Malpractice Problem Research Articles

A Phenomenological Analysis and Evaluation of the Meanings Attached to Examination Malpractices by the Teachers and Students in Kisii County, Kenya.

In Kenya the problem of examination malpractice keeps on recurring amidst stringent measures. This study gives the perspective where understanding the meaning attached to examination malpractice by the teachers and students helps in minimizing the annual cyclic examination malpractices. Its main objective is to present a phenomenological analysis and evaluation of the meanings attached to examination malpractices by the teachers and students in Secondary schools in Kisii County. The study was carried out in Kisii County, Kenya. It focused on students and teachers in secondary schools in the County who have experienced the problem of examination malpractice. Given that examination malpractice is an ethical problem and those who engage in it justify their actions using certain ethical theories, the study was guided by normative ethical theories. It utilized descriptive survey research design through open-ended questionnaires for data collection. Purposive and snowball sampling procedures were used to pick the respondents whose number was indeterminate given that the study is qualitative and only interested in getting the qualitative data as opposed to quantitative data. This fitted well with the snowball referrals from one relevant participant/interviewee to another. The study adopted hermeneutic and transcendental phenomenological approaches for both prescription and analysis of data. The findings showed that: there are examination malpractice meanings that are popular/conventional such as a deliberate act of a wrong doing and implied/unconventional such as an effect of pressure to get good examination grades; the meanings attached to the examination malpractice by the teachers and students in Kisii County influence the perpetuation of the menace. The study makes the following conclusion: Implied/unconventional meanings influence examination malpractice more than the popular/conventional meanings if the cyclic perpetuation of examination malpractice is to be justified. The study recommends that curbing measures should be directed equally on both the implied/unconventional and the popular/conventional meanings given that paying attention to only the latter has not given the expected educational outcomes.

A Phenomenological Analysis of Experiences of Parents, Teachers and Students about Examination Malpractices in Kisii County, Kenya

While the problem of examination malpractices in Kenya has been a perennial one, the efforts put in place to address it have not fully borne fruits. This study focused on understanding this scenario from the phenomenological perspective that sought to examine the experiences of teachers, parents and students in Kisii County about examination malpractice and the relationship therein. The following was its objective: explore the complexity of examination malpractice, its related ills and the responsibility of the education stakeholders as experienced by the teachers, parents and students in Kisii County. The study focused on parents, students and teachers in secondary schools in the county who have experienced the problem of examination malpractice. It was guided by normative ethical theories to understand its persistence. It utilized descriptive survey research design through focused group discussions and open-ended questionnaires. Purposive and snowball sampling procedures were used to pick the respondents complemented by document analysis. The study adopted hermeneutic and transcendental phenomenological approaches for both prescription and analysis of data. The findings showed that: forms of examination malpractice are either conventional or non-convectional and are grounded in either the positive or negative experiences of teachers, parents and students; The study makes the following conclusions: focusing on both conventional and non-conventional forms of examination malpractice gives a wider understanding of what ails the examination process in Kisii County; understanding the negative and positive experiences of teachers, parents and students in regard to examination malpractice as well as understanding its complexity is key in formulating a comprehensive solution to the menace; and the network to hold those who engage in examination malpractice responsible to be widened. The study recommends more focus on both the conventional and non-conventional forms of examination malpractices to capture in detail what ails the examination process in Kisii County; utilization of both the negative and positive experiences of the students, teachers and parents to come up with more all-encompassing solutions to the issue of examination malpractice that is grounded in their experiential attitudes;-, and more analysis of the complexity of examination malpractice to generate more lasting solutions to the menace.

Criminal Liability Arising from Medical Malpractice on Patients: A Review from the Perspective of Positive Law And Islamic Law

The suspicion in cases of medical malpractice in is only slightly raised, meanwhile, there are actions by the health profession by doctors as medical personnel which have the potential to be a malpractice that can be reported by the public, but are not resolved legally because the community only has limited knowledge of science medical and because there is no form of specific legal regulations governing malpractice in Indonesia so that the occurrence of these malpractices can cause legal problems. This study aims to determine criminal liability for medical malpractice acts committed by doctors to patients in anticipating and dealing with medical malpractice problems in criminal cases. The research method used in this study is doctrinal, where the author collects material from the literature, both hardcopy and softcopy, which is related to the title of this research by using an analysis of the research object. Criminal malpractice occurs when a patient dies or is disabled and/or seriously injured as a result of actions taken by health workers who are careless or less careful in making efforts to treat patients who die or are disabled and are criminally liable as a result of medical malpractice acts committed. doctors on patients can be accounted for under Article 359 and Article 360 of the Criminal Code. In this case the health law is considered insufficient and does not clearly regulate the crime of medical malpractice. So it is necessary to regulate the crime of medical malpractice by giving birth to a new health law, namely by explicitly regulating criminal liability for medical malpractice acts by doctors against patients in Indonesia.

Предупреждение врачебных нарушений при ведении беременных женщин с выявленной ИППП: экспертное мнение медицинского юриста и дерматовенеролога (междисциплинарная дискуссия)

The urgency of the medical malpractice problem is due to the fact that the presence of sexually transmitted infections (STIs) in women of fertile age is a common cause of reproductive loss. The authors discuss what an obstetrician-gynecologist should pay attention to at the stage of preconception period and during pregnancy in patients with an identified STI. The article also raises the following important interdisciplinary discussion issues: which specialist should treat the pregnant woman with identified STI and her sexual partner? Should only an obstetrician- gynecologist be involved in the treatment process? At what point does subjectively conscientious medical treatment become inappropriate? It remains relevant and necessary to have correct and unambiguous formulations in clinical recommendations on the pregnancy management with identified STIs (namely, chlamydia, gonorrhea and trichomoniasis) and on the professional interaction of obstetrician-gynecologists with dermatovenerologists in such cases. Besides, it is necessary to develop a legal and structural algorithm for the prevention of medical malpractices to prevent the legal liability of both a medical organization and a specific attending obstetrician-gynecologist in the pregnancy management with STIs. KEYWORDS: sexually transmitted diseases, pregnant women, obstetrician-gynecologist, dermatovenerologist, clinical recommendations, gonorrhea, chlamydia, trichomoniasis. FOR CITATION: Khryanin A.A., Radchenko M.V. Prevention of medical malpractices in the pregnancy management with STIs: expert opinion of a medical lawyer and a dermatovenerologist (interdisciplinary discussion). Russian Journal of Woman and Child Health. 2024;7(3):259– 265 (in Russ.). DOI: 10.32364/2618-8430-2024-7-3-7.

Research on the Application of Financial Fraud Technology Governance in China

The problem of financial malpractice in listed companies has emerged since the beginning of accounting and has not been completely solved. Throughout the development of China's securities market in the past 30 years, although it is becoming more and more mature, the problem of financial malpractice has always been a pain point in the development of the securities market. The fundamental reason is that listed companies are driven by various interests. Therefore, employing effective methods to preclude and manage financial fraud within listed companies has become a crucial matter for market health. In recent times, blockchain has entered the public eye, and its inherent technological features make it the ideal tool for suppressing financial fraud. As such, this paper analyzes the current situation of financial fraud in China, combines the emerging technology of blockchain in China, and fits the advantages of blockchain with financial fraud. By doing so, it aims to contribute to the improvement of China's financial fraud situation, and to offer some solutions to the problem of accounting fraud in China through the application of blockchain technology.

Pros and cons of telemedicine in diagnosis and management: A cross sectional survey

Introduction: Cost effectiveness, equity, and quality all are problems facing the health care services in both developed and developing countries. Modern technologies as telemedicine tried to help population especially in epidemics. Many malpractice problems facing doctors and other health care workers due to using telemedicine. This study aimed to clarify the pros and cons of telemedicine. Method: Survey was done and validated to health care worker sectors, patients and judicial workers sectors, to evaluate the telemedicine according to their practice. Results: about one thousand volunteers shared in this study, 616 (61.3%), 68 (6.8%) judicial workers, and 320 (31.9%) other jobs. Most of doctors 95% of them refuse to use telemedicine in the provisional diagnosis, 77.3% claim that it is very difficult to give accurate diagnosis through media, 75.6% of them convinced that telemedicine and increase the malpractice issues and medical responsibilities. In judicial workers 64.7% of them prove that there is increase in malpractice issues due to use of media. On the other side 55% of the other job sectors agree with the use of telemedicine especially in time of epidemics. Conclusion: Telemedicine has many pros and cons. The main cons were that the inability to give the actual diagnosis and occurrence of medical errors, while the main pros was that the use of telemedicine to follow up already diagnosed patient. Governments should legalize the using of telemedicine by enacting law that prohibit the use of it except between doctors to take medical decision or exchange opinion.

Model of Criminal Case Settlement of Doctor Malpractice Based on the Value of Local Wisdom

Introduction: Recently, the malpractice problem in medical service has been widely talked about in thesociety of different groups of people, which often leads to the criminalization of doctors.Purpose of Research: This research aims to acknowledge and analyze the formulation of malpracticecriminal act regulation in the criminal law system in Indonesia and the model of criminal case settlement ofdoctor malpractice based on the value of local wisdom in Mojokparak village.Research Methodology: This research was conducted in Mojokparak Village with qualitative methods andresearch specifications on legal pluralism.Discussion: The criminal provisions for doctor malpractice are regulated in Article 190 of Law Number 36Year 2009 concerning Health. Articles in the Criminal Code that are relevant to criminal liability related tomedical malpractice are Articles 359, 360, and 361. Mojokparak village is dependable on Islamic values thatare developed through Islamic boarding school. In this regard, the normative values of religion in the Islamicboarding school community cannot be separated from the discourse and practical movements of daily life,especially in the settlement of doctor malpractice criminal cases. The settlement of that case is done by thevalue of deliberation and consensus to find real justice.

An IoT model for securing examinations from malpractices

The primary objective of university education is to provide students with the required information and skills to enable them to make a successful contribution to the national development effort. In order to evaluate the level of expertise and skill of students, this preparation includes frequent examination and appraisal in the form of tests. Manual exams are carried out by most universities; Post Graduate and Under Graduate in India. Due to multiple uses made of the outcomes of the students, these examinations have high stakes. Consequently, the experiments became subject to different types of malpractice. Test malpractice affects the success of students in exams and leaves the scores/grades earned inaccurate, hence a challenge to examination bodies and the nation's education system (India). These are all disturbing signs that pose a danger to the nation. Examination malpractice has eaten deep into the Indian culture of education. Therefore, the object of this paper is to explore the problem of examination malpractice in India. The paper covered relevant measures, procedure setting/implementation and suggestions for this action. And finally, a model is proposed to stop malpractices in the examination. This IoT based model is used for detecting any metallic object or object in a range more than normal IR proximity sensor range. The block diagram of proposed model and circuit diagram for that model discussed in detail. This proposed model may be used for any investigation in the universities examinations.

TINJAUAN YURIDIS PENEGAKAN HUKUM MALPRAKTIK DOKTER PADA PELAYANAN KESEHATAN DALAM PERSPEKTIF HUKUM PIDANA

The problem of malpractice committed by doctors and medical personnel in health care is an act that is very detrimental to the patient in conducting treatment can result in worsening medical conditions, or death of a patient. Errors in carrying out the medical profession will form criminal liability. Therefore, it is necessary to have a special legal certainty in the health sector to provide legal justice for injured patients. the research used is normative juridical research or normative law. The approach taken is, the law approach, case approach and conceptual approach. Based on the results of the discussion, it was found that the process of criminal law enforcement for medical malpractice cases is regulated in Article 360 paragraph (1) and (2) of the Criminal Code which contains elements of negligence (kulpa) of doctors or medical personnel. To provide a stronger guarantee of legal certainty, law enforcement for medical malpractice and health workers is regulated in Law No. 36 of 2009 concerning Health and Law No. 36 of 2014 concerning Health Workers.

Interpretation of 2020 NCCN Clinical Practice Guidelines in Oncology-Bone Cancer

The specialty of bone cancer has developed rapidly in China in recent years, but because of the low incidence of these diseases and the unbalanced development of different regions, the malpractice problem of diagnosis and treatment is still outstanding.The NCCN clinical practice guide for bone cancer in the United States has been updated for several years and is now more mature and has been recognized worldwide.It can provide reference for medical professionals in related fields in China, it covers the most common bone tumors such as osteosarcoma, Ewing's sarcoma, chondrosarcoma, giant cell tumor of bone and chordoma.This article describes and interprets the core diagnostic and therapeutic contents of NCCN clinical practice guide for bone cancers.

Análise da presença de lesão por pressão em pacientes hospitalizados e as principais comorbidades associadas

O presente estudo objetivou analisar a presença de Lesão por Pressão (LP) em pacientes hospitalizados, observando as principais comorbidades associadas. Trata-se de uma análise documental retrospectiva com perfil observacional analítico, de caráter quantitativo e transversal. A pesquisa foi realizada em um hospital de alta complexidade da rede pública, situado no estado da Paraíba e se deu por análise criteriosa de 884 prontuários médicos dos pacientes internados nos meses de janeiro a dezembro de 2019, sendo incluídos no estudo aqueles que possuíssem pelo menos uma LP durante sua estadia hospitalar. Foram avaliadas informações como perfil sociodemográfico, idade, sexo, histórico clínico do paciente e enfermidades associadas, além de observada a pontuação na escala de Braden para identificar o risco de desenvolvimento da lesão. A amostra foi composta por 85 pacientes, que apresentaram em sua maioria (83,5%) mais de 65 anos de idade, sendo 47 (55,29%) do sexo feminino e 38 (44,71%) do sexo masculino. Foi observada uma incidência de 11,5% de presença de LP nos pacientes, caracterizando-se como um número ao qual deve-se atentar, visto que se trata de uma complicação classificada como evitável na maioria dos casos, e sabendo-se ainda da existência de subnotificação por ser considerado um problema de negligência médica. A Diabetes Mellitus (DM) e a Hipertensão Arterial Sistêmica (HAS) foram apontadas como as principais comorbidades associadas, sendo que dos pacientes que desenvolveram LP, 10 (11,8%) possuíam DM, 21 (24,7%) possuíam HAS e 33 (38,8%) possuíam as duas doenças, acarretando implicações na cicatrização e agravamento da lesão. Assim sendo, torna-se relevante ressaltar a importância da monitorização sistemática do paciente, a fim de se verificar as comorbidades existentes e os riscos de ocorrência da lesão, para assim maximizar os cuidados de prevenção, proporcionando uma melhor estadia hospitalar ao paciente e evitando altos custos com o tratamento.

The need for healthcare reforms: is no-fault liability the solution to medical malpractice?

Healthcare reforms in India have been a much-debated issue in the recent past. While the debate has focused mainly on the right to healthcare, another by-product that has evolved out of the debate was the current problem of medical malpractice and the healthcare law. The last decade has seen an increase in the healthcare facilities in the country. This, however, has come with a bulk of medical error cases which the courts have entertained. According to reports, there has been an increase in medical litigation cases by 400% in the last decade. There are about 5.2 million cases of medical error in the country every year. While there exists a standard legal system in the country which entertains such complaints of medical malpractice, the attempt by regulators and medical practitioners should be to reduce these cases. This paper seeks to analyze the extent to which medical malpractice cases affect consumers (patients). It analyzes the existing medical liability system which has mainly evolved through the jurisprudence laid down by the English courts and critiques it. It also looks into the major reasons for such medical mishaps. Authors argue that a "No-Fault" system may give better outcomes. They analyze this by looking at the no-fault liability model implemented in New Zealand. Narratives of no-fault liability being implemented in India have also been used. These are showcased from instances of Motor Vehicles Act, 1988, and Clinical Trial regulations. It is also argued that a by-product of a no-fault liability system is stringent regulations which are used to reduce the possibility of medical mishaps altogether. Lastly, the possible problems of the no-fault liability system are discussed in the paper.

Response and Implications of Medical Accidents in Japan -Forced on the medical malpractice investigation system and inexecutive reward system-

의료사고의 피해환자 또는 그 보호자는 막상 이러한 사고를 직면하게 되면 정신적ㆍ육체적인 어려움을 겪게 된다. 의료사고의 피해에 대하여 어떻게 도움을 받아야하는지, 어떠한 도움을 받을 수 있는지, 또한 법원에서의 피해의 입증을 어떻게 하여야 하는지 등 여러 부분에서 어려움이 있다. 일본은 2014년 중한 의료사고의 발생으로 특정기능병원의 승인을 취소하기에 이르게 된 동경여자의과대학 병원사건과 군마(群馬)대학 의과대학 부속병원 사건 등과 관련한 2건의 의료사건은 무엇보다 의료사건으로 존재하는 문제의 심각성을 인식하는 계기가 되었다. 이러한 심각성을 계기로 일본은 2015년 의료사고조사제도를 실시하여 오늘에 이르고 있으며, 무과실보상제도 또한 시행중에 있다. 이렇듯 일본은 의료사고조사제도를 법제화함에 있어 법률단계에서의 명확화를 이루어 하위법령에 위임사항을 최소화 하였다는데 의의가 있으며, 환자의 안전관례 체계 수립에 우리에게도 많은 시사점을 주고 있다. 우리나라 또한 환자안전을 위하여 필요한 사항을 규정하고 환자의 보호 및 의료 질(質) 향상에 이바지함을 목적으로 환자안전법 등을 시행하고는 있으나 일본의 경우와 같이 세부적인 제도적 장치의 마련은 아직 미시행중에 있다. 이에 본 논문은 일본에서 의료과실의 문제에 대한 해결책으로 시행되고 있는 제도들의 내용과 과제에 대하여 검토하고 우리의 현상과 향후 과제를 점검하여 보았다.Patients of medical accidents and their guardians experienced mental and physical difficulties when faced with such accidents. They have found difficulties in many areas, such as how to get help and what kind of help is available for them in the damages of medical accidents, and how to prove thier damages in court. Above all, Japan became aware of the seriousness of the problems that have existed in medical accidents in 2014 through two medical accidents that are related to the case of the hospital in the Tokyo Women’s College of Medicine which led to the approval cancellation of a certain hospital and the case of the hospital attached to the University of Gunma. Due to such seriousness, Japan has implemented a medical malpratice investigation system since 2015 and is also carryijng out a no fault liability for compensation system. As such, it is meaningful that Japan has made the medical malpractice investigatjion system legal. because this legislation has minimized the system’s delegation to the it’s subordinate laws by making it clear at a legal level, and has many implications for us to establish the patient safety practice system. Our country is also implementing the patient safety law to define what is necessary for patient safety and contribute to the protection of patients and the improvement of medical quality. However, we haven’t yet provided the institutional strategies like Japan. Therefore, this paper examined the contents and tasks of the institutions being implemented as a solution to the problem of medical malpractice in Japan and checked our phenomena and future tasks.

Malpractice Claims in Dakhalia and Damietta Governorates: A 10 Year Evaluation Study

The practice of medicine is becoming increasingly more complex. Physicians and other healthcare providers face increasing administrative and legal challenges. Malpractice Claim puts physician's finances, reputation, professional advancement, personal relationships and health at risk. In Egypt, medical malpractice problem has been magnified during the last few years. The aim of this study was to through light on medical malpractice claims in Dakahlia and Damietta regions. Results of the present study showed that there is annual increment in the number of claims. According to specialty, anesthesia was the highest percentage followed by surgery and gynecology/obstetrics.By locality, most claims were against central hospitals followed by private, general and least was university hospitals. However, claims were proved positive mostly in private hospitals followed by central, general and lastly university hospitals. For private hospitals, the most proven claims were for gynecology/obstetrics, then anesthesia but for central hospitals, anesthesia represented the most proven claims followed by surgery. Good medical practice and a good medical-patient relationship are still the best ways to minimize lawsuits and their repercussions.

Investigating academic malpractice within an MBA Marketing module

This paper reports on progress and findings to date on an ongoing action research project designed to address the problem of academic malpractice, notably collusion, amongst postgraduate students on an international MBA programme. Its roots lie in 2008 when it was found that case study assignments had largely designed-out plagia-rism but that collusion had taken its place with the result that 132 cases were taken to the University?s Unfair Practices Committee. Understanding the problem was ap-proached in several ways, including reference to existing literature, which highlighted the importance of students? previous cultural and educational experiences, and quali-tative research drawing on students? views and feelings. As a result, a two-pronged strategy was adopted, one element being a zero-tolerance policy with all MBA assign-ments submitted to the Turnitin text matching software and wide broadcasting of the dangers and penalties resulting from malpractice. These were coupled with strength-ening the induction and Study Skills elements of the programme in order to develop students? independent study skills and understanding and ability to comply with UK academic conventions. We conclude that the dual strategy of prevention and cure was effective, resulting in the overall rate of academic malpractice falling from a high of 34.8%, and of collusion of 26.6%, to single figures with both being maintained with subsequent cohorts. The ongoing question of how best to adapt teaching practices to suit the background and expectations of international students remains unresolved. Therefore, further research is being conducted with selected preliminary findings be-ing presented in this paper.

Multi –Mode Biometric Solution for Examination Malpractices in Nigerian Schools

The major technique for admitting students to an examination over the years has been through the presentation of a token. The student possesses a physical and portable device which contains the user identity. Examples of such devices include ID cards, Library Cards, Fees Clearance Cards, Photo Cards, etc. However, this method of authenticating a student for an examination has an obvious problem. The problem is that object can be misplaced, stolen, forgotten at home or somewhere, and ID card can also be faked. This paper presents a multi-mode biometrics (fingerprint and face) solution to the problem of examination malpractice in Nigerian schools. The appearance of both fingerprint scanner and web cam on modern laptop and notebook computers motivate the writing of this paper.

MALPRAKTIK DOKTER DALAM PERSPEKTIF HUKUM

Now adays malpractice problem of health service start to talk lively by the various society. That matter is seen from many indictment cases of malpractice which submitted by the society about a doctor profession that regarded to have inflicted the patient in conducting a task which are cause the wrong act, feel pain, injury, physical defect, body damage, and death. A law justification of doctor malpractice which is cause the inflicted of patient, so the victim side could be demand for materil and immateril compensation. The law protection of doctor malpractice’s victim who is demand to the court, a judges could apply a Res Ipsa Loquitur doctrine, its means that the victim sides does not need to prove the presence of carelessness substances, but they enough to show the truth.Keyword: Malpractice, Res Ipsa Loquitur

Physicians Influence and the Malpractice Problem

Dr. Hickson is the Joseph C. Ross chair, Department of Medical Education and Administration, associate dean for clinical affairs and director of the Center for Patient and Professional Advocacy at Vanderbilt University Medical Center, Nashville, Tennessee; Dr. Entman is professor emeritus, Department of Obstetrics and Gynecology and physician liaison for the Center for Patient and Professional Advocacy at Vanderbilt University Medical Center, Nashville, Tennessee. Corresponding author: Gerald B. Hickson, MD, Center for Patient and Professional Advocacy, Vanderbilt University Medical Center, 1313 21st Avenue South, Suite 405, Nashville, TN 37232; e-mail: [email protected]. Financial Disclosure The authors did not report any potential conflicts of interest.

In Response to “Oncologists and Medical Malpractice”

I would like to expand on the excellent article by Patricia Legant, MD, “Oncologists and Medical Malpractice.”1 Regarding informed consent issues (“Potential Areas of Litigation,” point 4),1 there is wide variation in practice on what is appropriate and necessary. As an example, we reported on the wide variation of informing patients on the leukemogenic potential of chemotherapy drugs.2 With that said, I believe that ASCO should provide on its Web site consent for chemotherapy narratives, not just patient information materials, but actual consent documents for patients to sign. The current situation seems to be that each practice needs to “re-invent the wheel.” I note Dr Legant's choice of words that physicians should “make an effort” and “mention” to patients possible events such as infertility, death, and late second malignancies. I thought the word choices were curious, and I wonder if the author herself is ambivalent. Dr Legant wisely goes on to elaborate some of the difficulties involved in the interactions of patients and families under enormous stress in discussing these issues. The ambiguous language may reflect the mixed emotions that are shared by many practitioners, which is why my own findings of how physicians handle this type of issue revealed such variable practices on this issue.2 Since the practice of what to tell a patient is imprecise to say the least, making a claim (ie, a lawsuit) against a physician could be relatively easy since an attorney probably could readily find an expert who has a different viewpoint of how much should be included. For what it is worth, my own practice is that my consent form does list death as well as fatal forms of leukemia. While I question Dr Legant on the seemingly weak wording highlighted above, I also note that she employs stronger language later in the article that states, “Current calls for cancer patients always to get a second opinion are often no more than thinly disguised marketing ploys, and also serve to erode patient trust in all their oncologists” (“Ways to Avoid Litigation,” point 5).1 We have previously commented on the dangers of cancer care becoming commercialized and the marketing that follows.3 The potential downside of second opinions (eg, treatment delays) is rarely discussed. However, physicians in private practice, as I am, do enjoy the legal protection that second opinions confer, as well as the camaraderie it provides with our academic colleagues. These advantages are typically done at public expense (typically Medicare), and the financial costs of this “benefit” is rarely discussed, let alone the opportunity costs of important projects that are not funded as a result of what must be a significant expenditure. I have previously questioned the practice of pathology review of all patients at tertiary care centers.4 I would also like to expand on the issue of good communication (“Ways to Avoid Litigation,” point 1).1 My colleagues remind me, as does Dr Legant, that good communication with patients is important in preventing lawsuits. I have previously written on this challenge.5 However, many times, the problem comes about from a family member who lives out of town, and/or whom I have had no contact with, and the “questions” come about after the patient is deceased. My colleagues seem to believe that their excellent relationship with their patients and their spouses will prevent malpractice problems. Meanwhile, a patient's family member, with whom the physician has had little or no contact, could represent the real threat. All the more reason to heed the other advice in the article by Dr Legant.1

Medical malpractice in the age of technology: How specialty societies can make a difference

In the United States, medical malpractice litigation, and the rising cost of malpractice insurance, is a crisis that threatens to restrict patient access to high-risk services, especially obstetrics and certain surgical procedures. Radiation Oncology, though a small specialty, is very technologically oriented. Because the history of product liability and malpractice litigation in this country parallels the technologic revolution, practitioners of this specialty are clearly at risk for litigation. Because legislative relief is unlikely to be forthcoming in the near future, many specialty societies have assumed the responsibility for devising means to protect members from frivolous law suits, without compromising a patient's right to due process. To date, Radiation Oncology societies have not taken a leadership role in this movement, preferring instead to cede this responsibility to the American College of Radiology. Opportunities exist for specialty societies to define standards of care and establish guidelines for expert witness testimony. To date, the courts have been supportive of these efforts. Herein, we summarize some of the salient issues of the malpractice crisis facing Radiation Oncology and offer suggestions for change within the specialty to better address the malpractice problem.