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Medical Malpractice Reform

Isn't it time for accountability?

organic225
post 21.Oct.2012, 05:04 PM
Post #1
Joined: 7.Apr.2012

It seems like every other day there is a story on The Local regarding some case of medical malpractice. I know there are many good aspects of Swedish healthcare, but I'm surprised that there's not more of an outcry among the Swedish public when it comes to these cases of medical negligence. For example, why is it tolerated that when someone calls an ambulance complaining of chest pain, shortness of breath, etc., that the dispatcher can decide the caller does not need emergency services? I understand that ambulances are not to be used in non-life threatening situations (in the U.S. they are even used for transport, often at great cost), and that people should get themselves to an ER by some other means if possible.

I remember reading the case of an elderly patient undergoing kidney surgery, and the anesthesiologist and nurse decided to go for lunch in the middle of the operation. The patient died. It is my understanding that Sweden has a "no-fault" medical system, where medical professionals very rarely face real consequences for such negligence. I am not suggesting Sweden adopt a malpractice system like that in the U.S., as that goes too far in the other extreme. But in general, compensation should be higher and in certain cases medical staff should be fired and even criminally charged. I am suspicious that it partly has to do with the strength of the doctors' unions.

We all need to remember that as patients, we are the customers and the medical professionals are providing us a service. In any other field, if you as a customer were cheated by a merchant (say you were overcharged or subpar work was done), you would have recourse through the law. Yet when it comes to being a patient, those providing the service can actually kill you, and, for all intents and purposes, get away with it.

Everyone pays for healthcare through their taxes. We as patients deserve a system that works for us. It is time for balanced malpractice reform in Sweden.
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Puffin
post 21.Oct.2012, 05:47 PM
Post #2
Location: Dalarna
Joined: 5.Apr.2006

You have to remember that The Local aims to be a sensationalist tabloid newspaper to get a high hit rate - so you will not get an accurate view if you rely on it as your only news source

Complaints and malpractice allegations are investigated by the National Board of Health & Welfare (Socialstyrelsen)
http://www.socialstyrelsen.se/reportingmalpractice
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organic225
post 21.Oct.2012, 06:22 PM
Post #3
Joined: 7.Apr.2012

While I agree that The Local is often sensationalist, are you saying that the medical malpractice cases it has been reporting are false?

I am aware of Socialstyrelsen and the system in place to adjudicate claims. I'm not saying there aren't benefits for a patient in a no-fault system. For instance, a patient's malpractice claims will generally be resolved much more quickly, albeit with lower compensation. The main problem is that the compensation system is not linked to medical staff. There is an informative article in the Center for Justice & Democracy journal at New York Law School entitled, "Medical Malpractice in Sweden and New Zealand: Should Their Systems Be Replicated Here? In my opinion, this is an objectively written article which discusses the pros and cons of the system. Here are some poignant excerpts:

"Sweden’s system also has enormous problems. Because it is a “no-fault” or “no-blame” system where monetary damages are never tied to a doctor or caregiver,39 the compensation aspect has been completely separated from the system that handles complaints against medical staff. In the separate process that handles complaints against medical staff, action is only taken in 6 percent of all cases.40 The impact is clear: Medical errors kill 3,000 people each year in Sweden.41 These errors include babies overdosing on painkillers, elderly patients dying as the result of incorrect diagnoses, ambulance drivers ignoring calls42, injuries during childbirth, incorrect drug dosages, mixed up test results and infections following surgery.43 In fact, patient safety has become such a concern that there are actually calls to look to the United States as a model for Sweden.44

For example, in Sweden recently, a doctor, who missed at least 27 cases of skin cancer, was only dismissed when the hospital was unable to rule out even more missed cases.45 In a separate incident, a doctor was not suspended after failing to detect cancer seven different times. In that case, the Swedish Medical Association admitted that hospitals rely on less secure procedures because of doctor shortages.46

Additional problems exist with Sweden’s ambulance prioritization system, which has finally come under review. Multiple deaths include: a woman in renal failure with pneumonia who died the day after an ambulance refused her; a man who died of a ruptured spleen after an ambulance refused him; and a man who suffered a heart attack after being told to buy cough medicine.47

Even more disturbing, the evidence suggests that Sweden’s medical malpractice record is actually getting worse. In the last five years, written complaints over treatment increased 80 percent48 and, in the last decade, compensation payments for malpractice have doubled.49 Moreover, in the first three months of 2011 alone, Swedish patients lodged 700 new complaints against medical workers. These were added to 2,300 outstanding complaints that had yet to be processed.50

In fact, Sweden has become a safe harbor for doctors who should not be practicing at all. Take Dr. Johanne Krogh, who began practicing at Hudiksvall Hospital in 2007. Her background check was so insufficient that her employers did not know she was notorious in Norway for medical malpractice. One incident in Norway involved Dr. Krogh losing her temper in the middle of a surgical procedure and storming out of the room, leaving a bleeding patient on the table. Her behavior was so egregious that the Norwegian patient insurance system paid 29 claims relating to her work and received over a dozen more claims. While Norway removed her orthopedic and surgical licenses after the first 20 payouts, nothing stopped her from moving to Sweden where she continued to practice as of 2010.51 This type of oversight hardly makes Sweden a model system for patient safety."


Here is a link to the full article:
http://centerjd.org/content/white-paper-me...be-replicated-0

Yes, there are citations from The Local. At the same time, there are citations from numerous sources, so this can hardly be called sensationalist.
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Migga
post 21.Oct.2012, 07:18 PM
Post #4
Joined: 26.Jul.2011

Who says Swedes tolerates malpractise?

The healthcare system is not perfect but I think it works well enough. If something goes wrong it`s reported, the news writes about it, an investigation is started and if there is malpractise the one responsible is punished. The fact that you hear about it shows that it works somewhat. There will always be problems, the way one deals with the problems is how you know if things are working somewhat or not.

With that said there could probably be more done and done better.
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Bender B Rodriquez
post 21.Oct.2012, 07:40 PM
Post #5
Joined: 25.Mar.2006

QUOTE (organic225 @ 21.Oct.2012, 06:04 PM) *
It seems like every other day there is a story on The Local regarding some case of medical malpractice. I know there are many good aspects of Swedish healthcare, but I'm s ... (show full quote)

I assume that you don't speak Swedish, otherwise you would know that there was a public outcry over this.

Medical errors are a big problem and there needs to be more accountability, however reading the headlines of TheLocal gives a very skewed picture. To put it in perspective you can for example read this: http://www.medicalnewstoday.com/releases/11856.php
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cogito
post 21.Oct.2012, 07:45 PM
Post #6
Joined: 30.Dec.2009

QUOTE (Migga @ 21.Oct.2012, 06:18 PM) *
. If something goes wrong it`s reported, the news writes about it, an investigation is started and if there is malpractise the one responsible is punished.

Examples of that punishment?
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organic225
post 21.Oct.2012, 07:55 PM
Post #7
Joined: 7.Apr.2012

"Wouldn't it be more effective to bring your issues to Socialstyrelsen and Göran Hägglund, the minister of health and social affairs, instead of posting under an anonymous handle on TheLocal discussion forums?"

Ah, the expected smug answers have begun to trickle in. It seems like I've upset you, as your snide remark suggests that you are annoyed that I would bring up this issue in this forum. It's okay to talk about everything else, but if someone questions the merits of a Swedish institution or system, there is often a knee-jerk reaction as if it is somehow blasphemous.
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Bender B Rodriquez
post 21.Oct.2012, 08:01 PM
Post #8
Joined: 25.Mar.2006

QUOTE (cogito @ 21.Oct.2012, 08:45 PM) *
Examples of that punishment?

The most common punishment is that you lose your license to practice medicine.
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organic225
post 21.Oct.2012, 08:04 PM
Post #9
Joined: 7.Apr.2012

QUOTE (Bender B Rodriquez @ 21.Oct.2012, 07:40 PM) *
I assume that you don't speak Swedish, otherwise you would know that there was a public outcry over this.Medical errors are a big problem and there needs to be more accoun ... (show full quote)

I knew someone would bring up foreign statistics in an attempt to deflect from having a reasoned discussion about Swedish healthcare. This is a forum dedicated to life in Sweden after all. There are issues with patient safety everywhere, and the United States can certainly improve in this regard. However, American doctors are held accountable, whereas Swedish doctors, by and large, are not. I'm sorry if this is upsetting to Swedish pride, but it is the truth. Now, if you would like to open a thread about problems with the American healthcare system, I will gladly take part in a discussion.
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what would thomas paine d...
post 21.Oct.2012, 08:13 PM
Post #10
Joined: 15.Oct.2012

I agree that TL does not accurately portray healthcare in Sweden. The reality of healthcare in Sweden is far, far worse than TL even begins to suggest. There was also a TL article, by the way, that mentioned medical deaths at 4,000 per year. Please remember that these are deaths that the state owns up to. I'm sure there are easily more. Thank you to the OP for making note of the article and link! The Swedish state is guilty of gross medical and mass willful negligence.

Another recent article:
Throughout Sweden, healthcare services are experiencing huge economic problems and further forced cutbacks. Budgets for four out of five university hospitals, for example, will be slashed by 1, 55 billion SEK with 2000 jobs to be cut as well, and further rationing of the existing shortage of hospital beds.

The financial manager of Skåna’s university hospital said it was the worst rationing in ten years. The public-relations manager for Stockholm’s Karalinska hospital said the hospital is already functioning at full capacity and that reductions aren’t going to help departments which are already on their knees.

Other healthcare cuts throughout Sweden include reducing the healthcare budget in Dalarna by 300 million SEK by eliminating 200-to-240 nursing jobs. Gävleborg is cutting 157 million SEK from its budget by eliminating those in “medicinvården och operation” [English translation?]. Sörmland is cutting 300 healthcare jobs plus some within the kitchen and cleaning staff as well.

A councilman from Västerbotten said healthcare doesn’t receive the necessary tax funding, so budgets have to be reduced. Until 2011, counties and municipalities received additional economic support from the government, but there are no government grants in the recent budget proposals. Increased healthcare costs, for example, are often linked to new medicines, cures, and treatments to reduce suffering. A councilwoman in Södermanland said the budget cuts were serious and that it was hard to keep costs down, but what was most worrisome was that patients were demanding more and more.

The Swedish Association of Local Authorities and Regions (SKL) said that in the future,”we” [individuals or communities?] will need to pay more out of pocket. Furthermore, communities will not be able, through the taxes alone, to provide what every resident wants. And that this must be discussed at the national level.

http://www.ka.se/index.cfm?c=102280
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Bender B Rodriquez
post 21.Oct.2012, 08:16 PM
Post #11
Joined: 25.Mar.2006

QUOTE (organic225 @ 21.Oct.2012, 09:04 PM) *
There are issues with patient safety everywhere

Exactly, that's why you have to put things in perspective instead of reading articles on TheLocal (or rely on a paper that uses citations from TheLocal)...
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organic225
post 21.Oct.2012, 08:26 PM
Post #12
Joined: 7.Apr.2012

I was writing under the assumption that it is a given that there are issues everywhere. It would be unreasonable to believe that there are not; however, I do not see how this acknowledgment can be tied to the veracity of articles in The Local. They are not mutually exclusive. If you have information that contradicts what The Local has reported on these issues, I would like to see it.
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organic225
post 21.Oct.2012, 08:45 PM
Post #13
Joined: 7.Apr.2012

Your post implied that the subject was not worth discussing here. Based on your reasoning, it is fruitless for common people to discuss societal issues which affect them unless some government representative with the authority to institute changes is present. Now that is "braindead" logic.
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organic225
post 21.Oct.2012, 09:10 PM
Post #14
Joined: 7.Apr.2012

Ah yes, finally the ad hominem attack, the last refuge of a lost argument.
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cogito
post 22.Oct.2012, 11:10 AM
Post #15
Joined: 30.Dec.2009

QUOTE (organic225 @ 21.Oct.2012, 04:04 PM) *
I'm surprised that there's not more of an outcry among the Swedish public when it comes to these cases of medical negligence.-

Because they have been indoctrinated to believe that
1, Swedish healthcare is the best, and
2. complaining is seen as unpatriotic.

QUOTE (Puffin @ 21.Oct.2012, 04:47 PM) *
You have to remember that The Local aims to be a sensationalist tabloid newspaper

This common response is known as Shoot the Messenger (because we don't like the message). In primitive societies the king would order the messenger be killed. Nowadays, Defenders of the Throne can just bash the press.

If change happens it will be, in part, thanks to TheLocal's exposure of negligence and indifference in Swedish heathcarae. Before TL, the Swedish media used to be complicit in covering up the numerous examples of malpractice.

QUOTE (organic225 @ 21.Oct.2012, 07:04 PM) *
I knew someone would bring up foreign statistics in an attempt to deflect from having a reasoned discussion about Swedish healthcare.

"It's the same everywhere" is the pavlovian response whenever Sweden's healthcare failures are exposed.
But it is not the same everywhere. Healthcare is superior in most European nations as well as in Thailand and (was) in the U.S.
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