Message written in June 2015 on Indemnity Crisis

The College has been handling stress related to professional indemnity for 7 months now. It may not be useful to repeat details of the old and new schemes here.  Suffice it to say that the new scheme does not explain coverage after retirement enough to alleviate anxiety of obstetricians.  We also identified inconsistency in facts which unfolded in front of our eyes. Efforts of diplomacy and dialogue to the existing provider were poured in at all levels. Those who had sweated all felt like banging their head against stone wall.  I myself flew to London in February. Throughout the time of the meeting, I emphasized that I went there to find a way of mutual benefit, to create value. Again, every answer I encountered to any suggestion, logical or naive, was too simple: NO.

Doctors were of course disappointed.  They felt like trapped suddenly, without any time to think. Some doctors felt obliged to make their major decision of stopping to deliver babies over a matter of days. Patients were distressed. Was this emotion: in a sense yes, but more panic than angry.

Obstetricians asked for help, and as collective body of professional College, we begged for help from other stakeholders. Everyone in Hong Kong answered with sympathy, except for some rare medical leaders who insisted that the present arrangement from the indemnity provider was good enough.

We did not spring to society to seek sympathy. We knew simply that we could not and should not. The society looks at doctors as strong protectors. They have a choice between public and private doctors. There is no point for private doctors to yell panic. We are expected to help ourselves first. Occasional reporting about bad doctoring gives bad impression that private obstetricians may sometimes function harmful. We have to do internal tightening first, if we want the slightest favor from society. The first response of College to peer groups was that we would look into internal control and risk management so as to reduce chance of compensation. I truly believe that it is root of the problem. The present provider of indemnity might not have functioned to what we like, but the root of the problem is escalation in compensatory costs. We won local respect. I offered to the provider possibilities to control the claims hand in hand. Unluckily the approach was not trusted to be useful by an organization based overseas.

All over the world there are more than one indemnity providers to hospital doctors, interestingly, with the exception of Hong Kong, after another party pulled out from the city.  So another arm of the response called for itself: introduction of competition.  Many obstetricians agreed and the College followed this consensus. We worked very hard on it in 2015. Did we judge the existing indemnity provider with our ethics in the way to seek alternative? Answers from individuals could be yes, maybe, no.  But the College action was mere logical response after research, without any element of ethics, emotion or even feelings.

Do doctors want to ‘remove’ an existing indemnity provider? Everyone has the answer in his heart, but final results depend on the interplay between providers.  Would doctors change to an alternative scheme: time will tell.

Has the College leadership put emotions into the handling? I would digress and simply tell a teaching. Prof Allan Chang, a mentor to many leaders now, taught me that emotions may be used but cannot be allowed to assume control.  I let loose my emotions deliberately in many occasions. Emotions and feelings make the difference between humans and other beings. I have myself repeated one statement: Ares may have emotions but his office is not entitled to have feelings. At times, things hurt Ares, but his office functions like Mr Spock in Star Trek.

It is always right to introduce competition, which is itself a good medicine to existing players. We hope that the medicine works for HK, the doctors, the future competitor(s), and also the collaborating indemnity provider in good relationship with HK already for a century.

We have functioned very humbly.  Even for myself, I think the number of times when ‘thank you’ comes from bottom of my heart in the past half year, exceeds that over the past decade. God may be teaching our doctors, me particularly, to be meek.

Doctors, obstetricians in particular, private obstetrics does not die anywhere in the world. Even in America it is reviving. Things go in cycles. Very soon we shall prove to the world that humble HK obstetricians may also provide out of box solutions to apparently impossible situations. The audience may keep eyes wide open.