Guest Lorae Posted February 14, 2004 Report Share Posted February 14, 2004 Anyone know the cost for a practicing physician?? How about the differences between specialties?? Link to comment Share on other sites More sharing options...
Guest Ian Wong Posted February 14, 2004 Report Share Posted February 14, 2004 In Canada, all that's handled by the CMPA, the Canadian Medical Protective Association. This link may be of help: www.cmpa-acpm.ca/portal/pub_index.cfm?FILE=MEMBER_FEES&LANG=E Ian Link to comment Share on other sites More sharing options...
Guest Lorae Posted February 15, 2004 Report Share Posted February 15, 2004 Wow! What discrepancies! For the most part, I am relieved! I am looking into doing anaesthesia and critical care - looks like I'll be paying $300/month (ish)... but am i reading the chart right???? OBGYN: Quebec=1500/month, Ontario=$7000/month who can afford that?? according to income statistics they earn 300k annually... - after taxes and office overhead I don't think they'd have anything left if they paid $7000 per month - am I reading that wrong??? Link to comment Share on other sites More sharing options...
Guest UWOMED2005 Posted February 15, 2004 Report Share Posted February 15, 2004 I'd look at overall average overhead rather than individual premiums. The best figures I've ever found for salaries of physicians in Ontario are here: pub125.ezboard.com/fpremed101frm25.showMessage?topicID=16.topic Link to comment Share on other sites More sharing options...
Guest Lorae Posted February 15, 2004 Report Share Posted February 15, 2004 yeah, but when someone is trying to decide on a specialty I think it's important to look at individual premiums. If that is truly accurate and OBGYN's pay $7000 per month in Ontario I would predict a shortage of them. Who would want to pay that? Obviously I'm not advocating choosing a specialty based on income, but those premiums are astronomical. Link to comment Share on other sites More sharing options...
Guest aneliz Posted February 15, 2004 Report Share Posted February 15, 2004 The Ontario government pays the balance of the premiums for the OB/GYN's (and the family docs delivering babies)....they only end up actually paying the same as the 'average' doc. Problem is that they have to 'pay out' ALL of the insurance money up front and then get 'reimbursed' it by the notoriously slow Ontario government.... So they need to come up with the cash and be able to 'carry' it until they get the money back. If the Ontario government EVER tries to stop paying the extra malpractice insurance, there will be an instant (like <24 hours) work-stoppage by the OB/GYN's and there will be nobody in the province willing to deliver babies...which is a problem...and the Ontario government knows it....so they keep paying. If you want outrageous malpractice premiums, the OB's in California are paying ~250 000 USD per year....with no subsidy from the government! Link to comment Share on other sites More sharing options...
Guest Lorae Posted February 16, 2004 Report Share Posted February 16, 2004 Yeah I heard that quarter million figure from one of the surgeons at work today - that's insane. hmm... this reminds me of another insane thing - but I'll start another thread The surgeon i was talking to said that the OBGYN malpractice skyrocket happened after a woman sued for "wrongful birth" and won 12 million! Said that because her kid wasn't "normal" there must have been negligence in the delivery - but there wasn't a diagnosable event (hypoxia, etc).... I'd like to read more about that case if anyone has the information. Link to comment Share on other sites More sharing options...
Guest cracked30 Posted February 16, 2004 Report Share Posted February 16, 2004 Just for clarification, OBGYN still pay more than the average doc even after the reimbursment, almost twice as much. Link to comment Share on other sites More sharing options...
Guest seonagh Posted February 16, 2004 Report Share Posted February 16, 2004 There is a "wrongful life" case mentionned as an example in the Herbert book "Doing Right". It is a great book on medical ethical issues. In the example given in the book the woman contracted Chicken Pox early in the pregnancy. The couple wanted little intervention (refusing an ultrasound earlier etc) The doctor told the couple that the risk due to the Chicken pox was small and not a reason for an abortion and they carried the baby to term. The baby was born with congenital varicella syndrome. Although overall the case was not won (the judge found that it was not certain that the family would have aborted even if the risks had been elaborated on), the doctor was found to be negligent. Seonagh. Link to comment Share on other sites More sharing options...
Guest moo Posted February 16, 2004 Report Share Posted February 16, 2004 I can only offer an American perspective, but it's true that ob/gynes here pay a hell of a lot for malpractice. I don't know if you watch any American TV, but there are ads nowadays for lawyers targeting new mothers and among the things they can sue for are whether a C-section was perfomed, whether the child experienced "trauma", and other ridiculous things (can't remember the whole list off the top of my head). One of my preceptors last term was an ob/gyne and (aside from having an MD, PhD, MPH) he had just gotten his JD just so he can protect himself from the lawyers. Today, the average ob/gyne in Illinois has to deliver 150 babies just to pay his/her malpractice! As a result ob/gynes are moving in droves to neighboring states or leaving practice altogether. As an example, that same ob/gyne told us that he had a colleague who was a pharmacist before being a doctor, had now returned to working as a pharmacist making 90k/yr without the headaches of insurance and fear of being sued over her. Granted this is an extreme case, but it illustrates the problem this has become. Incidentally, ob/gynes are not the only ones with this problem. Among the highest sued specialties are family docs, as well as pediatricians and internists. it is no wonder that today, they teach you to practice defensive medicine, and as a result this drives up health care costs. These frivolous lawsuits have got to stop. Otherwise, this will not only drive physicians out of business but it will eventually endanger the lives of the patients the system is designed to help. Link to comment Share on other sites More sharing options...
Guest Lorae Posted February 17, 2004 Report Share Posted February 17, 2004 So this is it then???? Fetal heart rate is 60, you can either: a) do a c-section and save the baby's life and get sued for traumatizing the birth or procede with vaginal delivery, get sued for delivering a kid with cerebral palsy, lose your license for negligence sounds great I'd probably go back to pharmacy in that situation too. I just can't believe it's that bad. Link to comment Share on other sites More sharing options...
Guest UWOMED2005 Posted February 17, 2004 Report Share Posted February 17, 2004 It's actually not that bad. This is going to sound awful, but you don't have to worry too much in that situation because those exorbitant malpractice insurance fees aren't going to waste. The CMPA is phenomenal - they make sure to retain some of the best lawyers in Canada. In contrast, many of the "ambulance chasers" are bottom of the barrel types who prey on the patient and patient's family's emotions. As well, many of the cases that go to lawsuit are for frivolous reasons (and in contrast, often the justifiable cases are missed!) or involve cases of being stuck between a rock and hard place (ie Lorae's example) and in the end the courts often realize this. The CMPA has a fantastic success rate in cases. Even if the CMPA loses, it will usually be by an out of court settlement so your reputation isn't tarnished. And you yourself won't end up picking up the tab. . . the insurance will. So there isn't a real need to worry about being sued, though no physician or surgeon would ever claim the experience is enjoyable. And the fact is (almost) EVERY doctor gets sued. We were specifically told by one of our profs that within ten years of our career, it was almost certain every one of us would have a lawsuit in place against us. I've only met one physician who has never been named in a lawsuit (an anaesthetist of 18 years.) So don't worry, getting sued isn't the end of the world. But I see two major problems with this. First, from my limited experience I'd argue there is a complete disasociation between responsibility and punishment in the current medicolegal system. Most of the lawsuits and complaints to the Royal College that I've seen are for the most ridiculous and unfounded of complaints, or involve difficult situations where no clear course would have been correct. On the flip side, I've already seen a few cases of medical error that will go missed because the lay people can't recognize it as error. So why worry about doing things right? You're going to be sued no matter what you do, right? (This is not my real opinion btw) Second, with the malpractice insurance system, you're paying for every boob who reads too much into point #1 and acts negligently. I remember my neurology clinical methods instructor complaining about a ?neurologist? in Toronto who was doing ?EMGs? a couple of years back and ridiculously wasn't changing the electrode between patients. He ended up spreading Hepatitis B to a number of patients, and the settlement was astronomical. My clinical methods instructor's point was that this one idiot, who ended up having no personal suffering as a result of the CMPA covering the bill, resulted in a very significant increase in malpractice fees for everybody else. Link to comment Share on other sites More sharing options...
Guest cracked30 Posted February 18, 2004 Report Share Posted February 18, 2004 Well, get the story straight before you tell it. The neurologist owned an EEG and EMG clinic. He had a technologist who, unbeknownst to the neurologist, was infected with Hep B and was lax in the sterilization procedures. The neurlogist was sued for the tech's negligence, because, as a doctor, you are responsible for the activities of the people that you employ. The technologist was never sued or brought in front of his "college" Link to comment Share on other sites More sharing options...
Guest Ian Wong Posted February 18, 2004 Report Share Posted February 18, 2004 Here's a link to the CMAJ article that reported this outbreak: collection.nlc-bnc.ca/100/201/300/cdn_medical_association/cmaj/vol-162/issue-8/1127.htm The payout for this was 27.5 million dollars. Of note, the CMAJ article states that the technologist was unaware of this Hep B status, but he was pinned down as all other clinic staff were Hep B negative on serologic testing. He also failed to use gloves when inserting the electrodes. This is an interesting quotation from the article: Before Jan. 19, 1996, reusable subdermal electrodes were used almost exclusively for in-clinic EEGs. The procedure involved placing thin metal rods with sharpened ends under the patient's scalp.[...]After Jan. 19, 1996, the technician switched to using only disk electrodes for all EEGs.I'm unable to guess from this article whether using reusable needles might have been the standard of care back then (although I doubt it, given that we knew all about HIV, Hep B and C at that point). That's always something that I've been leery about as a physician, knowing that the actions of your clinic staff are ultimately reflective of yourself. While the physician really should know exactly what is occurring in his/her own clinic, the reality is that you can't be everywhere at once, and negligence on the part of your support staff isn't something that you may even be aware of, until it's too late (as in this example). Ian Link to comment Share on other sites More sharing options...
Guest UWOMED2005 Posted February 18, 2004 Report Share Posted February 18, 2004 Yeah, sorry cracked. I only heard the story second hand from my neurology clinical methods instructor. . . and at that it's been a year since I heard the story properly. The principle remains the same, even though I'll admit I don't personally know what fault lay with the neurologist in question. Link to comment Share on other sites More sharing options...
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