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CLAIM TRENDS
January
2000
Where
We Have Been
As
we close out 1999 and begin the year 2000, a retrospective claims and risk management
review is in order. According to the PIAA Claim Trend Analysis, the number of
medical malpractice claims closed over the last decade remain steady, with slight
decreases in 1997 and 1998. While we have seen a slight decrease in the number of
claims, the amount of money paid to close those claims has risen dramatically.
Indemnity payments, adjusted for inflation, have risen 37% in the last decade with the
largest increase (17%) between 1996 and 1998. NPM’s claims data parallel these
national statistics, also reflecting an increasing severity.
Where
We Are Going
A
brief glance at the news reports or a conversation with your neighbor is all you need to
judge the tenor of public opinion regarding perceived problems in the health care
industry. 1999 culminated in a flurry of
criticism from the public sector and legal activity from governmental entities. Here is a sampling:
The National Academy of Sciences Institute of Medicine reported that medical
errors kill tens of thousands of patients each year; President Clinton reacted to that
report by forming a task force to seek a 50% reduction in medical errors over the next
five years; federal legislation was proposed that would open the National Practitioner
Data Bank to public scrutiny; Congress argued extensively over legislation that would
enable patients to sue their HMOs; and, finally, HCFA attributed Medicare’s 1999 zero
inflation rate to the war on health care provider fraud and abuse. The public is clearly suspect of the health care
industry as a whole. Our claims data
suggests that physicians are not immune from this distrust.
What
We Can Do
With
all of this negative publicity, it is imperative that physicians work to win back the
trust of their patients. NPM’s claims
analysis revealed that the top three issues identified in 1999 closed claims were:
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Delayed
or inappropriate treatment, diagnosis, follow-up, referral and exam;
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Failure
to respond to patient complaints; and,
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Failure
to coordinate care among specialists and other providers.
What can you, as physicians, do? Recommit to an effective risk management program
that focuses on the following three areas:
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Maintain
technical expertise and practice only within the scope of your expertise. Communicate with other health care providers
effectively to promote uninterrupted patient care.
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Establish
and nurture the physician-patient relationship. Share
the risk of health care with your patients by involving them in decision making and
emphasizing the importance of the physician-patient relationship.
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Evaluate
and create office systems that enhance patient care.
Commit to identifying and managing risks in your office. Train your office personnel to do so as well.
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