FOR IMMEDIATE RELEASE:
October 26, 2000
Court Decisions Good for Illinois Patients
October 26, 2000
In Neade v. Portes, M.D., the Supreme Court reversed an earlier appellate court decision and held that a patient cannot bring both a malpractice action along with a claim that the doctor had breached his or her fiduciary duty by failing to disclose to the patient the ways he or she is paid by a managed care company. The Supreme Court said that all claims really come from the same facts and the patient is alleging malpractice. Therefore a single complaint rather than two separate complaints is more appropriate.
"This case demonstrates the importance of the relationship between doctor and patient. Patients must understand the way their managed care company operates. The managed care company is responsible for identifying the provisions of the plan and it remains the plan's responsibility to make patients familiar with those provisions," said Dr. LeRoy Sprang, president of the Illinois State Medical Society (ISMS).
ISMS developed the Managed Care Reform and Patient Rights Act (in 1999) with language that obligates managed care plans to disclose to subscribers the relationship between the plan and the doctors.
In Garibaldi v. Applebaum, the court used the ISMS developed (1995) economic credentialing law (section 104) in their decision. The law requires hospitals to provide the opportunity for an independent hearing if hospital medical staff membership or privileges are reduced or taken away for economic reasons. In this case, the doctor was given a hearing in accordance with this law.
"When hospitals remove doctors for reasons that have nothing to do with their clinical ability, everyone loses. This decision will help foster a climate where patients can choose among qualified physicians to meet their medical needs," said Sprang. The Illinois Supreme Court, like the lower appellate court, confirmed that the ISMS-backed economic credentialing measure is an important protection for physicians, whose provisions -- including a fair hearing for the affected physician -- must be adhered to by hospitals throughout the state.
The Illinois State Medical Society is a professional organization that represents and unifies its physician members as they practice the science and art of medicine. The Society represents the interests of member physicians, advocates for patients and promotes the doctor/patient relationship, the ethical practice of medicine, and the betterment of the public.
Dr. Sprang is an ob-gyn practicing in Evanston.
ISMS permits and encourages reproduction of ISMS news releases with the request that ISMS is credited as the source of the information.