Role of Risk Management in Medical Malpractice

Role of Risk Management in Medical Malpractice

The role of risk management in the health care industry begins with many preventative actions. One of the most argued and sensitive subjects in the last decade has been that of medical malpractice. Severe bleeding during operations, breathing problems due to incorrectly performed procedures, among other malpractice issues are becoming increasingly popular for legal suits between patients and medical providers. To fight back, medical providers are working to change the legal system (Grady, 2010). One simple questions remains. Is malpractice improving, or are laws simply protecting negligent medical providers?

History of Medical Malpractice

Preventable medical errors kill or injure hundreds of thousands of Americans annually. Of this amount, 98,000 are killed at a cost of $29 billion. Medical errors have become such a large cause of death that the Centers for Disease Control has claimed it as the sixth leading cause of death in America. Approximately one out of every three Americans has either experienced or has had family experience medical negligence, making the problem an epidemic, according to University of Pennsylvania law professor Tom Baker (Baker, 2005).

An increase in malpractice lawsuits at the turn of the millennium allowed Americans to fight against medical wrong-doing. However, the medical industry worked hard to change laws to lower malpractice suits. The tort reform, which fought to take legal rights away from patients, made it more difficult for patients to win justifiable damages. Unfortunately, this is growing concern for patients, as it is not resolving the issues, but rather, simply protecting the medical negligence (REFERENCE).

3.0 The Legalities and Patients

Civil justice is helping in the reform against medical negligence. The system provides patients the right to seek compensation for their injuries due to negligence and encourages preventative patient safety systems. The risk of ignoring malpractice instead of resolving the issues and taking responsibility is creating an ever-increasing depletion of patient safety and care quality. States that have lower standards are among those that have the worst possible care (CIVIL SYSTSEM)

4.0 Doctors and Defensive Medicine

In response to the ever-increasing malpractice lawsuits, doctors have been ordering unnecessary tests and medical procedures. Though no singular reason has been able to be targeted, two theories are among the most popular beliefs as to why doctors are responding in such a manner (DEFMED).

First, some believe that doctors are providing extra, unnecessary care as an attempt to cover all medical possibilities in the event of a lawsuit. The arguable cost of these extra procedures and tests are likely concluded to lower the liability of the doctor. A more popular theory is that of additional income. The Government Accountability Organization (GAO) found that doctors most often practiced defensive medicine because it meant more income for their practice. It is believed by some researchers that physicians are picking patients and referring them to have profitable procedures done at locations that the physician has financial interest in. Though the government requires the physicians to inform patients of any financial investment prior to their procedures, the American Hospital Association is considering banning the practice altogether to discourage doctors from having financial bias (REFDEF).

5.0 Malpractice Insurance

Malpractice insurance has been the target of risk management during the health reforms. Caps have been placed on many types of medical lawsuits, which are allowing insurance companies to benefit their profit and cause financial strain on the injured. Insurance companies are not doing their portion in preventing injuries by preventing compensation to the injured. In states where doctors were less required to take responsibility for malpractice, patient safety was also at dangerously low levels. Conversely, doctors in states requiring more liability saw far better overall patient safety (REFCIVJUST).

6.0 Texas Sample

Texas has seen a considerable amount of detriment with the medical malpractice problem. In one particular case, a patient from San Antonio, Texas was seeking help at her local hospital emergency room regarding an excruciating pain in her leg. Diagnosed with "bilateral leg pain," the emergency room doctor ran some tests and then requested that she get further assistance from her regular physician. Within 72 hours, the patient discovered her legs had turned deep red and had to be transported by ambulance to a separate hospital. Doctors at the second hospital had concluded that the leg tissue had died, due to one of her veins being severely clotted. Among other issues, the patient found that her kidneys were failing. Because of the harshness of the medical emergency, the patient went unconscious, waking up weeks later to having two amputated legs (Ramshaw, 2010).

Clearly, the patient was devastated, but more so than that, she became aggravated at the original emergency room doctor's diagnosis. Had the problem been resolved earlier, there was a chance that her legs would have survived the incident. She had the perfect malpractice case, except that she was in the state of Texas, and no lawyer would take the case (Ramshaw, 2010).