Could it be that SG peasants in Pub Hosp cannot afford litigation; Pte healthcare patients with personalized service too happy to complain?
Widened rich poor divide @
http://consumer-protection1.blogspot.com/2007/10/singapores-rich-poor-divide.html Fewer suits filed against public hospitals
S'pore bucks rising global trend; yearly figures here fall from 15 cases to about 11
By SALMA KHALIK Health Correspondent
ST Oct 20, 2007
MORE people around the world are suing their doctors, but the trend here is reversed at least in the public health sector.
Between 1997 and 2000, there were 15 cases a year, but the figure has come down to 11.2 in recent years.
The reason for the fall, said National Healthcare Group (NHG) chief Dr Lim Suet Wun, is better communication between doctors and patients, and better care.
The importance of good doctor-patient communication was the subject of Minister of State for Health Heng Chee How's speech at the Singapore Medical Association's 11th Ethics and Professionalism convention last night.
The event also saw the launch of Medical Protection Society (MPS) Educational Services, the training arm of the London-based MPS, which insures most doctors here. MPS Educational Services was formed when MPS acquired Australia's Cognitive Institute, which teaches doctors communication skills.
Mr Heng said studies have shown that patients often make claims or file suits as a result of being poorly informed about their treatment process or options.
He added that some health-care providers also underestimate the seriousness of disputes and think that offers of money or fee waivers will settle them.
"When mishandled, more dissatisfaction is caused and the disputes escalate," he added.
Dr Mark O'Brien, Cognitive's medical director confirmed that five worldwide studies showed that 95 per cent of people do not file a claim against doctors when things go wrong.
He said: "The real cause of litigation is poor communication. The incident is just the catalyst."
MPS medical director Priya Singh said people sue because it is often the only way they can get answers to what went wrong.
She said an Australian study showed that doctors trained to communicate with their patients had the number of complaints against them halved, at a time when other doctors were seeing twice the number of complaints.
Cognitive has run more than 130 courses here in the past four years for nearly 3,000 doctors from the public sector, and will be extending these to staff from private hospitals as well.
To prevent disputes from flaring up into legal suits, the Health Ministry started a medical mediation scheme in July to tackle disputes at lower cost roughly $200 a day for each party.
Three months on, however, the scheme has not had a single case. A ministry spokesman attributed this to the hospitals resolving their disputes internally.
Dr Lim said hospitals under NHG, which runs the public health cluster in the West, have adopted an "upfront" approach they tell patients when something goes wrong, instead of being defensive. He said: "It has not been easy. The doctors feel insecure and sometimes guilty about what has happened."
He suggested that public hospitals here are seeing lower litigation rates also because they have been improving their service and cutting down on errors.
While litigation figures may have fallen, the amount of damages awarded has been going up. The biggest payout from a medical suit here is $2 million, paid last year.
Doctors here have been paying higher premiums for insurance coverage against suits: in 2002, doctors providing cosmetic or aesthetic treatments paid $9,750; this year, they had to pay $27,000.
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