Earlier this year, at the Casualty Actuarial Society’s Seminar on Reinsurance in New York, in a session titled “The Impact of the Affordable Care Act on Medical Professional Liability – an Update”, three insurance experts, a medical malpractice underwriter and two casualty actuaries, spoke about the likely effect – in terms of medical malpractice suits – of the Affordable Care Act (ACA).
Since the Act came into being, around 20 million people have signed up, which means huge scope for medical malpractice lawyers and medical negligence attorneys pursuing claims during the next decade. According to a national insurance program for medical professionals, MGIS’s executive VP and chief underwriting officer, Elke Kirsten-Brauer, roughly 25 percent of these 20 million patients have had no previous medical insurance, and are therefore likely to be unfamiliar with the healthcare system.
Kristen-Brauer also points out another factor which could lead to more medical malpractice claims – the growing dilution of doctor-patient relationships. Expanded care teams are increasingly replacing the old care model, whereby a physician would make the initial diagnosis, and then oversee treatment. The patient’s physician still makes the diagnosis and referral to a surgeon but during the hospital stay, it’s now becoming far more common for ‘hospitalists’ (a term coined back in 1996 by Wachter and Goldman in the New England Journal of Medicine) to monitor patient care – a role traditionally undertaken by the patient’s physician. Physicians do however, continue with care once the patient has left hospital, although there is a growing trend for nurses to take on some of their duties at the doctor’s office instead.
What this means for patients, of course, is that they are less likely to have consistency of care from a single doctor, instead, trusting their healthcare needs to an ACO (accountable care organization). All over the country, hospitals have been buying up small practices, integrating them into their own ACOs, and hiring medical professionals to run them.
The reality for patients is that they no longer have continuity of care and patient-doctor trust. According to Deloitte Consulting casualty actuary, Kevin Bingham, this lack of physician connection with patients is how many malpractice lawsuits begin.
Bingham also makes a case for changing medical demographic trends; as patients become heavier, there is increased need for diabetes care, and growing instances of joint problems. In addition, as the senior population grows, so do the medical issues. All of these come with the possibility of medical malpractice claims, ergo, the more patients with these complaints, the more likelihood of lawsuits.
That said, other experts are of the opinion that the number of medical malpractice suits might actually decrease, due to the fact that care from ACOs is more standardized, with less risk of something going wrong.
If you or someone you care about has suffered because of what may be medical mistakes, you should seek legal counsel as soon as possible. Our expert medical negligence lawyers will be able to answer your questions, and ascertain what compensation you are entitled to.