Wednesday, September 28, 2005
Malpractice is the reason why many doctors stop treating nursing home patients
"The letter, which was sent to about 130 patients or their families, said that it was ending doctor's visits to nursing homes due to the rising cost of malpractice insurance and the practice of nursing homes limiting their own liability by continually contacting patients' medical-care providers.
'Hundreds of faxes, phone calls and inquiries concerning our patients flow to our offices from the nursing homes daily,' the letter reads, referring to about 130 patients.
Dr. Robert Monteiro, of ECIM, said the 'unstable situation in nursing homes' was a concern since there can be problems with high turnover at facilities.
'And so that's the environment that we were practicing in,' he said. 'It became a very difficult environment.'" (via Common Good)
"The letter, which was sent to about 130 patients or their families, said that it was ending doctor's visits to nursing homes due to the rising cost of malpractice insurance and the practice of nursing homes limiting their own liability by continually contacting patients' medical-care providers.
'Hundreds of faxes, phone calls and inquiries concerning our patients flow to our offices from the nursing homes daily,' the letter reads, referring to about 130 patients.
Dr. Robert Monteiro, of ECIM, said the 'unstable situation in nursing homes' was a concern since there can be problems with high turnover at facilities.
'And so that's the environment that we were practicing in,' he said. 'It became a very difficult environment.'" (via Common Good)
Posted by Kevin |
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Comments:
Kevin, your headline for this item is not fair or balanced. The fact that you filter a complex and interesting set of circumstances (a single anecdote rather than a nationwide phenomena) through a single lens of malpractice reform is disappointing. Would a headline that stated "Doctors discontinue care because of greed." been fair or accurate? That's about the level of accuracy and thought you put into this entry.
So what is keeping them from requiring a waiver and hold-harmless agreement?
The problem is that patients and their families want care while in nursing homes, but expect to impose the existing liabilities on the physicians who provide that care and won't pay adequately for the privilege. The costs reflect the risks, and the patients won't pay the costs. No surprise there is no market here. What is surprising is that so many people expect there should be.
The problem is that patients and their families want care while in nursing homes, but expect to impose the existing liabilities on the physicians who provide that care and won't pay adequately for the privilege. The costs reflect the risks, and the patients won't pay the costs. No surprise there is no market here. What is surprising is that so many people expect there should be.
# posted by 
: 11:08 AM
: 11:08 AM
"The costs reflect the risks,"
How are you determining the costs and what is the basis for your determination of the risk?
How are you determining the costs and what is the basis for your determination of the risk?
# posted by : 11:33 AM
: 11:33 AM
Simple: the costs of medical malpractice insurance if a practice sees nursing home patients--when it is available at all--is more than when a practice certifies to their insurer that they do not see nursing home patients.
# posted by : 11:40 AM
: 11:40 AM
"Simple: the costs of medical malpractice insurance if a practice sees nursing home patients--when it is available at all--is more than when a practice certifies to their insurer that they do not see nursing home patients."
Actually, all you assessed there was the cost. It doesn't appear if you know if it's any more risky or not, or whether the cost should be higher, and if so why and what could be done to combat it.
Physicians should be wary of hooking up with the nursing home industry.
Actually, all you assessed there was the cost. It doesn't appear if you know if it's any more risky or not, or whether the cost should be higher, and if so why and what could be done to combat it.
Physicians should be wary of hooking up with the nursing home industry.
# posted by : 12:03 PM
: 12:03 PM
"Actually, all you assessed there was the cost. It doesn't appear if you know if it's any more risky or not, or whether the cost should be higher, and if so why and what could be done to combat it."
It doesn't matter whether the physician thinks the risk is greater or not. For the doctor, that isn'r even all that relevant. Malpractice insurers query their insureds at their annual renewal application time whether the practice is engaged in seeing nursing home patients. The quote follows, that is, if the application is approved. Sometimes it isn't.
The assessment of risk isn't the doctor's, it is the insurer's.
So the assessment of risk is imputed from added cost of the liability insurance. Is that a fair reflection of the added risk? Who knows? It really doesn't matter, since you can't practice without malpractice insurance in most hospitals.
It doesn't matter whether the physician thinks the risk is greater or not. For the doctor, that isn'r even all that relevant. Malpractice insurers query their insureds at their annual renewal application time whether the practice is engaged in seeing nursing home patients. The quote follows, that is, if the application is approved. Sometimes it isn't.
The assessment of risk isn't the doctor's, it is the insurer's.
So the assessment of risk is imputed from added cost of the liability insurance. Is that a fair reflection of the added risk? Who knows? It really doesn't matter, since you can't practice without malpractice insurance in most hospitals.
# posted by : 12:14 PM
: 12:14 PM
So you don't care how your insurer sets your rates? You just care what they are?
Then perhaps you shouldn't say things like "the costs reflect the risks", when you have no idea what the costs reflect.
Then perhaps you shouldn't say things like "the costs reflect the risks", when you have no idea what the costs reflect.
# posted by : 12:28 PM
: 12:28 PM
Anon 1:29, are you deliberately trying to be obtuse? Your point here is impertinent.
If you are trying to understand the reasoning of the doctors in the article, that is, why see nursing home patients if doing so results in increasing your malpractice liability premium, then my post pretty much states the situation.
To the practitioner, the situation is obvious. I am gathering by your brief comment that you don't practice medicine or understand the issues here.
Do you think the article misses some important element of this problem? If you do, please explain. Otherwise you seem like you are trying to make an argument of nothing.
If you are trying to understand the reasoning of the doctors in the article, that is, why see nursing home patients if doing so results in increasing your malpractice liability premium, then my post pretty much states the situation.
To the practitioner, the situation is obvious. I am gathering by your brief comment that you don't practice medicine or understand the issues here.
Do you think the article misses some important element of this problem? If you do, please explain. Otherwise you seem like you are trying to make an argument of nothing.
# posted by : 1:19 PM
: 1:19 PM
"Physicians should be wary of hooking up with the nursing home industry"
Whoever said anything about "hooking-up" with the nursing home industry? This article doesn't have anything to do with that.
Whoever said anything about "hooking-up" with the nursing home industry? This article doesn't have anything to do with that.
# posted by : 1:42 PM
: 1:42 PM
"I am gathering by your brief comment that you don't practice medicine or understand the issues here."
I don't practice medicine, but it doesn't take a license to practice medicine to note that the risk isn't even discussed in this article. All you know is the claim that premiums are higher (how much you don't know) if you work in a nursing home. You don't appear to know why that is, or have any information regarding the reasons premiums are higher. You just know they are. So really, all that's being assessed is the cost. That is the sole reasoning behind the physicians' decision. Risk does not enter into the decision.
The ONLY element of the problem addressed by this article is the cost. And it simply states insurers charge more if you work in a nursing home. Wouldn't you like to know why?
I don't practice medicine, but it doesn't take a license to practice medicine to note that the risk isn't even discussed in this article. All you know is the claim that premiums are higher (how much you don't know) if you work in a nursing home. You don't appear to know why that is, or have any information regarding the reasons premiums are higher. You just know they are. So really, all that's being assessed is the cost. That is the sole reasoning behind the physicians' decision. Risk does not enter into the decision.
The ONLY element of the problem addressed by this article is the cost. And it simply states insurers charge more if you work in a nursing home. Wouldn't you like to know why?
# posted by : 3:30 PM
: 3:30 PM
Are you assuming that there is a rational relationship between the extra claims risk encountered by physicians serving nursing home patients and the extra cost of malpractice liability insurance for those doctors who have this kind of practice? In a competetive insurance market, there should be. Is this in fact a competetive market? I don't know, do you?. Is the typical premium commensurate with the extra risk? Who knows? If the revenue gained from this activity falls short of the costs, or if engaging in this area of practice causes a doctor's insurer to drop his coverage, what does it matter if the insurers are charging fairly? This is the situation of the doctors here.
Are you really looking for an answer?
Are you really looking for an answer?
# posted by : 4:54 PM
: 4:54 PM
Nursing homes are sued so often that administrators pressure the nurses to call the doctor for the trivial and idiotic, often throughout the night.
A common 2AM call:" Your patient stumbled to the floor on the way to the bathroom, but seems fine."
A common 2AM call:" Your patient stumbled to the floor on the way to the bathroom, but seems fine."
# posted by : 5:28 PM
: 5:28 PM
"Are you really looking for an answer?"
Actually, I'm looking for an admission. An admission that this decision has nothing to do with anything other than higher insurance rates. The reason they are higher and the cures for those are unknown.
Kevin's headline is misleading, but he's in PR mode, not truth mode when ventures in this arena, so I understand. But Premiums are the reason doctors stopped treating those patients, not malpractice.
Actually, I'm looking for an admission. An admission that this decision has nothing to do with anything other than higher insurance rates. The reason they are higher and the cures for those are unknown.
Kevin's headline is misleading, but he's in PR mode, not truth mode when ventures in this arena, so I understand. But Premiums are the reason doctors stopped treating those patients, not malpractice.
# posted by : 6:01 PM
: 6:01 PM
"Premiums are the reason doctors stopped treating those patients, not malpractice."
So what?
Premiums have to be paid. Even when there is no malpractice, claims have to be defended. Activities that doctors do that are perceived by their insurers as being high-risk cause premiums to be increased or coverage to be dropped. This isn't a property and casualty risk here; of course it is about malpractice.
So what?
Premiums have to be paid. Even when there is no malpractice, claims have to be defended. Activities that doctors do that are perceived by their insurers as being high-risk cause premiums to be increased or coverage to be dropped. This isn't a property and casualty risk here; of course it is about malpractice.
# posted by : 7:05 PM
: 7:05 PM
"And it simply states insurers charge more if you work in a nursing home. Wouldn't you like to know why?"
Ummm, maybe because nursing home patients and their families sue often and for a lot of monye?
Ummm, maybe because nursing home patients and their families sue often and for a lot of monye?
# posted by : 7:33 PM
: 7:33 PM
"Actually, I'm looking for an admission. An admission that this decision has nothing to do with anything other than higher insurance rates"
Well, you are in the wrong place for that.
This is a blog thread. Why don't you write the doctors who are interviewed in the article to see if they have any "admissions" for you.
Well, you are in the wrong place for that.
This is a blog thread. Why don't you write the doctors who are interviewed in the article to see if they have any "admissions" for you.
# posted by : 8:29 PM
: 8:29 PM
I DON'T UNDERSTAND. IF ALL YOU LAWYERS THINK THE REASON THE HEALTH CARE SYSTEM IS SO SCREWED UP IS BECAUSE THE INSURANCE COMPANIES KEEP RAISING RATES AND ARE MAKING SO MUCH MONEY, WHY HAVEN'T YOU ALL QUIT LAW AND GONE INTO INSURANCE? (AND KNOW I WON'T STOP SCREAMING, I'M SO PISSED OFF)
# posted by : 8:53 PM
: 8:53 PM
It's very simple. Insurance is a very competitive industry. If a company is getting greedy then another will swoop in with lower rates and steal away the first company's business.
# posted by : 7:25 AM
: 7:25 AM
If suing doctors is such an easy way to get rich, why haven't all you doctors and all these insurance execs at these allegedly broke insurance companies become lawyers suing physicians?
I think the reason you may be screaming is that your ignorance has left you feeling helpless.
I think the reason you may be screaming is that your ignorance has left you feeling helpless.
# posted by : 7:54 AM
: 7:54 AM
"I think the reason you may be screaming is that your ignorance has left you feeling helpless."
Obviously not.
The poster is trolling. Best ignored, because he really isn't inerested in the problem or in a discussion, just provocation.
Obviously not.
The poster is trolling. Best ignored, because he really isn't inerested in the problem or in a discussion, just provocation.
# posted by : 8:37 AM
: 8:37 AM
If I was trolling I'd probably be posting in all caps about how horrible physicians are.
Pointing out the lack of physicians' knowledge of anything regarding this issue other than the amount of their malpractice premiums is not trolling. Pick a topic on this issue and I'll be glad to cordially discuss it with you.
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Pointing out the lack of physicians' knowledge of anything regarding this issue other than the amount of their malpractice premiums is not trolling. Pick a topic on this issue and I'll be glad to cordially discuss it with you.
# posted by : 8:41 AM
: 8:41 AM
