RESUMO
During the past few years there has been an enormous increase of inquiries for medical certificates concerning suspected mistakes in medical treatment (medical malpractice). The profound changes of the social circumstances and the social law (e.g. section 66 SGB V) are responsible for this situation. The legal involvement of the "Gesetzliche Krankenversicherung" (GKV) and the "Medizinischer Dienst der Krankenversicherung" (MDK) into social legislation concerning the expert opinion are mentioned. The general development of the judgement of medical malpractice and its legal background, which bases on the contract between doctor and patient, is shown. As a practical example serves the description of the procedure of judging medical malpractice in the MDK. First statistical results, which have been developed since summer 1997 in Hamburg are presented. Some interesting tendencies are obvious: orthopedics and surgery are involved with more than 50%. "Characteristic mistakes in therapy" are the most important question for the expert opinion. Creating a medical certificate concerning medical malpractice takes about 6-12 weeks. This tendency is decreasing because of fast learning procedures, caused by the increasing demand of expert opinions. The medical judgement of medical malpractice will become one of the main tasks of the medical service in health insurance. The "MDK's" have to adapt to this change in tasks in medical, legal and organisation-technical respect, if they want to offer competent and up to date judgement in future times.
