By MINDY NUNEZ DUFFOURC

A New Era of Amazon Healthcare Should Take a Cue From Germany to Provide Support for Medical Malpractice Victims

Amazon, JP Morgan Chase, and Berkshire Hathaway recently announced plans to form a joint non-profit enterprise aimed at providing affordable, high-quality, transparent healthcare to hundreds of thousands of their U.S. employees. Although a healthcare venture departs from their prior expertise, the companies’ combined wealth, resources, and history of market innovation provide hope that this new alliance can reshape the delivery and cost of healthcare in the U.S. As Amazon and company attempt to tackle America’s healthcare problems with a new delivery model, there is also potential for them to support patients who encounter another critical problem in America’s healthcare system – the problem of medical errors.

Johns Hopkins estimates that 250,000 deaths in the United States are caused each year by preventable medical errors. Eliminating medical errors is admittedly difficult. It requires interdisciplinary collaboration, unlikely political alliances, and changing the longstanding “culture of silence” in healthcare. In contrast, supporting patients who are damaged by medical errors, which can have a larger positive effect on the healthcare system, can be easily achieved. And it doesn’t even require innovation. Germany has implemented a model for patient support that can be adopted in the United States.

In Germany, patients who suspect medical errors have a legal right to assistance from their healthcare insurers. This support can include assistance obtaining medical records, the examination and evaluation of documents submitted by patients, helping patients find an attorney or support groups, and providing patients with a free expert medical assessment. In addition, German public healthcare insurers, which insure 90% of the country’s population, are required to fund the Unabhängige Patientenberatung Deutschland (Independent Patient Counseling Germany – UPD). UPD is established pursuant to German federal law and provides patients with free expert medical and legal consultations. At UPD, patients who suspect that they were injured by a treatment error can receive a free online, telephone, or personal consultation from experts to help them understand their legal rights.

UPD also recognizes the power gap that exists between patients and doctors and offers psychosocial counseling to assist patients with fears associated with questioning or confronting their healthcare providers. According to Heike Morris, UPD’s Legal Director, their “main goal is ‘health empowerment,’ which means giving people the information they need to help themselves.”

Following treatment errors, early access to information and patient support are crucial. In addition to respecting a patient’s autonomy and right to information regarding their medical treatment, there is evidence that patients’ desire for information is a main driver in their decision to file a lawsuit after a suspected medical error. According to Morris, “so many patients are not interested in litigation, they just want to talk to their doctors and understand what happened and feel that the doctor takes them seriously.” Similarly, healthcare researchers in the United States report that patients’ desire for information is a main driver in their decisions to file medical malpractice lawsuits. Although some healthcare providers in the U.S. have implemented communication and resolution policies to improve communication with patients after medical errors, there is some inherent distrust in systems set up by healthcare providers, who are responsible for the errors in the first place. While provider-run communication and resolution programs are vital to changing the “culture of silence” in medicine, the immediate response to medical errors in the United States still lacks an independent and accessible source of support for the injured patient.

The type of support for patients that exists in Germany is virtually non-existent in the United States. There are no federal or state laws establishing support services for patients following a treatment error. In addition, health insurance companies in the United States are neither legally obliged nor do they voluntarily provide support to their insureds in the aftermath of a treatment error. Maybe in the new age of Amazon healthcare, patients who find themselves injured by a medical error in the United States will have access to the kind of assistance and support available in Germany. In addition to strengthening patients’ rights and respecting patient autonomy, providing early access to information following medical errors though independent patient support has the potential to decrease medical malpractice filings and the associated costs on the healthcare system, touching upon Amazon’s goals of providing better, more transparent healthcare at a lower cost.

Mindy Nunez Duffourc is a U.S. attorney and Ph.D. candidate and lecturer at the University of Passau in Germany. She also served as a 2016-17 Alexander von Humboldt German Chancellor Fellow, during which time she conducted a comparative study of medical negligence in the U.S. and Germany. Publication of her research is forthcoming in the Winter edition of the American Journal of Law and Medicine