What's Up Nurse?Doctor's Professional Liability Insurance

A career as a doctor used to be regarded as one of the most respected professions, in which the Thai public was not only grateful for the service but also reluctant to take legal action in the case of medical mishaps. Furthermore, it is a standard procedure at most hospitals that before surgery, patients and their relatives generally agreed not to take legal action against doctors if the operation was not a success. However, despite such agreements, legal action still could be taken against doctors if medical errors happen. As witnessed recently by a high profile case of a doctor who was sentenced to 4 years in jail after a teenage girl died after a “simple” lipo-suction operation went wrong. In this issue of M&W we talked to Khun Norarit Jotikasatien, Managing Director of Paiboon Insurance about doctor's professional liability insurance.

Not many people know this but most hospitals in Thailand have already taken out medical malpractice liability insurance coverage a long time ago. But the insurance policy only covers the hospital and not the doctors. Therefore, this is a case of every man for himself and those doctors out there who are still uninsured better read this column carefully. Thai doctors that used to work in the US and returned home take it for granted that no doctors in their right mind would practice without proper insurance because in America , people routinely sue each other for the smallest wrongdoing. It is almost like a national hobby. But things are changing in Thailand too. In the past, the mindset was that legal action against doctors would get nowhere. But the attitude of suing both the doctors and hospital for malpractice is changing fast as it is becoming increasingly common and more publicized, particularly among doctors who work with well known and well-to-do patients.

Currently, only 10% of the more than 10,000 doctors in Thailand have professional liability insurance whereas in the US it is by law that all practicing doctors must have insurance. In fact this type of insurance was made available in Thailand more than 10 years but so far only a few cases have been underwritten. Moreover, several insurance companies have avoided writing such policies altogether for business reasons. But the trend is on the increase as people become better educated and are more aware about their rights.

Two of the big players in this market are Paiboon Insurance and Bangkok Insurance Plc. Both offer similar policies with annual premiums of 10,000 to 20,000 Baht per year, which is quite cheap when compared to the US where damages awarded by juries for malpractice can run into several millions dollars. Typically, maximum liability limit is around Baht 2 million per occurrence and Baht 4 million per year depending on the types of plans. Medical professions are divided into 3 main groups:

• Dentists

• General Practice

• Surgeons

Needless to say, dentists are the cheapest to insure and surgeons are the most expensive. Paiboon Insurance also offer group discount rate for 3 or more policy holders. To qualify one needs to have at least 5 years working experience, a valid medical license that has never been revoked and has not been sued in the past two years. Most policies do not cover cosmetic plastic surgery, hair transplants, silicone implants or special weight reduction diet treatments.

Once again an insurance is something that one buys but hope not to use. Doctor's professional liability insurance is no exception but it's just that doctors have a much harder profession than most people and potentially are more at risk from malpractice. We've heard of stories about surgeons leaving behind equipments inside the body of patients before. May be it was a joke but nonetheless, the risks are definitely there. Given that the insurance premiums are relatively cheap here, think of it as Baht 50 per day or Baht 5 per patient that you treat, then it is a small price to pay. So all you doctors out there, I hope you do the right thing to protect yourselves.