Analyzing patient safety information from the new database and other sources to assess and comply with the existing system of standards, as well as the safety of physicians’ tools and practices; assessment of the health insurance market to identify past and current legal costs associated with medical liability, factors contributing to the increase in legal costs, and factors leading to the stabilization and reduction of health insurance premiums; finally, examining the database of cases of failed negotiations under the new program to identify the causes, trends and consequences of such events.
The current compensation system does not support open communication between doctor and patient, which can positively affect patient safety. On the contrary, it threatens the patient’s safety by creating an atmosphere of fear around the issue of medical liability. Research has consistently shown that doctors are reluctant to talk about medical errors, which is understandable because they consider that they do not have adequate legal remedies5. However, this limitation makes it difficult to implement systemic and programmatic measures to prevent medical errors.
To overcome the stalemate in the debate on medical liability, we introduced the National Law on Disclosure and Compensation of Medical Errors (Bill MEDiC; S. 1784) to guide the reform towards improving patient safety (see box). The proposed MEDiC program provides grants and technical assistance to physicians, hospitals, insurance companies, and health care systems to implement malpractice and compensation programs. The MEDiC model allows the confidential disclosure of medical errors to patients, so that they feel safer. Once an error is detected, compensation should be negotiated for the patient or his family and appropriate procedures should be adopted to prevent further violations.
We suggest that in the program presented, physicians should have some protection against professional liability in order to create conditions for the disclosure of medical information. By promoting better communication between doctor and patient, this law should help solve problems outside the courtroom. In turn, physicians using MEDiC can count on savings from lower legal protection costs to lower professional liability insurance premiums and can use them to support patient safety initiatives.
The MEDiC program is based on national programs that have proven that it is possible to protect both patients and doctors, while improving the quality of healthcare. Many hospital systems and professional insurance companies already have policies for disclosing medical errors. As a result, doctors, insurers and hospitals have reduced administrative and legal costs. Research has also shown that patients have more confidence in their doctors and are more satisfied with their care. Fewer lawsuits have been filed, litigation costs have been reduced, compensation payments to patients have been accelerated, and the number of patients receiving compensation for damages has increased due to the implementation of the medical error disclosure program.