The Asian outlook
In developing countries in Asia, practitioners and establishments have typically been protected by the respect people have for the medical profession – the idea of suing a doctor or nurse or other healthcare provider is quite alien, particularly in countries where civil liberties are a fairly new concept.
For the most part, insurance for medical professionals is optional in the region and, in countries without a history of litigation, may seem like an unnecessary luxury.
But that is changing. Malaysia and Macau are pushing forward with compulsory professional indemnity insurance for their doctors and, as countries compete for increasingly mobile patients, it’s likely that others will follow suit. The rising middle classes can go to Singapore for high quality care; Thailand, Korea and Hong Kong are booming in the aesthetic medicine sector, with patients from neighbouring countries generally being the greater percentage. Malpractice exposures are now even more widened.
Patients are voting with their feet. They are increasingly seeking (and can afford to pay for) better treatment, and are more likely to complain about substandard care. Legal systems have been slow to keep up with the changing situation: one paper estimates that medical malpractice cases in Malaysia can take four years to resolve (Cohen & Hughes, 2007)
From a commercial perspective, there is heightened activity amongst the big hospital chains and conglomerates looking to expand into new and emerging markets in Asia, namely in Myanmar, Cambodia, Vietnam and even Laos. Larger hospital chains and primary care facilities (which are often owned by multinationals) continually seek to attract foreign doctors and treat expats, making it harder for smaller, uninsured clinics to compete. This is increasingly evident in Thailand, where the humble family medicine or general practice clinic is slowly in danger of becoming a distant memory. Sources in the broking community there are quite pointed in the fact that these practitioners are flocking to the big hospitals, where top of the range facilities, treatments and liability coverage beckons.
How does the West compare?
In the West, medical malpractice lawsuits are relatively commonplace and medical professionals cover themselves through malpractice insurance, which is typically a legal requirement
In the US, the concept of negligent referral is well established, meaning that GPs can be held partly responsible for poor care at the hands of third parties.
In Australia, the majority of medical professionals, from doctors to physiotherapists, are required to hold compulsory insurance, so while they may have to spend time defending themselves, their insurance coverage deals with the legal expenses. During 2012-2013, the most recent period for which data is available, there were 2,450 medical negligence claims (excluding Western Australia, which didn’t file statistics).
You might not be surprised that 47 per cent were related to emergency treatment and surgery, but other, higher profile disciplines featured highly too. There were 33 claims related to gynaecology, and 62 for orthopaedics. Even psychiatrists were the subject of 26 cases.
The value of being prepared
So how do you protect yourself against malpractice exposures?
You might think that the best way to avoid malpractice lawsuits is to simply provide the best care that you can, but unfortunately even that won’t stave off legal action. Nor is providing good care at your own practice enough. Protect yourself with medical malpractice insurance coverage. Should the worst happen, it can potentially save your livelihood, and can even help attract patients in an increasingly competitive international healthcare marketplace.