The Malpractice of Suing Malpractice

In reaction to the news raised by one of my doctor-friends

http://news.inq7.net/opinion/index.php?index=1&col=&story_id=13862

My .02 on this –

Medical malpractice law must be rooted first in the improvement of medical services. Rather than using the malpractice law as a goad to pinpoint accountability and assign blame, the key factors government should be considering are:

1. The state of the medical profession in the country
2. The professionalism and adequate preparation of medical professionals
3. Giving appropriate monetary and non-monetary rewards and recognition to medical professionals to prevent their exodus
4. Making basic medical care more affordable to the greater mass of the Filipino public.
5. Increasing basic public health awareness so that medicine will be more preventive than curative.
6. Putting more money in public health programs as a percentage of GDP.

The other obvious factors in developing a medical malpractice law are:

• Creating and maintaining a largely incorruptible implementing mechanism. Who determines the degree of malpractice or neglect? How will they be selected? What is the nature of their involvement – paid or voluntary, temporary or permanent? How do you make them resistant to monetary or other forms of pressure? And most importantly – what makes you sure that making them cops won’t ruin their professional competence and/or judgment?
• Ensuring that cases are adequately and expeditiously filed and decided upon. Who will report cases? Who will conduct preliminary investigation? How will you secure support from hospital administrators? Where will documentation support come from? Who will rotate the evaluation of cases? How many people will you assign eventually to the whole support structure? How will you ensure that cases of “justice delayed, justice denied” will not proliferate?
• How can you protect doctors from wrongful filing or nuisance cases?
• How will you educate doctors in the nuances of the law? And who will educate them? How do you assign levels of accountability – supervising physician, ER physician, head nurse, shift nurse….heck, even the freaking janitor – when a case comes up?
• In the end, where will all the money come from to make sure this law is properly implemented?

I realize that there are a lot of holes in what I just mentioned, and/or somehow there are structures in place that will do some of the roles…

The government can’t implement a medical malpractice law, not with health care receiving less than 5% of total GDP! It’s f**king crazy if you ask me. The medical profession is best served by a better government program that is focused on developing better health professionals and delivering medical services where they are most needed, i.e. at the rural and barangay levels.

To do that, there are several directions, but the one that sounds best to me is to make internships and training more “organic,” i.e. assigning more interns to do more community work.

The real winners for any medical malpractice law in the Philippines would be the insurance and the medical supply companies, i.e. pharmaceutical manufacturers, medical laboratories, the whole kit-and-caboodle that support the medical profession, without necessarily translating into better medical services. Doctors will ask for more tests, more lab work, instead of doing some real doctor-ing. Yup, these “do-gooders” will have just ensured that medical professionals will seek work overseas, where at least their medical insurance bills would be covered by the higher standard of living of their patients and higher paychecks for them, too.

A law is needed, but lawmakers and public affairs people should first put the state of public health in the Philippines in the proper context.

That’s just about it. More if I think of something later.