Roytowski D, Smith T R, Fieggen A G, Taylor A
S Afr Med J. 2014 Nov;104(11):736-8. doi: 10.7196/samj.8336.
From a litigation perspective, neurosurgery is considered a 'super high-risk' field, and this has been associated with rapidly increasing malpractice cover costs. In 2013 the annual Medical Protection Society fee for cover was R250,900. We wished to determine whether high malpractice cover was influencing how neurosurgeons managed patients. A 40-question online survey asking questions on defensive medicine was distributed to determine perceptions around liability risk and whether these influenced how patients were managed. Eighty-four per cent of respondents agreed that a medicolegal crisis existed, and over half (53.8%) had been sued for malpractice during their career. Altering practice behaviour to minimise the risk of a lawsuit is common. The increasing number of legal claims against respondents in this survey has resulted in most neurosurgeons practising defensive medicine. Arguably this will result in increased healthcare costs, inferior patient care and decreased access to skilled surgeons.
从诉讼角度来看，神经外科被视为“超高风险”领域，这与医疗事故保险费用的迅速上涨有关。2013年，医疗保护协会的年度承保费用为250,900兰特。我们希望确定高额的医疗事故保险是否正在影响神经外科医生对患者的治疗方式。我们开展了一项包含40个问题的在线调查，询问有关防御性医疗的问题，以确定对责任风险的看法以及这些看法是否影响了患者的治疗方式。84%的受访者认为存在医疗法律危机，超过半数（53.8%）的人在职业生涯中曾被起诉医疗事故。改变医疗行为以降低诉讼风险很常见。本次调查中针对受访者的法律索赔数量不断增加，导致大多数神经外科医生采取防御性医疗措施。可以说，这将导致医疗成本增加、患者护理质量下降以及获得熟练外科医生治疗的机会减少。
