How to safeguard Interests (including professional indemnity) Treat cases which fit in your

• Qualification

• Infrastructure

• Competence and skill

Why? Because legal rule is

• If you treat beyond the area of qualification, competence and skill then you are negligent per say.

• Higher the risk under taken higher degree of qualifications, skill and competence is legally required.

• Treating with inadequate infrastructure may amount to deficiency in service except in emergency.

Recognize complications and

• Prevent or treat them as soon as possible yourself, if not possible then

• Refer to appropriate specialist or

• Transfer in a well equipped ambulance, preferably accompany patient yourself or rmo

• To a hospital/place with better infrastructure to monitor and treat.

Why? Because legal rule is

• You are suppose to reduce risks to health of a patient by giving medical care and

• You do not guarantee or warrantee cure, that is what is legally required.

How to protect rmp in cases of death which are

• Sudden and unexpected death.

• Death after a procedure or after surgery or after iv and im injection and

• In an expected death where a lot of complications have occurred and huge amount of money is spent in treating them then

• if possible call some doctors to see even when you know that they can not do any thing further or help the patient

• Never ever transfer a dying or dead patient to other hospital

• Complete your notes and records first to your satisfaction till then

• Let terminal oxygen, iv ect. Continue till doctors have completed records

• You finally declare death, but how ?

How to declare death?

• Ensure your notes and records are complete

• Take some relatives in confidence and talk to them about certainty of death. Be tactful and empathetic while declaring death, show genuine sorrow.

• Ensure that chief / main doctor is present to declare death and do not do through your junior doctor to prevent later on lots of heartaches and headaches.

• While declaring death do not irritate them with pending bill, proposed postmortem, information to police, harsh language, arrogance, pointing out relatives negligence, gloat with 'that you have done everything'

How to protect yourself from courts

• Receive and reply notices and comply with summons/dates

• Seek advice of good medicolegal expert/opinion.

• Take medical indemnity insurance for minimum 20 lakhs

• Seek expert witness affidavits

• Submit eye witness to avert allegations of 'was not present during emergency'

Which are the health related insurance sectors which will change the practice of medicine in future

There are two broad areas of insurance sector which will affect the practice of medicine in india. They are-

• Mediclaim policies with third party administrators acting as cashless treatment providers to policy holder patients

• Medical indemnity and hospital error and omission policy and its variants like comprehensive insurance for doctors covering property, vehicle, indemnity, errors and omissions along with medi-claim.

Contract of insurance is also known as insurance policy

• Contract of insurance has following elements.

• Insured has to fill a proposal form disclosing all the true facts about insured objective/thing-life or non life.

• Insured pays consideration known as premium in proportion to amount of insurance as per the tariff.

• Liability of insurer company arises when the loss occurs to insured due to contingencies described in insurance policy up to insured limit. contract of insurance is known insurance policy, which is the document which regulates the claims to be processed.