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REUTERS: 1% of U.S. Docs Responsible for 1/3 of Malpractice Payments

Sat, 01/30/2016 - 01:09
In an article released on January 27, Gene Emery of Reuters writes that a large portion of the malpractice claims that result in payments to patients are caused by a small fraction of doctors in the United States.

Key Facts:

  • "Almost one third of the cases were sparked by a patient's death. About 1 percent of physicians had at least two paid claims against them and those doctors accounted for 32 percent of paid claims."
  • "One hundred twenty six doctors had more than five paid claims against them."
  • "The median payment among all claims was nearly $205,000."
  • "Doctors who accumulated two lawsuits where money was paid out were twice as likely to be successfully sued for malpractice a third time compared to doctors who only had one paid claim against them. Doctors with more than five paid claims were 12 times more likely to face a subsequent claim."
  • "Compared to general practitioners, recurrence rates were roughly two times higher in the fields of obstetrics and gynecology, orthopedic surgery, plastic surgery and general surgery. The recurrence rate was highest for neurosurgeons, at 2.3 times that of GPs."
  • "They found that physicians under age 35 were two thirds less likely to have to pay on a malpractice claim after an initial payment." 
  • "The odds of paying out on a subsequent claim were 38 percent higher among male doctors than female physicians." 
  • "Doctors trained outside the United States were 12 percent more likely to have to pay out on more than one claim."
Mr. Emery derived these statistics from an article published by Dr. David Studdert et al. in The New England Journal of Medicine, titled "Prevalence and Characteristics of Physicians Prone to Malpractice Claims."

New CMS Regulations Target Health Insurer Provider Directory Inaccuracies

Thu, 01/14/2016 - 00:45
As reported by Melinda Beck of the Wall Street Journal, health insurers may now face significant penalties under new regulations from the Centers for Medicare and Medicaid Services (CMS) for inaccuracies in their provider directories.
With the advent of these new regulations, health insurers may face fines “up to $25,000 per beneficiary for errors in Medicare Advantage plan directories and up to $100 per beneficiary for errors in plans sold on the federally run exchanges in 37 states,” writes Beck.
These new regulations are in response to the problem of patients being unable to identify in-network providers due to directory inaccuracies. This can result in unforeseen high out-of-pocket costs for patients.
Directory inaccuracies arise, and have become so widespread, because of frequent changes in provider information. As Beck writes, “Keeping directories up-to-date is difficult in part because relationships between doctors and hospitals are complex and frequently changing. Many physicians see patients in multiple locations and may be in different insurance networks at each one. According to LexisNexis Risk Solutions data, 30% of U.S. doctors change affiliations every year.”
CMS’ new regulations call for insurers to update their directories by contacting providers on a quarterly basis to verify information.

For more information, access the full WSJ article here.

After Successful 2015, Looking Forward to 2016!

Thu, 12/31/2015 - 20:00
For the first time in the association's history, NAMSS has surpassed 5,500 members in 2015, representing a nearly 15% increase in membership since 2011! The continued growth and success of our organization is due to the tireless efforts of our dedicated staff, as well as the unparalleled commitment of our members across the country. Not only do the Medical Service Professionals who comprise the NAMSS membership serve as the gatekeepers for patient safety at their hospitals, health systems, and other medical organizations nationwide, they also serve as critical and irreplaceable ambassadors for NAMSS.

A great debt of gratitude is also owed to our current president, Linda Waldorf, for her steady and competent leadership over this past year. Growth-oriented and ever strategic, we will continue to rely on her expertise and passion in the future.

Thank you to all who have contributed to NAMSS's success in 2015. We look forward to an exciting 2016! Happy New Year!

Burnout and Depression an Increasing Issue for Physicians

Fri, 12/11/2015 - 00:00
Two new studies out this week show that depression and professional burnout are becoming more common among America’s new, young doctors. According to the Washington Post, the firstof these studies - published in the Journal of the American Medical Association - found that “nearly one third of doctors in the early stages of their careers screened positive for depression or had symptoms during their medical training.”
New physicians are particularly susceptible to depression in the years spent in internship and residency immediately following medical school due to long hours and taxing personal, physical and professional demands. One of the study’s authors, Dr. Douglas Mata, also attributed the rise in depression to the fact that many new physicians spend “40 to 50 percent of their time on the computer” completing clerical tasks, affording them fewer opportunities for rewarding and enriching clinical experiences.
“The implications for patients also are important. Depression among residents has been linked to poor-quality care and increased medical errors,” the Washington Post states.

The secondstudy, conducted by researchers at the Mayo Clinic, found that burnout is also an increasingly prevalent issue among doctors, with over 50% of physicians reporting that they “felt emotionally exhausted and ineffective” or that “work was less meaningful,” according to the Washington Post.

SD Circuit Court Rules Health Providers Can Be Sued Over Credentialing

Fri, 11/06/2015 - 22:09
According to a report by the Washington Times, a circuit court judge in South Dakota has ruled that hospitals and health providers can face lawsuits for "negligent credentialing," joining South Dakota with more than 30 other states who allow such lawsuits.

For the full story, click here.

Court Rules in Favor of Hospital's Right to Shield Medical Documents

Mon, 11/02/2015 - 19:31
According to a story from News 4 Jacksonville, the 1st District Court of Appeals in Florida ruled in favor of a Jacksonville hospital's right to not turn over certain medical documents in a malpractice case. Citing federal protections in the Patient Safety and Quality Improvement Act of 2005, the Court asserted that federal law took precedence over a 2004 constitutional amendment in Florida which"sought to ensure broad access to records held by hospitals and other health providers about 'adverse' medical incidents." For the full story, please click here.