Medical professional liability and the delivery of obstetrical care. Vol. 1

Medical professional liability and the delivery of obstetrical care Vol. 1 Vol. 1 /

Detalles Bibliográficos
Autor principal: Institute of Medicine (U.S.).
Autor Corporativo: Institute of Medicine (U.S.). Committee to Study Medical Professional Liability and the Delivery of Obstetrical Care (-)
Otros Autores: Rostow, Victoria P. (-), Bulger, Roger J., 1933-
Formato: Libro electrónico
Idioma:Inglés
Publicado: Washington, D.C. : National Academy Press 1989.
Edición:1st ed
Colección:Medical professional liability and the delivery of obstetrical care
Materias:
Obstetricians > Malpractice > United States.
Physicians' malpractice insurance > United States.
Ver en Biblioteca Universitat Ramon Llull:https://discovery.url.edu/permalink/34CSUC_URL/1im36ta/alma991009820427506719
Tabla de Contenidos:
  • Medical Professional Liability and the Delivery of Obstetrical Care
  • Copyright
  • Chairman's Preface
  • Contents
  • 1 Summary of Conclusions and Recommendations
  • MEDICAL PROFESSIONAL LIABILITY CONTROVERSY
  • PROBLEM MOST ACUTE IN OBSTETRICS
  • LIABILITY'S BROADER SCOPE
  • ETHICAL CONSIDERATIONS
  • STUDY FOCUS AND FINDINGS
  • Maternity Care in the United States
  • Availability of Obstetrical Providers
  • Obstetrical Care for Poor Women and Women Served by Medicaid
  • Practice of Obstetrics
  • Obstetrical Malpractice Insurance
  • The Tort System and Its Alternatives
  • THE COMMITTEE'S RECOMMENDATIONS
  • Long-Term Recommendations
  • Short-Term Solutions
  • 2 Maternity Care in the United States
  • OBSTETRICAL PRACTITIONERS
  • Obstetrician-Gynecologists
  • Family and General Practitioners
  • Certified Nurse-Midwives
  • Other Practitioners
  • FACILITIES OFFERING PRENATAL CARE
  • Hospitals
  • Local and State Health Departments
  • Community and Migrant Health Centers
  • LABOR AND DELIVERY SERVICES
  • FINANCING OF MATERNITY CARE
  • NEED FOR OBSTETRICAL CARE
  • Evidence of Existing Shortages of Obstetrical Services
  • Insufficient Prenatal Care
  • Arrested Decline in Infant Mortality
  • Inability to Pay for Care
  • Physician Shortage in Rural Areas
  • Projected Increase in Need for Obstetrical Services
  • REFERENCES
  • 3 The Effects of Medical Professional Liability on the Availability of Obstetrical Providers
  • OBSTETRICIAN-GYNECOLOGISTS
  • Careers in Obstetrics
  • Concerns About Professional Liability
  • Response to Concerns About Liability
  • Elimination of Obstetrical Practice
  • Reduced Volume of Obstetrical Care
  • Reduced Care of High-Risk Women
  • Trends
  • FAMILY PHYSICIANS
  • Malpractice Insurance Costs
  • Other Economic Factors
  • Concerns About Professional Liability
  • Response to Insurance and Liability Concerns.
  • Elimination of Obstetrical Practice
  • Adverse Effects on Rural Areas
  • NURSE-MIDWIVES
  • Availability and Costs of Professional Liability Insurance
  • Response to Insurance Problems
  • Changes in Practice Setting
  • Changes in Techniques of Practice
  • REFERENCES
  • 4 The Impact of Medical Professional Liability on the Provision of Obstetrical Care to Poor Women and Women Served…
  • PROFESSIONAL LIABILITY AND OBSTETRICAL CARE UNDER MEDICAID
  • BACKGROUND: THE ROLE OF MEDICAID IN THE DELIVERY OF OBSTETRICAL CARE
  • Physician Participation in Medicaid
  • Reduced Obstetrical Care for the Poor
  • High Insurance Premiums, Low Reimbursement Rates
  • Fear of Suit
  • Professional Liability Concerns and the Reduction of Care
  • PROFESSIONAL LIABILITY AND OBSTETRICAL CARE IN COMMUNITY AND MIGRANT HEALTH CENTERS
  • Problems Recruiting Providers
  • Problems with Access
  • Reduced Quality of Care and Increased Risk of Suit
  • Prohibitive Insurance Costs
  • CONCLUSION
  • REFERENCES
  • 5 The Effects of Medical Professional Liability on the Practice of Obstetrics
  • CHANGES IN PRACTICE PATTERNS OF INDIVIDUAL PHYSICIANS
  • THE RISING CESAREAN SECTION RATE
  • Electronic Fetal Monitoring
  • History
  • Regulatory Failure
  • Results of Randomized Clinical Trials
  • Effect of EFM on the Frequency of Cerebral Palsy
  • Electronic Fetal Monitoring, Cerebral Palsy, and Medical Malpractice
  • Conclusion
  • PRACTICE PATTERNS IN DEPARTMENTS OF OBSTETRICS
  • Reported Changes in Practice
  • Implications for Training
  • Effects on Careers in Obstetrics
  • Effects on Access to Care
  • IMPACT OF MEDICAL PROFESSIONAL LIABILITY ON THE PHYSICIAN-PATIENT RELATIONSHIP
  • The Importance of Trust
  • Consequences of the Breakdown in Trust
  • REFERENCES
  • 6 Obstetrical Malpractice Insurance
  • THE STRUCTURE OF THE MARKET
  • Limits of Coverage.
  • Availability of Medical Malpractice Insurance
  • Physicians
  • Nurse-Midwives
  • THE AFFORDABILITY OF PREMIUMS
  • Premiums as a Percentage of Gross Income
  • Premiums as a Percentage of Professional Expenses
  • Premiums as a Percentage of Net Income
  • Rising Professional Liability Premiums Linked to Increases in Fees
  • PROFITABILITY OF MEDICAL MALPRACTICE INSURANCE
  • Insurer Risk Management Activity
  • Data Gathering and Analysis
  • Clinical Standard Setting and Protocol Development
  • Educational Efforts
  • Discounted Premiums as Risk Management Incentives
  • PROPOSALS TO ALTER THE MEDICAL MALPRACTICE INSURANCE SYSTEM
  • Spreading the Costs of Coverage Over a Wider Base
  • Limiting the Number of Claims
  • Limiting the Amount of Awards
  • Experience Rating of Physicians for Medical Malpractice
  • CONCLUSION
  • REFERENCES
  • 7 The Legal System: The Committee's Findings and Proposals for Change
  • THE TORT SYSTEM
  • Tort Reforms: The Committee's Findings
  • TORT REFORM: THE COMMITTEE'S RECOMMENDATIONS
  • ALTERNATIVES TO THE TORT SYSTEM
  • No-Fault Compensation for Certain Events
  • Virginia's Compensation System for Birth-Related Injuries: A Case Study of DCE
  • The AMA-Specialty Society Medical Liability Project
  • Claims Resolution Function
  • Credentialing and Disciplinary Functions
  • Codification of the Legal Elements of Medical Liability
  • Private Contracts
  • Economic Damage Guarantee (Moore-Gephardt Proposal)
  • Social Insurance
  • OTHER NEEDED REFORMS
  • Expansion of the National Health Service Corps
  • Extension of the Federal Tort Claims Act Coverage
  • Liability Coverage for Physicians Providing Public Health Services
  • REFERENCES
  • 8 Principal Findings and Recommendations
  • PRINCIPAL FINDINGS
  • Medical Malpractice Insurance Trends and Their Implications
  • Effects of Professional Liability Concerns on Access to Care.
  • Effects of Professional Liability Concerns on the Practice of Obstetrics
  • Effects of Professional Liability Concerns on the Physician-Patient Relationship
  • RECOMMENDATIONS
  • Long-Term Recommendations
  • Short-Term Solutions
  • Glossary
  • Bibliography
  • CASES, REGULATIONS, AND STATUTES
  • Appendixes
  • Appendix A Summary of Methodology Used in Studies of Changes in Obstetrical Practice
  • Survey Population
  • Samples
  • Response Rates
  • Phraseology
  • Appendix B Summary of Study Results Regarding Changes in Obstetrical Practice
  • Appendix C Summary of Study Results Regarding Professional Liability, Family Practitioners, and Rural Areas
  • Appendix D State and National Liability Surveys Summarized
  • State Studies
  • National Studies
  • Appendix E Survey of Selected Risk Management Activities
  • Appendix F Risk Management Activities and Experience Rating Policies of Selected Malpractice Insurers
  • Appendix G Possible Modifications to the Virginia Neurological Birth-Related Injury Compensation Act
  • Members of the Committee
  • Index.

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