The jury is out on IHC arbitration

Proponents of binding arbitration between patients and physicians say the agreements ultimately benefit the patients. The agreements help stabilize the cost of physicians medical malpractice insurance, which would ensure that patients have access to physicians in high-risk specialties such as obstetrics and neurosurgery.

Sounds reasonable.

But before patients sign the dotted line on binding arbitration agreements with their family physician — as 400 members of the Intermountain Health Care Physician Group are asking their patients to do in a six-year experiment — they owe it to themselves to read the fine print. Patients who sign these agreements give up their right to sue IHC for medical malpractice. The agreements not only cover the primary care physician but any IHC specialist or facility to which the patients may be referred in the future.

If there is a dispute, it must be settled through binding arbitration, which means the outcome of the proceeding is final. A court could only review whether arbitrators followed proper procedures in the closed-door arbitration hearings.

Physicians are quick to note that many professionals use binding arbitration and the medical profession should have it at their disposal, as well. As a matter of basic fairness, they probably are right. The "binding" aspect of the agreements is troublesome, however.

Physicians differ from other professionals because medical errors can adversely effect a patient's quality of life and even cause his or her death. Aren't the victims of these errors entitled to their day in court? What if an arbitrated settlement is inadequate to cover a severely injured or sick patient's care for the rest of their lives? With binding arbitration, there is no further review of the outcome and, therefore, no public accountability.

Legal issues aside, requiring patients to sign mandatory binding arbitration agreements before they receive non-emergency care is a horrible public relations move on behalf of IHC. Sure, patients can sign the agreement, receive care, and rescind it within 30 days. But they can't go back to that physician, no matter how long they have been a patient. Considering that most people's health-care choices are limited by their insurance plans, the majority of contract with IHC institutions and care providers, there aren't a lot of options.

If one accepts the rationale for binding arbitration, why couldn't IHC have limited this requirement to new patients only? Existing patients, presumably, entered their doctor-patient relationship with a vastly different understanding as to what their legal rights would be if something went horribly wrong.