Medical Malpractice and the Risk in Healthcare in Saudi Arabia
Medical malpractice or medical error is usually defined as any preventable event that causes abusive medication use or patient harm under the healthcare professional’s and patient’s control. Abdel-Latif (2016) argues that the issue of malpractice concerns in Saudi Arabia has been due to society’s multicultural background and the high employment rate of foreign professionals in institutional and non-institutional health sectors. The author also states that despite the country’s high rate of medical errors, there needs to be more awareness of reporting procedures for such malpractice, along with the time constraints connected with reporting. In this sense, it is important to review the malpractice allegations among medical professionals in different regions of Saudi Arabia that could be connected to cultural or language differences.
Malpractice Insurance for Physicians and Dentists in Saudi Arabia
Before including allied health workers, such as nurses and pharmacists, in malpractice insurance, there were only two main groups – physicians and dentists. The rationale for insurance may be that physicians and dentists constitute the largest group of healthcare specialists who face malpractice allegations by patients and are required to bear higher costs than allied healthcare workers. In addition, physicians who work in different spheres also have various risks and costs. According to AlDakhil (2015), obstetrics and gynecology specialists in Saudi Arabia face the highest rate of allegations, forcing them to rely on insurance more than other specialists.
On the other side, there is little reason for the exclusion of nurses and other workers from medical error insurance. Alsulami et al. (2013) point out that besides physicians, nurses are among the largest groups that cause malpractices due to their function in administering drugs and treatment. The author points out that it is widely common for Middle Eastern countries to lack proper educational programs to prevent drug errors along with the development of patient safety. In this sense, it can be assumed that nurses and pharmacists who are also responsible for drug distribution should be included in the given insurance benefits to mitigate the risks.
International Benchmark for Malpractice Insurance
The international practice of malpractice insurance includes the judgment by the court on whether the professional is eligible to cover costs. Overall, there is a detailed evaluation of circumstances related to the case, along with the presence of all important medical records and evidence. Further, a medical expert will be invited to examine the given data and testify at trial.
Depending on the expert’s report and evidence found by an attorney, the decision will be made over the responsibility of compensation and insurance inclusion. According to Born and Karl (2016), the American malpractice insurance market is considered one of the most profitable within the insurer’s job. They claim that in the past forty years, the insurance market of medical errors has boomed with rising profits for insurers and higher costs for healthcare professionals.
Perception of Allied Health Malpractice Insurance in the Middle East and Its Differences from the International One
The current perception of allied health malpractice insurance perception is similar to those received from Saudi Arabia and in the international sphere. Saudi Arabia already includes allied health practitioners in malpractice insurance benefits. Cheluvappa and Selvendran (2020) point out the Australian system of malpractice cases regarding nursing errors, mostly medication administration errors.
This is similar to the described above case of nurses in Saudi Arabia held responsible for misuse of improper administration of drugs. Given that systems are perceived as similar overall in such cases, Alluhidan et al. (2020) claim that besides insurance benefits for nurses, it is vital not to overregulate nursing work for Saudi Arabian professionals. As for allied health practitioners, it is more important to ensure the protection of specialists rather than their control over malpractice issues. In this sense, international practice can differ in controlling allied health workers through tort laws, as in the example of the US or UK.
On the other hand, the nursing experience connected with malpractice litigation and insurance can differ due to these professionals’ high turnover rate. Konetzka et al. (2018) reflect on the connection between nurses leaving the profession due to the fear of malpractice cases and the absence of proper protective measures, such as insurance. In Saudi Arabia, because nursing malpractice insurance was optional, there was less emphasis on lawsuits connected with this profession (Alkhenizan & Shafiq, 2018). At this point, it can be claimed that nurses in Saudi Arabia face less stress connected with malpractice and insurance overall and thus have less connection with the turnover rate.
Perception of Physicians Towards Malpractice Insurance in Saudi Arabia and Its Differences From the International One
The issue of underreporting poses a high threat to the healthcare system of Saudi Arabia, so it is necessary to evaluate the reasons for the case. According to Alsafi et al. (2015), in the WHO report, there is a difference in perception of malpractice in the international and Saudi Arabian sense. Due to the fact that many physicians are foreign professionals, malpractice or admittance creates legal barriers for the specialist. Thus, there is a higher fear not of costs but of the possibility of deportation. Thus, these physicians tend to underreport the error if there is no harm to the patient.
In this sense, the international experience can vary greatly since the malpractice for native workers in other developed countries can result in legal allegations and costs, along with the possibility of losing their license to work. Thus, it puts the question of malpractice insurance on different degrees of discourse compared to Saudi Arabian and International experience.
Another difference between international malpractice insurance and Saudi Arabia is the state’s role in providing coverage standards along with all the procedures. The Saudi Arabian Council for Cooperative Health Insurance (CCHI) sets the minimum coverage for medical malpractice insurance. (Abdel-Latif, 2016). In addition, the government has a greater role in controlling the insurance market and providing necessary funds. On this occasion, malpractice insurance can be regarded differently in other countries, where private companies and specific cases differ in the costs and minimum prices for malpractice allegations.
Another sphere of malpractice insurance can be the dental experience, which is also important to review. Alsaeed et al. (2022) point out that most dental malpractice experiences happen without proper documentation, making the insurance decision more complicated. It is different from world experience in that dental malpractice in developed countries faces issues other than poor documentation. Hamasaki and Hagihara (2021) point out that most of the reviewed cases of Japanese malpractice litigations were due to the absence of consent received from patients on certain actions. In an international context, dental malpractice insurance faces a high inflation rate due to such errors, as provided in the example of Japan.
References
Abdel-Latif, M. M. (2016). Knowledge of healthcare professionals about medication errors in hospitals. Journal of Basic and Clinical Pharmacy, 7(3), 87. Web.
AlDakhil, L. O. (2016). Obstetric and gynecologic malpractice claims in Saudi Arabia: Incidence and cause. Journal of Forensic and legal medicine, 40, 8-11. Web.
Alkhenizan, A. H., & Shafiq, M. R. (2018). The process of litigation for medical errors in Saudi Arabia and the United Kingdom. Saudi Medical Journal, 39(11), 1075-1081. Web.
Alluhidan, M., Tashkandi, N., Alblowi, F., Omer, T., Alghaith, T., Alghodaier, H., Alazemi, N., Tulenko, K., Herbst, C.H., Hamza, M.M. & Alghamdi, M. G. (2020). Challenges and policy opportunities in nursing in Saudi Arabia. Human Resources for Health, 18(1), 1-10. Web.
Alsaeed, S., Aljarallah, S., Alarjani, A., Alghunaim, G., & Alanizy, A. (2022). Dental malpractice lawsuit cases in Saudi Arabia: A national study. The Saudi Dental Journal, 34(8), 763-771. Web.
Alsafi, E., Baharoon, S., Ahmed, A., Al Jahdali, H.H., Al Zahrani, S. & Al-Sayyari, A. (2015). Physicians’ knowledge and practice towards medical error reporting: a cross-sectional hospital-based study in Saudi Arabia. Eastern Mediterranean Health Journal, 21 (9), 655-664.
Alsulami, Z., Conroy, S., & Choonara, I. (2013). Medication errors in the Middle East countries: A systematic review of the literature. European Journal of clinical pharmacology, 69(4), 995–1008. Web.
Born, P. H., & Karl, J. B. (2016). The effect of tort reform on medical malpractice insurance market trends. Journal of Empirical Legal Studies, 13(4), 718-755. Web.
Cheluvappa, R., & Selvendran, S. (2020). Medical negligence – key cases and application of legislation. Annals of Medicine and Surgery, 57, 205-211. Web.
Hamasaki, T., & Hagihara, A. (2021). Dentists’ legal liability and duty of explanation in dental malpractice litigation in Japan. International Dental Journal, 71(4), 300-308. Web.
Konetzka, R. T., Sharma, H., & Park, J. (2018). Malpractice environment vs direct litigation: What drives nursing home exit?The Journal of Health Care Organization, Provision, and Financing, 55, 1-12. Web.