Rapid responses are electronic comments to the editor. They enable our users
to debate issues raised in articles published on bmj.com. A rapid response
is first posted online. If you need the URL (web address) of an individual
response, simply click on the response headline and copy the URL from the
browser window. A proportion of responses will, after editing, be published
online and in the print journal as letters, which are indexed in PubMed.
Rapid responses are not indexed in PubMed and they are not journal articles.
The BMJ reserves the right to remove responses which are being
wilfully misrepresented as published articles or when it is brought to our
attention that a response spreads misinformation.
From March 2022, the word limit for rapid responses will be 600 words not
including references and author details. We will no longer post responses
that exceed this limit.
The word limit for letters selected from posted responses remains 300 words.
Medical insurers have been reluctant to release figures about
premiums received from doctors, and compensation paid out to injured
patients. The reason: too "commercially sensitive". However, they are
quick to release general figures about rising incidence of malpractice
claims and the highest damages paid. Doctors should not accept these
statistics without questioning, as it is a prelude to rising premiums. In
Australia, one insurer is requesting (with support from Australian Medical
Association) government subsidy for $30 M to enable it to continue
trading!! Yet it had recently doubled its premiums, and then assured
doctors that its reserve-fund is now healthy. Plaintiff lawyers in
Australia have confirmed that despite claims of malpractice explosion,
survey of court lists have not shown any increase. So, my US colleagues,
don't be too trusting of the media and the insurers. Retain some healthy
sceptism. Whatever you do, don't think of your patients as potential
litigants. Insurers wanting us to renew our memberships have pushed the
line for a long time.
The day we think our patients are waiting to sue us is the day we give up
medicine. Good luck. Trust your medical skills and ethics - and, most of
all, your patients.
Perhaps the most attractive option to control out of control and
frivolous medical malpractice litigation is to establish the principle of
escrow deposits of funds by litigants and their lawyers prior to legal
action. The principle could envisage a sum of money paid into an escrow
account to the tune of say five times the requested financial settlement.
If the action is successful, the escrow fund is repaid in addition to the
awarded damges plus any costs awarded.
If the action is unseccessful or withdrawn the escrow fund is forfeited to
the defendant.
The element of risk to those initiating frivolous or mischievous actions
against doctors should prove deterent whilst those with good cases would
find settlerment in the normal way.
Trust your patients, doubt your insurers.
Medical insurers have been reluctant to release figures about
premiums received from doctors, and compensation paid out to injured
patients. The reason: too "commercially sensitive". However, they are
quick to release general figures about rising incidence of malpractice
claims and the highest damages paid. Doctors should not accept these
statistics without questioning, as it is a prelude to rising premiums. In
Australia, one insurer is requesting (with support from Australian Medical
Association) government subsidy for $30 M to enable it to continue
trading!! Yet it had recently doubled its premiums, and then assured
doctors that its reserve-fund is now healthy. Plaintiff lawyers in
Australia have confirmed that despite claims of malpractice explosion,
survey of court lists have not shown any increase. So, my US colleagues,
don't be too trusting of the media and the insurers. Retain some healthy
sceptism. Whatever you do, don't think of your patients as potential
litigants. Insurers wanting us to renew our memberships have pushed the
line for a long time.
The day we think our patients are waiting to sue us is the day we give up
medicine. Good luck. Trust your medical skills and ethics - and, most of
all, your patients.
Competing interests: No competing interests