Blocked from public health system, drunk doctor finds job at private hospital

SMH, 7 April 2017
Author: Harriet Alexander
“An anaesthetist who abandoned his patient mid-operation and then passed out from intoxication has found new employment at Shellharbour Private Hospital. The doctor who had a history of drinking on the job, has not returned to work at Wollongong Hospital since the incident on its premises in May last year. But the NSW Medical Board allowed him to continue practising under certain conditions”
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Medical Liability Reform in a New Political Environment

JAMA. 2017; 317(13): 1311-1312.
Authors: Anand Parekh, William Hoagland
“Many physicians, patients, and other interested parties do not consider the current medical malpractice system to be optimal. For example, it has been estimated that only 2% to 3% of patients who experience a medical error file a malpractice claim (although it is unclear how serious those medical errors were and if they would result in an adjudicated malpractice claim), the mean time from claim initiation to closure is more than 5 years, and nearly 50% of all compensation awarded to patients is consumed by attorney fees and administrative charges. With respect to clinicians, the annual risk of having an open malpractice claim has been reported to be 7.4%, and, by age 65 years, most physicians will have been involved in a malpractice claim. In addition, the adversarial nature of the current system makes it difficult to improve patient safety and also creates stress for clinicians.”
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Medical Liability — Prospects for Federal Reform

NEJM, 29 March 2017
Author: Michelle M. Mello, Allen Kachalia, David M. Studdert
“Medical malpractice reform appears to be back on the federal policy agenda. The appointment of Tom Price, a long-time proponent of tort reform, as secretary of health and human services, in conjunction with Republican control of both houses of Congress, has created fertile conditions for several Republican proposals that have languished for years without the requisite support. Although it has been debated many times, a major federal foray into medical liability, a state-based area of law, would be unprecedented. The prospect raises several questions: Which reforms are on the table? Would they be effective? And is the time right?”
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Cross-sectional survey on defensive practices and defensive behaviours among Israeli psychiatrists

BMJ Open 2017; 7:e014153.
Authors: Reuveni I, Pelov I, Reuveni H, et al
“Psychiatry is a low-risk specialisation; however, there is a steady increase in malpractice claims against psychiatrists. Defensive psychiatry (DP) refers to any action undertaken by a psychiatrist to avoid malpractice liability that is not for the sole benefit of the patient’s mental health and well-being. The objectives of this study were to assess the scope of DP practised by psychiatrists and to understand whether awareness of DP correlated with defensive behaviours.”
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NSW hospital patients not told their medical records were found in public areas

ABC, 20 March 2017
Author: Nick Dole
“NSW hospital patients have had their confidential details compromised on multiple occasions, including medical records being found in a public carpark. In many cases, patients were never informed because the Health District said there was not a “serious risk of harm”. The Central Coast Local Health District recorded more than 30 privacy breaches in 2014/15, and in 2015/16 there were 16.”
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Should hospitals — and doctors — apologize for medical mistakes?

The Washington Post, 12 March 2017
Author: Sandra G. Boodman
“For patients and their families killed or maimed by medical errors, Crisp’s experience — in which doctors clam up and hospitals deny wrongdoing and aggressively defend their care — remains standard operating procedure in most institutions. But spurred by concerns about the “deny and defend” model — including its cost, lack of transparency and the perpetuation of errors — programs to circumvent litigation by offering prompt disclosure, apology and compensation for mistakes as an alternative to malpractice suits are becoming more popular.”
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Florida dermatologist who falsely diagnosed hundreds of cancer cases gets $18m fine

BMJ 2017;356:j853
Author: Owen Dyer
“A Florida dermatologist who falsely told hundreds of his patients that they had skin cancer so he could bill for unnecessary treatments, including radiation, must pay $18m (£14.5m; Ä17m) to settle fraud claims made against him by the US government and a whistleblowing local doctor.”
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Stronger malpractice laws may not prevent surgical complications

Reuters, 13 January 2017
Author: Lisa Rapaport
“More aggressive malpractice climates don’t necessarily protect patients from surgical complications, a new study suggests. “It doesn’t really work – malpractice environment doesn’t influence doctors to provide better care,” Bilimoria said by email. “Rather, it may lead to defensive medicine practices where more tests and treatments are ordered unnecessarily just to try to minimize malpractice risk.”
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