Ärztepfusch: Den medizinischen Dienst der Krankenkassen nutzen

Immer mal wieder kommt es vor, dass Ärztepfusch die Patienten belastet. Unnötige Wurzelbehandlungen oder zu schnelles Auswechseln des Kniegelenks sind Beispiele für Ärztepfusch. Wer als Krankenkassenmitglied den Verdacht hat, dass bei ihm Ärztepfusch wirksam wurde, der kann sich an den medizinischen Dienst der Krankenkassen wenden.

Ärztepfusch: Den medizinischen Dienst der Krankenkassen nutzen
Ärztepfusch: Den medizinischen Dienst der Krankenkassen nutzen

Alljährlich legt der medizinische Dienst der Krankenkassen einen Bericht über seine Gutachtertätigkeit vor. Zwar ist die Zahl der Gutachten nicht hoch, doch in einem Drittel der Fälle wurde der medizinische Dienst der Krankenkassen fündig und konnte in einem Gutachten ärztliche Fehler dokumentieren.

Oft kommen Patienten nach Operationen zum medizinischen Dienst der Krankenkasse, weil sie schreckliches erlebt haben und nun den Grund für den Fehler personalisieren wollen. Die einfache Frage an den Gutachter ist: „Hat es einen Behandlungsfehler gegeben und gibt es hierfür eine persönliche Verantwortung?“

Der medizinische Dienst der Krankenkassen klärt diese Frage anhand objektiver Kriterien. Patienten können die Unabhängigkeit des Dienstes von den Ärzten und den anderen medizinischen Leistungserbringern nutzen, um sie sich eine ergänzende Meinung zu einer fehlgeschlagenen Therapie zu holen. Bestätigt das Gutachten den medizinischen Fehler, dann sind die Aussichten besser, in einem Schadensersatzprozess Erfolg zu haben. Dieser Erfolg im juristischen Verfahren kann aber nicht garantiert werden, denn solche Verfahren sind langwierig und die Kriterien, die Juristen an Ärztepfusch anlegen, können zu anderen Ergebnissen führen.

Deshalb hält der medizinische Dienst es für richtig, dass die Patientenrechte nach Ärztefehlern verbessert werden. Das Patientenrechtegesetz könne in diesem Sinne noch deutlich verbessert werden. Insbesondere die Beweislastverteilung wirkt sich oft zuungunsten der Patienten aus. Grundsätzlich muss jeder Betroffene nachweisen, dass er durch ein bestimmtes, persönlich zuzuordnendes Verhalten, geschädigt wurde. Eine Beweislastumkehr müsste dann überlegt werden, wenn eine Standardvorgehensweise zu einem völlig unzumutbaren Ergebnis geführt hat.

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