- Conamed proposed to adopt a new Mexican Model of Medical Arbitration.
- This Commission is in charge of promoting and fostering a good relationship, dignified treatment, values, adherence to the medical lex artis and ethics in the doctor-patient relationship.
- It also promotes medical research and for this purpose every year it receives interns who are in the last year of their studies.
The National Medical Arbitration Commission (Conamed) was created on June 3, 1996 as a decentralized body of the Ministry of Health (SSa). One of its objectives is to help protect the right to health protection, as well as to improve the quality of the provision of medical services.
Although it is not its only function because it is also in charge of other tasks. Within the list, it stands out that it promotes and fosters a good relationship, dignified treatment, values, adherence to the medical lex artis and ethics in the doctor-patient relationship.
Upcoming changes that could occur
A few days after turning 27, the conamed you could experience one of your biggest internal changes. All part of the adoption of a new Mexican Model of Medical Arbitration. This initiative and need was raised by the Technical Secretariat of the Mexican Council of Medical Arbitration (CMAM).
The representatives of the conamed The following changes were presented as fundamental premises for the adoption of a standardized model of medical arbitration:
The constitutional reform of June 18, 2008, established in its article 17, that “the laws will provide alternative dispute resolution mechanisms” recognizing the alternative tools to the jurisdictional ones to bring the population closer to options that allow agility, cost mitigation and technical focus on resolving issues, of a medical nature among others, under a friendly context such as mediation, conciliation and arbitration.
The medical arbitration organizations in the country (autonomous, decentralized or decentralized) should consider redefining their structures, compacting their administrative areas and increasing their fundamental areas of guidance, management, conciliation and arbitration.
As envisioned by the present administration, in the Health Sector Program 2020-2024specifically in its priority strategy “2.3 Strengthen a comprehensive care and social assistance model to optimize the efficiency and effectiveness of the processes and expand the coverage of health and social assistance services”, specific action (2.3.8) “Promote the use of alternative mechanisms, such as conciliation and arbitration, for the attention of controversies and conflict resolution in health”, from which the line of work of the administration in the health sector is established, and recognizes the legitimacy , effectiveness and benevolence of medical arbitration as a national model.
The relevance of operating a unique and approved arbitration process, as a product of the consensus emanating from the Mexican Council of Medical Arbitrationwill make it possible to have standardized management and care procedures, seeking not only to channel and resolve the complaints generated but also the exchange of experiences, information and the integration of national statistics to support decision-making in matters of public health policy.
Having a unique model of attention to complaints with common procedural rules, which give certainty to users and providers of medical services, under approved rules, will allow a positive impact on the quality of health services and patient safety.
Legally speaking, the National and State Medical Arbitration Commissions are not only procedural instances, but are, and should be, institutions specialized in dealing with nonconformities derived from medical care, of an executive nature, whose essential purpose is to formulate pronouncements, technical opinions and general recommendations to improve health services.
It is important to highlight that the Medical Arbitration Commissions have a sui generis legal nature, that is to say, that it is not possessed by any other technical-medical institution, since they are arbitrators within administrative law who resolve in accordance with the applicable civil legislation and also act as friendly fixers, in addition to technical skills, trust, high ethical and scientific profile, which allows them to develop institutional expert management activities before administrative and jurisdictional authorities.
Conamed developed the Medical Complaints and Opinions Service System (SAQMED) with the objective of facilitating the management and attention to users, obtaining at the same time substantive information on the matters received, attended and concluded, based on the data registered by the Guidance and Management, Conciliation and Arbitration areas. Its composition considers statistical variables that allow timely decision-making, institutional performance monitoring, strategy development, and accountability, so its adoption and coordinated operation by all State Commissions is desirable.
The legal structure proposed for the State Commissions, proposes the following approved scheme, derived from the disparity in the administrative nature, catalog of services and attributions, considering at least the standardization of the following factors:
- labor regime
- Heritage
- Object
- attributions
- Services
- Orientation and specialized advice.
- Management of Medical Care and immediate provision of services.
- Arbitration process: Conciliation and Arbitration.
- Issuance of institutional medical opinions.
- Recommendations and suggestions to the relevant instances.
- Issuance and opinion of legislative proposals related to the functions and powers of the Commissions.
The #CONAMED begins the review, update and improvement of the Mexican Model of #Medical Arbitration
A few days after the 27th anniversary of its creation, CONAMED proposes to improve the Mexican Model of Medical Arbitration, following the CMAM agreements. 👉 https://t.co/z0pS4mGsgm pic.twitter.com/3MBdmaTz2U
— National Commission for Medical Arbitration (@CONAMED_SALUD) May 26, 2023
In the Orientation and Management process, the proposals that citizens formulate in person, by telephone or by electronic means are addressed, from general information on the services provided by the institution, as well as the requirements to present a complaint or carry out procedures through for immediate management.
In order to promote the rapprochement of the parties to resolve the complaint, Conamed holds the conciliatory hearing, in which it proposes to those involved, after specialized analysis, that they present settlement alternatives, which, if accepted by the parties, originate the signing of an agreement in which the resolution agreements themselves are expressed, which must not be contrary to law.
Arbitration allows not only to characterize the medical care received, but also to identify the presence or absence of malpractice in less time than the jurisdictional route. Arbitration is the most viable option to resolve the conflict when the parties have not been able to reach an agreement through conciliation, since being a more flexible process and under the modality of an expert judgment, they guarantee a pronouncement objective and impartial, provided that:
- It allows the parties to set the procedure and avoid unnecessary paperwork.
- Indicates the applicable legislation.
- Appoints the competent judge for the execution of the award.
- Allows reconciliation at any time.
- Gives greater procedural speed.
- The procedure is confidential.
- Integrates the participation of specialists.
- It shortens instances, by waiving the appeal.
- It facilitates a better appreciation of what happened in the medical event.
- A special protocol is used for the knowledge and resolution of the case.
The Expert Management Model that operates at Conamed consists of participation with administrative and jurisdictional authorities, under a scheme in which institutional medical opinions are issued, in exercise of their technical autonomy; with the purpose of supporting the petitioning authority, regarding its interdisciplinary medical interpretation of the facts and evidence submitted to studies, which justifies its inclusion in the framework of powers of each Commission.
The recommendations are proposals addressed to the medical union and society in general, based on the analysis of the medical act of all complaint cases and the review of international literature, aimed at identifying deficiencies or faults committed in the provision of services. of health, in order to prevent and/or avoid its repetition.
In addition to the above, adopting a standardized model will allow:
- Homogeneous attention to users and service providers.
- Quality assurance and continuous improvement of medical care.
- Prevent acts of malpractice and reduce risks.
- Reduce disputes and complaints.
- Implement preventive and corrective actions and programs.
- Support and disseminate arbitration for dispute resolution.
- Feedback to the National Health System.
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