Thai medical official slams the new bill

[webfact]

MEDICAL MISTREATMENT
Medical official slams the new bill
CHULARAT SAENGPASSA
THE NATION

BANGKOK: -- DOCTORS are continuing their campaign against the controversial Protection of Victims of Medical Mistreatment Bill, saying the draft law will further complicate issues surrounding malpractice and sow seeds of reluctance among medical workers when it comes to providing treatment.

The bill will certainly widen conflicts between patients and doctors or medical personnel," Dr Methee Wongsirisuwan, a senior member of the Medical Council of Thailand (MCT) said.

Methee, who is an assistant to the council's secretary-general, described the draft law as a "populist policy" - that will please the public because it offers money.

If the bill is passed, he said up to Bt1.4 billion a year will be set aside to provide automatic compensation without the accused being given a shot at defence or medical mistakes being verified. Methee said this would not solve the problem of malpractice or accidental injuries causing disability or death.

"The bill will not solve the problem at the roots, and by paying victims without seeking the truth about mistakes or mistreatment is nothing but utter ignorance," he said.

Methee chose to speak up as a network of malpractice victims continue pushing for the bill through the National Legislative Assembly after failing to do so under previous governments.

The MCT official added that the existing Article 41 of the National Health Security Office Act already granted maximum compensation to medical malpractice victims and it was better because doctors and medical personnel are not deemed culprits who continue hurting or killing patients.

In comparison, the latest bill regards doctors and medical personnel as wrongdoers from the onset, whether or not their mistakes are intentional or accidental, and does not give them a chance to defend themselves or produce proof so they are not liable to lawsuits, the doctor said.

"This automatic accusation will discourage doctors from working as they may fear that complicated treatments will open the door to more mistakes - which will directly affect the patients," he said.

Also, automatic compensation will only encourage victims or their relatives to focus on finding fault with their doctors just so they can get money.

"The bill doesn't put any ceiling on the compensation amount," Dr Methee noted. He said Article 41 offers no more than Bt400,000 in compensation to each victim, and if the patient wants more, they will have to file lawsuits for compensation in court.

In order to better protect and compensate victims of medical malpractice, Methee said a special court, comprising doctors and specific judges, had to be set up instead of getting cases considered under the Protection of Victims of Medical Mistreatment Bill.

Malpractice cases could be tried in a special court by a quorum of special judges alongside doctors or qualified personnel who could provide expert opinions. Also, verdicts would be based on standards that can be used as criteria in judging future cases, Methee said.

So, there was no point in pushing through the bill as the huge budget needed to enforce the law could be better spent on boosting support for state hospitals so they have better equipment and can tackle staff shortages.

"State medical workers should be paid more so they do not leave to take up better paying jobs in private hospitals. Also, state hospitals need a sufficient supply of quality medicines," Methee said.

He lamented that doctors and medical personnel, especially those working at government hospitals, already face several setbacks, ranging from a heavy workload and lack of understanding from patients or their relatives to shortage of manpower and funds, as well as inadequate equipment and facilities.

Source: http://www.nationmultimedia.com/national/Medical-official-slams-the-new-bill-30257509.html


-- The Nation 2015-04-07

[WhizBang]

So, the Medical Council of Thailand does not like the idea of doctors being held accountable when they screw up. One has to wonder why?

[Always18]

So, the Medical Council of Thailand does not like the idea of doctors being held accountable when they screw up. One has to wonder why?

This is just a microcosm of the more general truth that "Thais do not like the idea of Thais being held accountable when they screw up"....................

[Pii Kate]

1. Look at the HIPPA laws in USA. Patients have a right to privacy.
2. Look at the Patient Rights Act. Patients have the right to expect and receive appropriate care in a timely manner and with dignity.

All of my doctors(in USA) took courses in customer relations meaning they learned to listen to the patient rather than put everyone on antibiotics and send them home. This reduces law suits as well when the patient feels heard and understood.

Insurance company intervention in what care can be given and how much effects patient care but health insurance is not an issue here.

[maidee]

do they keep lists of doctors who describe antibiotics for every single patient, whatever they need it or not ?

would be a good start

[cheeryble]

do they keep lists of doctors who describe antibiotics for every single patient, whatever they need it or not ?

would be a good start

I knew a pharmacist with a shop next to a surgery shared by doctors who said you could tell a lot about the doctor by the way they prescribe.

Makes sense.

[Suffinator]

Accountability ... something that doesn't exist in Thailand in any shape or form.

Criticism as we know from the government is an unacceptable practice as 'FACE' is far more important than any human life and that comes in second place to MONEY!

[Bluespunk]

"Also, automatic compensation will only encourage victims or their relatives to focus on finding fault with their doctors just so they can get money."

Tough.

Do your job properly and there won't be suits.

Stop whining about being held accountable.

No one cares.

[Bob12345]

So, the Medical Council of Thailand does not like the idea of doctors being held accountable when they screw up. One has to wonder why?

The first step would be to determine if the doctor actually screwed up. You normally do that by consulting experts and asking the doctor questions why he chose a certain approach.

If I read this article correctly that is how it is being done now, but the new law would limit the "truth finding" and just pays out quicker without first determining if someone screwed up or not.

[Bob12345]

"Also, automatic compensation will only encourage victims or their relatives to focus on finding fault with their doctors just so they can get money."

Tough.

Do your job properly and there won't be suits.

Stop whining about being held accountable.

No one cares.

Doing your job properly would be so easy to just do...

If someone comes in with the common cold you order a CAT scan (which costs about 40,000 baht and already has a queue of a week in government hospitals) just to make sure there are no further problems so you cannot be sued afterwards. Next you ask for a second opinion from another doctor (another 300 baht doctor's fee) and keep the patient in for observation (a few thousand baht per night).

It won't be long till all hospital beds are taken, doctors will spend their whole days making sure they wont be sued, and treatment costs per patients go through the roof. But that is just "tough" for the government who has to pay the bills and the people waiting in line all day long.

[Bluespunk]

"Also, automatic compensation will only encourage victims or their relatives to focus on finding fault with their doctors just so they can get money."

Tough.

Do your job properly and there won't be suits.

Stop whining about being held accountable.

No one cares.

Doing your job properly would be so easy to just do...

If someone comes in with the common cold you order a CAT scan (which costs about 40,000 baht and already has a queue of a week in government hospitals) just to make sure there are no further problems so you cannot be sued afterwards. Next you ask for a second opinion from another doctor (another 300 baht doctor's fee) and keep the patient in for observation (a few thousand baht per night).

It won't be long till all hospital beds are taken, doctors will spend their whole days making sure they wont be sued, and treatment costs per patients go through the roof. But that is just "tough" for the government who has to pay the bills and the people waiting in line all day long.

None of what you says changes the point I am making.

Doctors must be held responsible for their errors and incompetence.

Bed space and queues are another issue and nothing to do with the doctors making a mistake or botching treatment.

[Bob12345]

"Also, automatic compensation will only encourage victims or their relatives to focus on finding fault with their doctors just so they can get money."

Tough.

Do your job properly and there won't be suits.

I know of 2 doctors already (out of about 200 doctors who graduated in the same year as my wife) who stopped practicing medicine after they had been sued over the death of a mother during child birth. The family smelled money and made up claims to blame the doctors. It took months before the medical council concluded they could not be blamed but the added stress led to both of them quitting their specialization and stopping to practice medicine. Combine that with the current shortage of doctors in Thailand already and ask yourself if this the way Thailand should be going.

[Bluespunk]

"Also, automatic compensation will only encourage victims or their relatives to focus on finding fault with their doctors just so they can get money."

Tough.

Do your job properly and there won't be suits.

I know of 2 doctors already (out of about 200 doctors who graduated in the same year as my wife) who stopped practicing medicine after they had been sued over the death of a mother during child birth. The family smelled money and made up claims to blame the doctors. It took months before the medical council concluded they could not be blamed but the added stress led to both of them quitting their specialization and stopping to practice medicine. Combine that with the current shortage of doctors in Thailand already and ask yourself if this the way Thailand should be going.

Still does excuse incompetence and botched treatment.

Doctors have to be held responsible for their mistakes, if they are to blame for things going wrong they must be accountable.

[Jim walker]

But Thais never make mistakes so there would be no need for any accountability everyone knows that Thais know best and same for all Thai Doctors so just take your pills and don't forget to pay on the way out.

[Bob12345]

"Also, automatic compensation will only encourage victims or their relatives to focus on finding fault with their doctors just so they can get money."

Tough.

Do your job properly and there won't be suits.

Stop whining about being held accountable.

No one cares.

Doing your job properly would be so easy to just do...

If someone comes in with the common cold you order a CAT scan (which costs about 40,000 baht and already has a queue of a week in government hospitals) just to make sure there are no further problems so you cannot be sued afterwards. Next you ask for a second opinion from another doctor (another 300 baht doctor's fee) and keep the patient in for observation (a few thousand baht per night).

It won't be long till all hospital beds are taken, doctors will spend their whole days making sure they wont be sued, and treatment costs per patients go through the roof. But that is just "tough" for the government who has to pay the bills and the people waiting in line all day long.

None of what you says changes the point I am making.

Doctors must be held responsible for their errors and incompetence.

Bed space and queues are another issue and nothing to do with the doctors making a mistake or botching treatment.

Doctors must be held responsible for their errors and incompetence:

Quote: "In comparison, the latest bill regards doctors and medical personnel as wrongdoers from the onset, whether or not their mistakes are intentional or accidental, and does not give them a chance to defend themselves or produce proof so they are not liable to lawsuits, the doctor said."

I agree doctors must be held responsible for their errors and incompetence, but as the quote above shows the new bill will not help with determining errors and incompetence as doctors cannot defend themselves or produce proof to defend themselves.

Bed space and queues are another issue and nothing to do with the doctors making mistake or botching treatment:

In my comment I just made the point that bed space and queues are directly related to doctors being afraid of making mistakes. Please explain why there is no relationship.

(and the article is not about doctors making mistakes, the article is about how doctors can be sued for possible mistakes)

[smedly]

accountability in Thailand ?

would be a first

[Bluespunk]

"Also, automatic compensation will only encourage victims or their relatives to focus on finding fault with their doctors just so they can get money."

Tough.

Do your job properly and there won't be suits.

Stop whining about being held accountable.

No one cares.

Doing your job properly would be so easy to just do...

If someone comes in with the common cold you order a CAT scan (which costs about 40,000 baht and already has a queue of a week in government hospitals) just to make sure there are no further problems so you cannot be sued afterwards. Next you ask for a second opinion from another doctor (another 300 baht doctor's fee) and keep the patient in for observation (a few thousand baht per night).

It won't be long till all hospital beds are taken, doctors will spend their whole days making sure they wont be sued, and treatment costs per patients go through the roof. But that is just "tough" for the government who has to pay the bills and the people waiting in line all day long.

None of what you says changes the point I am making.

Doctors must be held responsible for their errors and incompetence.

Bed space and queues are another issue and nothing to do with the doctors making a mistake or botching treatment.

Doctors must be held responsible for their errors and incompetence:

Quote: "In comparison, the latest bill regards doctors and medical personnel as wrongdoers from the onset, whether or not their mistakes are intentional or accidental, and does not give them a chance to defend themselves or produce proof so they are not liable to lawsuits, the doctor said."

I agree doctors must be held responsible for their errors and incompetence, but as the quote above shows the new bill will not help with determining errors and incompetence as doctors cannot defend themselves or produce proof to defend themselves.

Bed space and queues are another issue and nothing to do with the doctors making mistake or botching treatment:

In my comment I just made the point that bed space and queues are directly related to doctors being afraid of making mistakes. Please explain why there is no relationship.

(and the article is not about doctors making mistakes, the article is about how doctors can be sued for possible mistakes)

Point 1: that's the spokesman's view, I would need to read the bill itself to know if he is putting a PR spin on it or not. But yes if that's the case the bill needs refining to allow for defending what they did, as he calls for later on in the OP. However the point I am making is that they must be held fully responsible if they have made a mistake.

Point 2: the doctors can recommend the things you mention, how long it takes them to happen is not within their power to decide. That is down to the govt investing in the infrastructure required. It is not linked to incompetence if it is beyond the doctors power to provide them in the timeframe they would prefer.

[halloween]

Doctor's don't admit their mistakes, they bury them. Or, in Thailand, burn them.

[Si Thea01]

I tell you why, too many stuffing up. Mine is a fine example. Went to major private hospital in Udon Thani for nasal polyp removal. Now have right eye that has suffered muscle trauma, so much so that had to have an eye operation in an attempt to rectify the problem but because the damage was so severe I now need a second operation to use other eye muscles in an attempt to restore the eye sight to some sort of normality.

Double vision, mixed messages to brain, unable to drive, restricted to home on most days, as wife works. The best I can expect is up to 85% normal vision and no further operations will have any benefit whatsoever. Have been like this now for some 9 months. The medical costs have been phenomenal, luckily majority covered by medical insurance but still out of pocked by 10,000's baht. Only avenue is for a government tribunal to look at it, but then if unsatisfactory, the last option is to sue. Normally the ones to benefit from this are the lawyers. So why not pass a bill to keep them honest and assist in genuine cases.

[tigermonkey]

Point 1: that's the spokesman's view, I would need to read the bill itself to know if he is putting a PR spin on it or not. But yes if that's the case the bill needs refining to allow for defending what they did, as he calls for later on in the OP. However the point I am making is that they must be held fully responsible if they have made a mistake.

Point 2: the doctors can recommend the things you mention, how long it takes them to happen is not within their power to decide. That is down to the govt investing in the infrastructure required. It is not linked to incompetence if it is beyond the doctors power to provide them in the timeframe they would prefer.

Regarding your Point 1 - yes, go ahead and read the draft bill. Unfortunately, the bill does start by presuming the guilt of the medical profession in order to expedite payment to the patient. It allows only for a cursory look at the case by a committee of unknown expertise. The decision is final and binding, with no allowance for response by experts or the medical professionals involved. This leaves the patient with his money (up to 400,000 Baht) and leaves the doctor with a "guilty as charged" on his record, allowing the patient to pursue him/her through the courts.

This is all being done purely to speed up the process. The present process works well but takes far too long.

With ASEAN on the horizon, this bill on the books, will cause many of the better doctors to pack up and go to Singapore or other.

[tigermonkey]

I find it truly sad that the present government continues to push to pass legislation, about which they seem to know very little or care very little. Perhaps neither of these are of concern to them, and they are merely seeking the visual effect of appearing to be doing something - and of course, it doesn't hurt if that action is 'populist' in that it delivers money to the masses.

The true problems in medicine in Thailand are many and they have similarities with other areas of concern. It is a two-tiered system with the upper tier vastly too wealthy, and the lower tier vastly under funded. Corruption is everywhere, particularly in government funded purchases of pharmaceuticals and equipment, There are no uniform standards of almost anything. Some medical school graduates are superb, while some others from lesser schools are not qualified to be paramedics.

In roughly a 60 KM radius of our home there are 9 'doctors" of whom I am aware, not including myself or those who work at government hospitals - they all see patients daily. Of those 9 -- 1 was barred from medical practice 20 years ago, 2 did not complete medical school, 1 never went to university ( his wife also 'sees' patients), 1 is a veterinarian and only one is actually competent.

There's lots to repair in the medical world - everyone knows the problems. Expediting payment on malpractice accusations seems a strange place to start.

Edited April 7, 2015 by tigermonkey

[smedly]

I find it truly sad that the present government continues to push to pass legislation, about which they seem to know very little or care very little. Perhaps neither of these are of concern to them, and they are merely seeking the visual effect of appearing to be doing something - and of course, it doesn't hurt if that action is 'populist' in that it delivers money to the masses.

The true problems in medicine in Thailand are many and they have similarities with other areas of concern. It is a two-tiered system with the upper tier vastly too wealthy, and the lower tier vastly under funded. Corruption is everywhere, particularly in government funded purchases of pharmaceuticals and equipment, There are no uniform standards of almost anything. Some medical school graduates are superb, while some others from lesser schools are not qualified to be paramedics.

In roughly a 60 KM radius of our home there are 9 'doctors" of whom I am aware, not including myself or those who work at government hospitals - they all see patients daily. Of those 9 -- 1 was barred from medical practice 20 years ago, 2 did not complete medical school, 1 never went to university ( his wife also 'sees' patients), 1 is a veterinarian and only one is actually competent.

There's lots to repair in the medical world - everyone knows the problems. Expediting payment on malpractice accusations seems a strange place to start.

the simple truth is that this is a 3rd world country (it shouldn't be) and along with so many other things regulation is none existent, no matter what sector you look - medical - legal - engineering - construction - government - finance,,,,, corruption rules, that is why Thailand fails as a nation, money money money

I will tell you this, several of my friends over the years have attended various hospitals for treatment and have been rightly screwed - always the focus is on money as opposed to actual healthcare, I've seen it so many times it is shocking, you have doctors who make stuff up just to keep them there - I am smarter than that and they don't like being questioned, as for mal -practise - the whole country is mal-practise with a capital "M" including the medical services - fancy trying to regulate that or anything else here

Reality - 3rd world - nothing more to say really

[Thai at Heart]

This ends with doctors getting liability insurance and undergoing peer review. Happens all over the world....

[Gonsalviz]

So, the Medical Council of Thailand does not like the idea of doctors being held accountable when they screw up. One has to wonder why?

Well I guess they could go theroute of the the good ole USA and end up with Obamacare.

[cheeryble]

So, the Medical Council of Thailand does not like the idea of doctors being held accountable when they screw up. One has to wonder why?

Well I guess they could go theroute of the the good ole USA and end up with Obamacare.

Oh yeah the USA....

Been visiting all my life since 1968 when I hitch hiked from NY to LA and back.

Now I cannot go there as I cannot reasonably insure against a medical event.

Imagine that.

Edited April 9, 2015 by cheeryble