An interdisciplinary review / Committee to Study Medical Professional Liability and the Delivery of Obstetrical Care, Division of Health Promotion and Disease Prevention, Institute of Medicine.

Format:

Book

Author/Creator:

Institute of Medicine (U.S.). Committee to Study Medical Professional Liability and the Delivery of Obstetrical Care.

Series:

Medical professional liability and the delivery of obstetrical care ; v.2

Language:

English

Subjects (All):

Physicians' malpractice insurance--United States.

Physicians' malpractice insurance.

Obstetricians--Malpractice--United States.

Obstetricians.

Physical Description:

1 online resource (256 pages) : illustrations

Edition:

1st ed.

Place of Publication:

Washington, D.C. : National Academy Press, 1989.

Language Note:

English

Summary:

The second volume of an overall look at the "malpractice crisis" sheds fresh light on the civil justice and insurance systems, medical liability issues, and their combined effect on health care for mothers and children. Topics include the liability implications of the rising rate of Cesarean sections, an evaluation of the American Medical Association's proposed alternative to the justice system for resolving medical liability disputes, and a review of legislative proposals under consideration.

Contents:

Medical Professional Liability and the Delivery of Obstetrical Care

Copyright

LIST OF CONTRIBUTORS

CONTENTS

PREFACE

KEYNOTE ADDRESS

THE MEDICAL BACKGROUND

The Impact of Technology Assessment and Medical Malpractice on the Diffusion of Medical Technologies: The Case of...

HISTORY OF FETAL MONITORING

EFFICACY AND SAFETY OF ELECTRONIC FETAL MONITORING

DIFFUSION OF TECHNOLOGY

Policies Toward Medical Technology

Policies Toward Development of Electronic Fetal Monitoring

Policies Toward Evaluation of Electronic Fetal Monitoring

Policies Toward Payment for Electronic Fetal Monitoring

Policies Toward Use of Electronic Fetal Monitoring

IMPACT OF TECHNOLOGY ASSESSMENT

INFLUENCE OF MEDICAL MALPRACTICE ON THE USE OF ELECTRONIC FETAL MONITORING

References

Is the Rising Rate of Cesarean Sections a Result of More Defensive Medicine?

HISTORICAL PERSPECTIVE

EPIDEMIOLOGY OF CESAREAN SECTIONS

Demographic Factors

Maternal Age

Prenatal Care

Maternal Demographics

Hospital Teaching Status

Private or Clinic Care

Hospital Ownership

Insurance Coverage

Comparison of National Cesarean Section Rates

ELECTRONIC FETAL MONITORING

DYSTOCIA

BREECH PRESENTATION

REPEAT CESAREAN SECTIONS

RISKS ASSOCIATED WITH CESAREAN SECTION

HAS THE INCREASED RATE OF CESAREAN SECTIONS LOWERED PERINATAL MORTALITY?

COST OF CESAREAN SECTIONS

HEALTH POLICY

SUMMARY

Medical Professional Liability in Screening for Genetic Disorders and Birth Defects

SCREENING PAST: PHENYLKETONURIA

SCREENING PRESENT: MSAFP TESTING FOR NEURAL TUBE DEFECTS

SCREENING FUTURE: DNA-BASED TESTING

CONCLUSIONS

EFFECTS ON ACCESS TO AND DELIVERY OF OBSTETRICAL CARE

Obstetrical Care for Low-Income Women: The Effects of Medical Malpractice on Community Health Centers.

MEDICAL MALPRACTICE AND LOW-INCOME WOMEN

PURPOSE OF STUDY

METHODOLOGY

RESULTS

Service Capacity

Provider Recruitment and Retention

Contractual Arrangements

Effect on Access to Maternity Care

Malpractice and Standards of Care

Increased Risk for Family Doctors

Accumulated Exposure

Per Se Risk

RECOMMENDATIONS

References and Notes

Medical Professional Liability and Access to Obstetrical Care: Is There a Crisis?

PROFESSIONAL LIABILITY CONCERNS AND CHANGING OBSTETRICAL PRACTICE

What Changes Are Occurring in Obstetrical Practice?

Are These Changes Occurring Because of Professional Liability Concerns?

Summary

THE IMPACT OF PHYSICIAN PRACTICE CHANGES ON ACCESS TO CARE

Access for Medicaid Recipients and Low-Income Women

Access to Care in Rural Areas

MEDICAID RECIPIENTS AND PROFESSIONAL LIABILITY

Cost of Insurance Coverage

Fear of Litigation

Medical Professional Liability and the Relations Between Doctors and Their Patients

CAUSES OF THE PROBLEM

Malpractice

The Tort System

Social Attitudes

Commercialization of Medicine

EFFECTS OF THE MALPRACTICE CRISIS ON DOCTOR-PATIENT RELATIONS

Changes in Attitudes

Changes in Practice Organization

Changes in Physician Behavior

Professional Liability Insurance and Nurse-Midwifery Practice

PROFESSIONAL LIABILITY INSURANCE FOR NURSE-MIDWIVES

Effects on Structure of Practice

Effects of Insurance Surcharges

Changes in Practice

CONCLUSION

THE LEGAL ISSUES

Market and Regulatory Approaches to Medical Malpractice: The Virginia Obstetrical No-Fault Statute

THE LOGIC OF MARKETS: WHY CONTRACT?

The Limitations on Contract

Imperfect Information

Binding the Child

Access for the Poor.

THE VIRGINIA NO-FAULT STATUTE

The Political Setting

The Statutory Design

Coverage

Funding

A Fault-Based Administrative Alternative for Resolving Medical Malpractice Claims: The AMA-Specialty Society Medical...

THE NEED FOR DRAMATIC CHANGE

PROPOSAL FOR A FAULT-BASED ADMINISTRATIVE SYSTEM

Medical Practices Review Board

The Claims Resolution Process

Prehearing

Hearing

Board Review

Judicial Review

Reforms of the Legal Rules Governing Medical Liability Determinations

Standard of Care

Causation

Informed Consent

Damages

Physician Monitoring and Quality Assurance

IMPLICATIONS OF THE PROPOSAL FOR LIABILITY AND ACCESS PROBLEMS

Implications for Resolving Liability Disputes

Implications of Proposed Changes in Legal Standards

Changes Resulting from Improved Physician Monitoring and Credentialing

Possible Modification of the Proposal for Specific Types of Claims

The Shadow of the Law: Jury Decisions in Obstetrics and Gynecology Cases

JURY VERDICTS AND THE DISPUTE RESOLUTION PYRAMID

JURY VERDICTS AND THE SHADOW THEY CAST

JURY VERDICTS IN OBSTETRICS AND GYNECOLOGY

General Contours of the Shadow

Distribution of Verdicts Among Sites

Plaintiff Success Rates

Types of Obstetrics and Gynecology Cases

Severity of Injury

Cause of Injury

Class of Injury

Awards

A More Detailed View of the Shadow

Pregnancy

Labor and Delivery

Abortion

Hysterectomy

Tubal Ligation

Cancer

Interpreting the Shape of the Shadow

The Virginia Birth-Related Injury Compensation Act: Limited No-Fault Statutes as Solutions to the "Medical Malpractice...

SIGNIFICANT FEATURES OF TRADITIONAL TORT AND ALTERNATIVE COMPENSATION SYSTEMS

General Descriptions of the Systems.

Traditional Tort Liability System

Comprehensive No-Fault Alternative

Limited No-Fault Statutes

How Is Each System Implemented? What Is the Source of Each System's Legal Authority?

The Traditional Tort System

The DCE System

The Virginia No-Fault Statute

What Triggers Liability? What Events Are Compensable?

Who Pays? Who Gets Paid?

How Is the System Funded?

How Are the Benefits Measured?

By What Processes of Decision Are Claims Handled?

How Exclusive Is the Remedy Provided? What Is the Interface with Other Compensation Systems?

COMPARING AND CRITIQUING THE GOALS AND OBJECTIVES OF THE THREE LIABILITY-COMPENSATION SYSTEMS

Legislative Proposals on Medical Professional Liability Regarding the Delivery of Maternal and Child Health Care

THE PROBLEM

STATE REFORMS

Collateral Source Rule

Joint and Several Liability

Limitations on Attorneys' Fees

Limits on Damages

ALTERNATIVES TO TORT REFORM PROPOSALS

Federal Proposals

Provider Proposals

INDEX.

Notes:

Bibliographic Level Mode of Issuance: Monograph

Includes bibliographical references and index.

ISBN:

9786610214471

9781280214479

1280214473

9780309543033

0309543037

9780585198903

058519890X

OCLC:

923267430