Malpractice Insurance Info & Resources

It’s becoming clear that not only are patients tired of the system, but medical professionals are not happy either. You would think that with all the different technology we have now that providing healthcare would be easier, but it seems to have created a more complicated system. Patients are more informed because of the Internet and they are demanding more answers. They have more questions to ask their doctors that requires more time, which there isn’t in most hospital environments.

It’s a tough, frustrating cycle.

The first step in change is to admit that there is a problem. It’s time for top-level executives and management in the medical community to notice that the current system is not working. Doctors and nurses are overworked. They would rather sell Tupperware than work another day in medicine. They’re stressed out and afraid of making mistakes. They don’t have the energy to provide the type of care that patients need. People require that basic human touch and to be heard. Patients want to know that they are respected and their health is a priority - not increasing hospital revenue or taking kickbacks from a pharmaceutical company for prescribing their toxic drugs.

Perhaps it’s time for the medical industry to get out of the “business” of medicine and into the business of healing people. What if medical professionals could spend just a few more minutes with each patient in order to build trust and develop authentic relationships?

There needs to be a shift in mindset of the medical system. It’s time to take a step back and think objectively about ways to improve the way healthcare is administered. Let’s inspire and support future doctors and healthcare providers so that they remain in the medical field. Many of them are passionate and dedicated to improving the health of our communities. Let’s reciprocate that passion towards them by taking steps to change.

Will this type of penalty issued by the government really help to reduce errors and improve safety? We probably will not know for a couple years, but it’s certainly a start. At least we know that the government is aware of how important this issue is and taking a stand to send a message to the medical community that the problem cannot continue any longer. 

Some people might argue that punishing hospitals may be counterproductive because that will cause more stress for medical professionals, which may lead them to practice even more defensive medicine. They will order more expensive tests in order to avoid errors in diagnosis.

Medical errors can happen anytime and there isn’t just one solution to this complicated problem. There are a number of ways to improve patient safety whether it’s having physicians enter patient information into the computer versus handwriting them on paper, washing hands consistently, using checklists, or simply spending more time with each patient and making sure there is open communication between patient and provider.

It may be important to note here that a Consumer Report released on December 16, 2014 says that patients who received respectful treatment by hospital clinicians reported fewer medical errors and better experiences. So could helping providers see patients as people be the key to safety instead of government fines? What if it could be as easy as being open and honest with each patient?

What do you think it will take to improve patient safety? Let’s get the conversation going on Twitter or Facebook. Share your thoughts by tweeting @Nexus_Insurance or posting on the Facebook page: facebook.com/NISMalpracticeInsurance.

In a recent poll conducted by SERMO, a social network for doctors, 54% of doctors considered themselves workaholics while 46% of doctors said they were not.

Given that most doctors spend more hours at work than your average person, it’s not surprising that the majority of them would be workaholics. After all, working an 80-hour work week was the norm during internship and residency. We can assume that doctors are passionate about the work they do and enjoy helping people, not to mention that they are paid handsomely for their contributions, which is another motivating factor.

There are some doctors, however, who are feeling the burn of being overworked. The mindset is that “this is just the way it is”. They have accepted this idea that their career will always come before anything else.

The truth is, work-life balance can exist for doctors if they choose to allow it and set priorities.  There’s nothing wrong with working long hours if you enjoy it and your family (if you have one) is understanding. On the other hand, if work interferes with your own personal health, causes resentment in relationships, and you become burned out, then maybe it’s time to step back and take inventory of your life.

So what steps can you take towards the life you really envision for yourself? In an article by Dr. Dike Drummond of TheHappyMD.com, he says that work-life balance depends on how often you say “No” in the right ways at the right times while saying “Yes” to the most important things in your life that are outside of your career. Dr Drummond suggests reflecting on what your desires are outside of your work and to make a list of relationships, hobbies, and experiences that are important to you. Make time for the things on this list by scheduling time on your calendar, then say “No” when work tries to creep in during those times that you have an important activity planned.

It will take some time to break that habit of saying “Yes” to work all the time, so if you’re serious about not allowing your career to run your life, make sure to implement this plan immediately.

Are you a doctor who is recovering workaholic? What steps did you take to turn your life around?

As all of this is going on, many people have lost sight of what health care is all about, which is healing people and caring for them. Organizations have become occupied with ways to cut costs, make more money, and expedite interactions with patients.

Yes, there are patient advocate groups and people who do remember why they got into the medical field in the first place, it seems as if they’ve been lost in the shuffle. Progress is being made as their voices have become more amplified with the Internet and social media, but at the same time change doesn’t seem to be coming fast enough. Because the media wants to focus on the politics and business of healthcare, we oftentimes get sucked into the drama, which is a major distraction.

You have to wonder sometimes if change will ever be made.

So what would this ideal medical world look like if we could shut out all the noise of politics and the business of healthcare?

First, there would be a culture of putting people first above everything else. Healthcare organizations would look out for their employees and ensure their wellbeing at all times. This means all medical professionals’ workloads would be less so they’re not experiencing burnout. Hospital executives would be concerned more with employee morale and patient safety rather than how much money they’re making or saving.

As for medical professionals, the threat of being sued for medical malpractice wouldn’t be a thought in their minds because they are so focused on being present with each and every patient. They genuinely care for their patients and develop relationships with them through constant communication. As a result, patients would feel protected and trust their healthcare providers.

Lastly, hospitals and medicine would truly contribute to healing people. Hospitals would be warm, inviting, and comfortable places. Processes and procedures would operate smoothly because people within the organization don't feel rushed, overworked, or overwhelmed with paperwork. There would be enough staff to take care of patients in a timely manner. People support each other and look out for one another. Everyone has the same vision.

What do you think? Can we work together to change the way people view healthcare?

There is already a lack of trust in the medical profession due to reports about hospitals overcharging patients for procedures. There are also media stories regarding medical errors that are not being reported. It's time to regain back that trust and bring back the human touch to healthcare.

With all the different technologies and apps that are being used now, that adds another layer of challenges for effective communication between people. Many people now prefer to communicate digitally, which creates issues of security and privacy between medical professionals and patients. This is especially the case for electronic health records (EHR) where there is always the potential for hackers  or third parties to gain access to people's information.

So what can be done to improve communication in the healthcare industry so that patients receive better care?

Offer communications skills training - It’s typically not a class you would see as part of a healthcare professional’s ongoing education curriculum, but communication happens every day between people. Whether it’s verbal, non-verbal, or written, communication skills are vital and can be the difference between a patient receiving quality care and a patient who is not satisfied and files for malpractice.

Simplifying technology surrounding electronic health records (EHR) - Patients have a right to view their health records, but gaining access to them can be a challenge. Other issues with EHRs include:

Not being able to access the EHR via the Internet

Cumbersome technology that is time-consuming for medical professionals

Inaccurate information about patients because of template-based notes

Be thorough during patient handoffs. The transfer of responsibility for a hospitalized patient from one resident to another can often be interrupted or rushed, which can contribute to miscommunication and errors. Sign-outs are often done via email, text, or written notes. Aim for handoffs that are face-to-face or via phone. Sometimes there are important details about a patient that can come up in conversation that wouldn't otherwise have been communicated.

Developing a system of consistent communication and trust will take time and commitment by everyone within an organization. Is it possible? Yes, but it will require a change in mindset and habits.

What other tips would you add to improve communication in healthcare?

So what do these lower malpractice insurance premiums mean? There are several ways we can look at it. First, these declines rates could mean that there is more competition in the insurance marketplace. Healthcare professionals have more choices available, so providers are more inclined to offer lower premiums. States like Michigan have a variety of carriers that 75% of providers in the state, and no carrier in particular has a dominant market share.

Another implication of lower malpractice insurance premiums is the decline of malpractice claims. Contrary to popular belief, malpractice payouts have actually decreased and only comprise about 2% of healthcare costs in the U.S. According to Diederich Healthcare’s “2013 Medical Malpractice Payout Analysis”, payouts were $3.6 billion in 2012, which was 3.4 percent lower than the previous year.

For medical professionals, lower malpractice insurance rates eases some of the financial burden, especially for independent physicians who have their own practice. Also, other doctors who have contemplated moving to another state because of high premiums may be able to stay put.

Malpractice insurance carriers base their rates on a number of factors, which includes the claims history of a region. How often are medical professionals held liable, and how big are the settlements? Some rates can be as low as a few thousand dollars for physicians while specialty doctors such as obstetrician/gynecologists can see premiums as high as $200,000 or more.

It’s hard to predict whether malpractice premiums will continue to decline, or if they’ll spike up again in the future. Regardless of what is happening in the marketplace, medical professionals can always do a number of things to help lower their premiums such as taking a risk management course, getting board certified, or continuously shopping around for the right policy at more affordable rates. Also, if a doctor has been claims-free for at least five years, some carriers will offer a discount.

1. Don’t offer advice or treatments if it is outside of your field of expertise. Likewise, don’t offer any type of medical care if you are not at work. Refer the person to their doctor or personal physician instead.

2. If you order a test for a patient, follow through with your colleagues to ensure the test was completed and find out the results. Communication is key when you have a patient under your care. Make sure that you and your colleagues are on the same page. It’s also important to communicate effectively with patients and that they understand what is going on at all times.

3. Document everything that happens between you and your patients. Be diligent about taking notes of any advice and treatments you offer so that outsiders are able to see your process in case of any misunderstanding.

4. Take a deep breath and slow down. This can be a challenge, especially if you work in a high-pace environment like the emergency room, or the ratio of patients to nurses is high. You may be in a rush to get to that next patient, but that can lead to careless mistakes. Even a short pause to take a deep breath can make a difference.

5. Get plenty of sleep. The effects of insufficient sleep have been well documented including cognitive issues, mood swings, reduced job performance, reduced motivation, increased safety risks, and physiological problems. Struggling to stay awake during your shift can lead to detrimental consequences including medical errors.

In addition to following these tips to avoid malpractice lawsuit, it’s also important for nurses to evaluate their malpractice insurance to ensure they have adequate coverage. Some nurses have their own liability insurance policy, but there are many who rely on their employer’s coverage, which may not be sufficient. One of the benefits of having your own coverage is that you get your own personal attorney who will protect your needs as opposed to serving your employer’s interests first.

The first step is to make a commitment to living a more mindful, balanced life. This requires a shift in mindset and paying attention to the things that are wasting your time while being more focused on your priorities. If you want to spend more time with your kids or a significant other, spend less time shopping online or watching mindless TV. Say “No” to the negative people in your life who suck your energy by their constant complaints.

One of the best ways to reduce stress is to get outside and exercise, whether it’s walking for 10 minutes each day or doing some type of outdoor activity. Besides the physical benefits of exercise including increased fitness and keeping diseases at bay, exercise helps to improve mental clarity including alertness and concentration.

Just about every doctor knows this, but how many actually do exercise on a regular basis is few, so it helps to have a reminder every once in a while. Finding a partner to exercise with helps to keep you on track and accountable.

Another great way to reduce stress is to find a hobby that activates your creativity. Do something fun that you can really get into so that it recharges your energy.  A hobby helps you get “lost in the moment” and is very relaxing. You’ll go back to work feeling more inspired and passionate about what you do.

Much of our stress begins in our mind, so it’s also very important to develop a healthy positive mindset. Stop focusing on past mistakes and stop worrying about what could happen in the future. Negative beliefs can take a hold of our mind and have power over us, which can drain us emotionally and spiritually.

Reducing doctor stress is one step to developing a healthier and happier medical community. A more relaxed, calm doctor can be more effective in their work and contribute to a better healthcare environment.

In 2004, the FDA implemented a new rule requiring bar codes on certain drug and biological product labels. Each patient is given a bar-coded identification wristband that transmits information to the hospital's computer. Before dispensing medications, nurses scan the wristband to pull up a patient's full name, social security number, and the exact medications the patient has been prescribed.

Another idea is to eliminate abbreviations and dosage expressions that can be misinterpreted. A study conducted by Bates DW, Cullen DJ, Laird N, et al. that was published in JAMA about medication prescribing discovered that more than 30% of all handwritten prescriptions had a mistake of some type that required deciphering and correcting by a pharmacist. For example, the number 1 error-prone medication is insulin in which the abbreviation "u" for units is often confused with the number 0. ISMP reports that these errors have been occurring for over 30 years.

Patients are often given the incorrect medication. There are thousands - if not hundreds of thousands - of medications on the market nowadays. It would be good to limit the look-alike and sound-alike drug names, and confusing packaging. The pharmacy manager should develop a sound policy and procedure for the safe distribution medication and supplies to patients.

Reducing medication errors will take a major revamping of the system. Development of new policies and procedures does involve many departments from pharmacy to risk management, legal counsel, and upper level executives. Included in these new policies and procedures is taking a great deal of care and consideration in hiring personnel, evaluating their competency, and ensuring proper training so that tasks are performed adequately.

A review of medication programs and quality improvement should be ongoing, and all personnel should be committed to the safe use and distribution of medications.

These are just a few of the major issues and solutions when it comes to medication errors. What other things can you think of to help reduce mistakes?

Then there are trial lawyers who fight tort reform, saying all they want to do is protect people against negligent medical professionals.

So who benefits from tort reform? Why does the reform debate sometimes feel stuck and no progress is being made?

Some might argue that trial lawyers only want to see an increase in malpractice caps because they stand a chance to make more money from their clients. An example of this is Proposition 46 in California, which proposes to raise the cap on non-economic damages, and is written and backed solely by lawyers. Many statewide and community organizations have opposed Prop 46 because they feel it will cost taxpayers millions of dollars, plus raise healthcare and malpractice insurance premiums.

Tort reform is a big issue with many aspects to consider. In a perfect world a solution would be one in which everyone benefits - victims of malpractice are compensated fairly, medical professionals are given reasonable rates for malpractice insurance without any fluctuations, the cost of healthcare would remain low, and taxpayers do not have to fit the bill for malpractice lawsuits.

However, maybe our focus is on the wrong things. We're thinking about all the financial aspects. Would our energy be best used if we paid more attention to patient safety and really made a push to ensure medical professionals are conscientious in their work? What if suddenly the number of incidents of malpractice dropped? If patient safety was the priority, we wouldn't have to worry so much about medical errors and lawsuits.