New Zealand A Study in a “no blame” culture of medicine - PowerPoint Presentation

New Zealand A Study in a “no blame” culture of medicine Viktoriya Tulchinskaya, MS4

View of the mountains in Glenorchy , South Island.

Background Information 1,500km east of Australia 2 major islands: North and South, separated by Cook Strait Population 4.5 million One of the most recent countries to be discovered and settled Settled by Polynesians around 1300ADEuropeans landed in 1643ADPrimary languages: English and Maori Image 1

Background Information Image 2 Rotation in Pediatric Neurology at Starship Children’s Hospital in Auckland Auckland: largest city in the country, population of 1.5 million Starship Children’s Hospital: first hospital in New Zealand built especially for children, in 1991

Topic of Interest: Attitudes and Practices around Medical Malpractice A common topic in the media. An area of concern for practitioners, in general. Something that is on my mind as a future provider.

Rationale: why this topic? Medical malpractice is a topic of which medical students are made aware very early in education. We are taught that much of the rationale behind medical decision-making centers on avoiding a lawsuit. Is this a “unique” culture of medicine, or do other countries approach medical malpractice in the same way? Obstetricians/Gynecologists encounter the most lawsuits of any medical specialty in the US. Image 3

Structure of Malpractice in New Zealand “No Fault” culture Focus on a “systems” approach to determining the factors that contribute to medical mistakes Patients get compensation from the government In return, patients cannot sue Provides more timely compensation to more patientsAccident Compensation Corporation (ACC) ACC: Claims are processed in weeks Decisions within 9 months Similar injuries receive comparable compensation Funded through general taxation and employer payments Compensation awards are lower than in malpractice suits

Interview with a Physician Physician perspective: Feels comfortable and safe practicing in this system Supportive environment Appreciate the fairness of examining all the systemic factors that led to the medical mistake Consider the evaluation and compensation system to be good, tooMore reasonable compensation for patients Physicians don’t have outrageous malpractice insurance payments Image 4

Conclusions/Suggestions In 2003, per capita health spending was $1,886 vs. $5,635 in the US New Zealand spends less on healthcare, less on malpractice, with comprarable patient outcomes Is there room for the United States to reform it’s malpractice system?Could it take an example from the system in New Zealand?

Most Profound Clinical Experience Since the cost of healthcare is covered for most patients in New Zealand, it was profound to see families who didn’t have to worry about paying for a child’s health care. Very sick children can stay in the hospital as long as they need, without caregivers worrying about money. Families can focus on more important things, like setting up support and services, and taking care of each other.

Most Profound Cultural Experience Tramping : a favorite Kiwi activity. Backpacking, hill walking, bushwalking, or hiking. The Department of Conservation maintains an enormous network of tramping tracks. Kiwis have a great pride for their country, and are known to enjoy spending time outside.

Tongrariro Alpine Crossing One of the “Great Walks”

References https://www.clubtravel.ie/cheap-sun-holidays/australia-and-new-zealand-holidays.aspx http://www.tourism.net.nz/new-zealand https://www.starship.org.nz/ https://www.bmj.com/content/359/bmj.j5534 https://www.babycenter.com/0_how-to-choose-an-obstetrician_1582.bc http://www.commonwealthfund.org/publications/in-the-literature/2006/feb/no-fault-compensation-in-new-zealand--harmonizing-injury-compensation--provider-accountability--and https://www10.aeccafe.com/blogs/arch-showcase/2014/11/20/starship-childrens-hospital-in-auckland-newzealand-by-stephenson-turner/