Future Healthcare

Stop your defence fees rocketing

Various factors help decide what private doctors pay for their indemnity subscription fee. Dr Gabrielle Pendlebury highlights ten of the biggest issues.

Many different components make up a member’s subscription rate to a medical defence organisation (MDO) and each of these are assessed annually. 

A change in any of those pricing factors can have a positive or negative impact on what doctors pay. 

Most of the subscription is based upon the risks for the area of practice, including the number and size of claims for the types of work a health professional does and the estimated costs of any future assistance.  

MDOs also look at the general costs of providing member benefits, such as medico-legal advice and support, and they estimate how much those costs could rise in future years. 

This is to ensure they have enough money in the mutual fund to meet the likely needs of the members now and in the future. 

1 ‘If it’s not written down, it did not happen’

Medical notes should not be treated as an infallible guide to the treatment provided. But record-keeping failures, such as minimal or inadequate entries, mean that a person reading the notes cannot work out what has happened at a previous consultation. 

This can lead to the presumption that a certain event, such as taking blood pressure, did not happen, even if it did.

Good record-keeping can often stop claims at the outset and easily resolve complaints. Or, when things have veered off course, give a clear indication where things went wrong, allowing for targeted remediation to improve practice. 

But recent case law shows that insufficiently detailed notes are not an adequate defence. For example, it is preferable to note which specific features were absent rather than recording ‘no red flags’. 

2 Avoid complaints by matching your expectations

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