, sickness, and the loss of wages. These instances are grounds for medical malpractice suits; the individual will file a medical malpractice suit to obtain a recoupment for the losses suffered.

• In these instances, the individual must hire a medical malpractice attorney to facilitate their medical malpractice case. The individual must demonstrate to the local court system that the misdiagnosis directly lead to a loss in the form of finances, physical pain, or emotional distress.

New York courts specializing in the state’s 4,000 medical malpractice cases filed annually have begun expanding following the success of a Bronx judge in expediting the settlement process.

The approach, which has shown to save money by reducing court backlogs, has been extended to the other boroughs, through the implementation of training and educational programs. 

Starting December 1st, New York Chief Administrative Judge, Ann Pfau, will become the coordinating judge of the court system’s medical malpractice segment. The program is using a $3 million federal grant to train more judges in expediting the process. 

Bronx Justice Douglas McKeon, who has focused on malpractice cases for over 15 years, said he helped settle over 1,000 malpractice suits in his career. The efficacy in settling such cases is attributed to the city’s Health and Hospitals Corporation—an entity which runs 11 public hospitals and uses its own claims and law department to settle cases in a streamlined fashion. 

Courpration deputy counsel Suzzane Blundi stated that the entity revamped their commitment to patient safety, developing programs to manage claims, improve care and decrease payouts. The effort also investigates malpractice claims early on to help expedite settlements. 

Severe complications like kidney failure and heart attacks during and immediately after labor and delivery are rising nationwide, says a CDC report.  The report, published in the November issue of Obstetrics & Gynecology, has serious implications for pregnant women, attorneys in the malpractice field, obstetricians, midwives, and other birth professionals.

Because the study the report was based on was conducted by the Centers for Disease Control, it could examine a very large, nationwide sample of births.  The Nationwide Inpatient Sample, used by the study, includes information on over five million patients annually at approximately 1,000 hospitals.  According to these samples, having a baby is the single most common thing that Americans do in hospitals—labor and delivery accounted for more hospital intakes than any other single cause.

Out of about 50 million births recorded during the period from 1998 to 2009, about 600,000 involved severe complications in delivery or in the immediate period after delivery.  Women were recorded as having severe complications if they had to receive a blood transfusion or had a serious infection or other illness. 

Some of these events had seen a significant increase over the eleven year timespan.  For example, the rates of blood transfusion went up over 180 percent.  Embolisms were also more common, as were tracheotomies and heart attacks.

However, not all of the news was negative.  Maternal death rates are on the decline even as overall complication rates have gone up.  The rate of in-hospital maternal death is just over one in 10,000—a 37 percent reduction overall from what the maternal death rate was at the beginning of the study.

Several theories have been proposed to explain the increasing rates of complications.  One of the reasons for the increase may be that minority women are still unable to get equal access to healthcare.  They experience both fetal and maternal death more frequently than white women across the board.

Uninsured mothers are another component of the increase in complications, because the greatest risks for complications occur in women who have not received routine prenatal care.  Higher rates of obesity in the American population have also led to an increase in complications like high blood pressure and diabetes, which can make giving birth significantly more risky even with modern medical technologies.

Older women are also significantly more likely to experience birth related complications, especially women over the age of 40 who are giving birth for the first time.  In recent years, more women in this age group have been able to successfully conceive and give birth thanks to assisted reproductive technologies.  While these technologies have benefited many people, they also put more high-risk patients into obstetrics wards every year.

According to the CDC,  the best ways for women to avoid pregnancy related complications and maternal mortality involve taking good care of their bodies before getting pregnant.  Losing weight, stopping smoking, and getting untreated diabetes or hypertension under control before becoming pregnant is critical to a healthy mother and baby.

Source: cdc.gov

Researchers are re-examining breast cancer treatment protocols after several recent studies have indicated that breast cancer may be overdiagnosed and overtreated in the United States.  One study, released last week in the New England Journal of Medicine, indicated that as many as 1.3 million women in the United States have been misdiagnosed with breast cancer in the last 30 years when their tumors were in fact benign.

This overdiagnosis rate is due to false positives in breast cancer testing, which sometimes cause doctors to begin full breast cancer treatment, including surgeries, chemotherapy, and radiation therapy, for women whose tumors would never develop into cancer.

A second study, released a few days later, followed up with women who had selected to undergo preemptive double mastectomies to prevent breast cancer from recurring.  Many of these women were under the impression at the time of their double mastectomy that they would be very likely to get new breast tumors if they did not have both breasts removed, even if cancer was present in just one breast.

The findings in the study show that in these cases, double mastectomies lead to significantly longer recovery times and more complications, including infections.  However, according to study authors, the chance that the women in the study would have actually experienced a recurrence of tumors in the breasts was less than 30 percent.

The study concludes that while women whose family history or genetic factors make them particularly susceptible to breast cancer may want to have preemptive double mastectomies, women without these factors may not want to.

Double mastectomy patients have a large amount of skin and tissue loss, and the study's results indicate that women report it may take up to two years to fully recover.  90 percent of women having the surgery indicated that preventing tumor recurrence was their main priority, even though the majority would not have suffered from a recurrence regardless of whether they had chosen lumpectomy, single mastectomy, or double mastectomy. 

For women without genetic factors like BRCA1 or BRCA2, researchers say that women who have early-stage breast cancer may be better served by getting a lumpectomy.  This outpatient surgery has significantly fewer long-term side effects and will usually result in cancer-free status for women without BRCA1 or BRCA2 genetic mutations.

Clinical guidelines for breast cancer patients have already been rapidly changing in the United States since 2010.  Recommendations for mammograms to be done once every two years for most women without risk factors like a family history of breast cancer have been met with skepticism by some patient care advocates and physicians.

Sources: nih.gov, nejm.org

Questions about the impact of current abortion and sex education laws remain after a new CDC report indicates that abortion rates are at an all time low.  In 2009, the year for which the data has recently been compiled, 784,507 abortions took place in American hospitals and abortion clinics.  This represented a five percent decrease from the previous year.  That decrease represents a record low in abortion rates in the United States.

There are several potential reasons for this decline.  One of the reasons, which the CDC mentions in its report, is that the percentage of women who are using more effective forms of contraception are going up.  Many more women report that they are using long-term contraceptives like implants, the NuvaRing, or the Mirena IUD.

Because these are the results of a survey from 3 years ago, they don't represent effects of recent abortion laws or the provisions of the Affordable Care Act that grant free contraceptives to women.  If the record low abortion rate is due to better access to high-effectiveness forms of contraception, it is likely that the ACA will continue to lower the abortion rate overall.

However, there are other reasons that abortions may be becoming less common.  The CDC notes that it appears more women are deciding to carry their unintended pregnancies to term rather than abort.  While this could represent a change in overall willingness to obtain an abortion, it could also be due to increasingly severe abortion restrictions that have decreased the overall availability of abortions in many states.

Most U.S. states have fewer abortion clinics today than they did in the 1980s, which means that abortion services are difficult to come by, especially for women who live far from major city centers and lack transportation.  In several U.S. states, only one abortion clinic remains open.  Some of these clinics are open only part-time, flying in doctors from other states because the area around the clinic is hostile to abortion doctors and nurses.

Because of these restrictions to access, it's difficult to gauge how much of the decrease in abortion totals should be attributed to better use of contraceptives and how much abortion restricting laws are responsible.

Some of the laws that have recently begun restricting abortion access in the United States include laws prohibiting abortions after 20 weeks because of much-maligned research pertaining to fetal pain.  There have also been restrictions attacking abortion clinics with everything from stricter building codes that require multi-million dollar remodels to statutes requiring doctors to give information the federal government says is misleading to pregnant women seeking an abortion.

However, there is one unquestionable bright spot in the CDC report.  For yet another year, the United States has recorded zero maternal deaths from illegal abortions.  Only 12 deaths resulted from the nearly 800,000 abortions performed legally in the United States.  This is a number that represents a significantly lower mortality rate than the maternal mortality rate of mothers who choose to carry their pregnancies to term, and indicates how safe abortion is in legal settings in the United States.

Sources: cdc.gov, washingtonpost.com

Women who are interested in changing the appearance of their vulva may want to pay attention to a new study released in the journal Obstetrics & Gynecology this month.  According to the study, the reasons that women seek out these cosmetic procedures are largely aesthetic, and they are often misinformed by internet sources about the risks and effects that they will see after the procedure is complete.

Currently, approximately 90 percent of people seeking any type of cosmetic surgery to change the appearance of their genitals are women.  The study in Obstetrics & Gynecology says that women seeking labiaplasty procedures (the most common genital “rejuvenation” procedure, in which the inner labia are reduced in size significantly) are generally concerned that they do not appear normal. 

The researchers concluded that most, if not all, of these women had very little to be concerned about: their labia were definitely within what was considered a normal range of sizes.  However, current trends for pubic hair removal and the appearance of women in pornography makes some women feel that their anatomy is a problem.

One of the most shocking facts that the researchers discovered was that vaginal “lifts” and labiaplasty are being recommended for patients who are getting younger and younger.  In one case, the researchers noted that a girl of just 11 years old was referred for a labiaplasty even though her anatomy was within normal limits and did not cause her discomfort.

Websites advertising these procedures often contained a mix of correct and incorrect information about what the expected results could be.  About half of the websites studied by the researchers promised women that they would be able to experience more sexual pleasure if they had labiaplasty or vaginal tightening surgeries.

They also noted that the websites in question tended to display a disgust with normal female genitals.  Because the sites were intended to promote surgery, the study says, they tended to invite negative comparisons to any genitals that didn't look the way that the surgeries make them look.

When women with normal genitals were referred to one clinic, they were told that their appearance was normal and asked if they would like a referral to counseling that could help them with their body image and self confidence.  While some of these women took the referral, over 40 percent of women who were told their bodies were normal still wanted to pursue surgery through any means necessary.

Currently, studies show that many of these procedures can actually reduce sensation, and their long term effects are unknown.  Several lawsuits are already pending against providers of vaginal rejuvenation procedures.  The Obstetrics & Gynecology study authors are calling for comprehensive policies to regulate the way in which providers of these surgeries are allowed to advertise.  Otherwise, the researchers warn that there could be public health ramifications if normal women and children continue to believe that their bodies are wrong and in need of surgical correction.

Sources: cdc.gov, wiley.com