Malpractice and medical liability

1,592 articles · Since 2004

Articles, page 22

Progressive health reformers need doctors to change the health system

October 1, 2011Oct 1, 20117

Doctors order too many tests. That's not a surprise for regular readers of this site, but even the physicians themselves think so. A recent survey reported that, "42% of the 627 respondents believed the patients in their own practice were…

Doctors order too many tests.

That’s not a surprise for regular readers of this site, but even the physicians themselves think so.

A recent survey reported that, “42% of the 627 respondents believed the patients in their own practice were getting too much care. Just 6% of doctors believed their patients were getting too little care … And 28% of the …

Patient voices

Patients generally seek attorneys out of anger rather than greed

Jessica Scott, MD, JD

September 28, 2011Sep 28, 20118

Patients often pursue litigation simply to obtain information that has not been forthcoming. Research shows that the three things patients want most in the face of medical error are: information about what happened; a sincere apology; and measures to prevent the error from happening to someone else. Financial compensation is lower on the list. Patients generally seek attorneys out of anger rather than greed. When unanticipated adverse outcomes occur, error …

Health technology

Legal weaknesses of an electronic medical record

Mike Koriwchak, MD

September 23, 2011Sep 23, 20118

Over the past several months I have read several online discussions and comment threads on the medical-legal issues raised by EMR, including an HIMSS brochure on the subject. Most of these discussions miss what I consider to be the most important legal weaknesses of an electronic medical record. I finally came across an online discussion that comes closer to covering what I consider to be the most …

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Physician voices

Patients lose if physicians are expected to practice perfect medicine

WhiteCoat, MD

September 9, 2011Sep 9, 201111

I discussed whether or not ambulances should be required to add equipment costing $12,000 in order to be able to transport 850 pound patients recently, so I won’t belabor the point here. Providing medical care to morbidly obese patients presents…

Then I read an article in the Florida Sun Sentinel about how some obstetrician-gynecologists in South Florida are refusing to provide medical care to obese women. …

Physician voices

How a doctor reviews cases for both plaintiff and defense attorneys

Charles A. Pilcher, MD

September 7, 2011Sep 7, 201122

Early in my career, a local defense attorney working with my hospital would occasionally ask me to review a case in which another physician client of her firm was the defendant. As Medical Director of Evergreen Hospital Emergency Department, I was comfortable with hospital records, knowing where to look in a record for information – both recorded and not recorded – that either helps or hurts a case. I found …

Physician voices

How managed care is bad news for pregnant women

Linda Burke, MD

August 31, 2011Aug 31, 201111

I read an article in my local newspaper the other day that gave me reason to pause. The State of Florida intends to hand over 3 million Medicaid patients to managed care companies who will reduce payments to physicians and hospitals. In exchange for accepting these low payments for professional services, doctors are guaranteed through pending legislation that no matter what egregious errors they make, the patient will only receive …

Patient voices

Should patients be allowed to record their office visit?

David Troxel, MD

August 31, 2011Aug 31, 201112

Whether your office has wireless access or not, there will be patients texting, surfing the Internet, Facebooking, and otherwise engaging with the outside world on their smartphones while in your office. These smartphones have another function: the ability to record…

These smartphones have another function: the ability to record audio or video. It is understandably tempting for patients to record consent discussions, medication and follow-up instructions, and other physician or staff interactions.

Recording a medical discussion via video or audio is …

Physician voices

Malpractice risks with special needs patients

Jock Hoffman

August 26, 2011Aug 26, 20113

Can you properly examine and treat a 400lb patient in your office setting? How about a four-year-old in your ED? A deaf woman in Labor and Delivery? An 82-year-old in the endoscopy clinic? Do patients who present with challenges beyond…

Once-accepted practices, e.g., jerry-rigging adult medical equipment for a toddler, guesstimating the weight of a patient who exceeds …

Patient voices

Talk to your patients before sending them home from the ED

Charles A. Pilcher, MD

August 26, 2011Aug 26, 2011

So you’re not having a heart attack like your wife thought. That’s the good news. But what is wrong, what did cause that pain, and what should you do from here on out? That’s the purpose of discharge instructions, and…

So you’re not having a heart attack like your wife thought. That’s the good news. But what is wrong, what did cause that pain, and what should you do from here on out?

That’s the purpose of discharge instructions, and it’s not enough for the ED staff to just print out some forms, say “sign here,” and send you on your way.

What constitutes good discharge instructions, and why are they critical …

Health policy

The emotional costs of malpractice mean more to doctors than money

Kevin Pho, MD

August 19, 2011Aug 19, 20117

Every year, according to a recent study from the New England Journal of Medicine, a typical physician has about a 7% chance of being sued for medical malpractice. Surgeons almost certainly will face a malpractice claim sometime during their career.…

Every year, according to a recent study from the New England Journal of Medicine, a typical physician has about a 7% chance of being sued for medical malpractice.

Surgeons almost certainly will face a malpractice claim sometime during their career. Neurosurgeons, for instance, have a 19.1% chance of being sued in a given year, while that number is 18.9% for …

Physician voices

How early closure can cause doctors to misdiagnose

Alex Lickerman, MD

August 12, 2011Aug 12, 20113

I had a patient once—a fellow physician—who came to see me complaining of mid-back pain. When I examined him, I found I could reproduce his pain by pressing firmly on the spot he said was hurting him. He said pressing there also made the pain radiate around to his stomach, a phenomenon known as “referred pain” that meant his pain was almost certainly caused by a trigger point. I …

Patient voices

What the death penalty has to do with medical errors

angienadia, MD

August 10, 2011Aug 10, 20115

A fascinating, beautifully-written article on a death penalty granted to a most likely innocent man, with interesting details on fire dynamics and the history of the judicial system pertaining to the death penalty. Reading about the system in place that…

Reading about the system in place that should prevent an innocent man from being wrongfully executed reminds me of the supposed system that prevents medical errors from occurring – both are imperfect, with innocent victims falling through …

Physician voices

Why you would want a younger doctor in the hospital

Maxwell S. Kennerly

August 10, 2011Aug 10, 20113

Recently, the American Journal of Medicine published a study with the unexpected conclusion that hospitalized patients were more likely to die or stay long in the care of an experienced physician than in the care of a recent graduate from…

Recently, the American Journal of Medicine published a study with the unexpected conclusion that hospitalized patients were more likely to die or stay long in the care of an experienced physician than in the care of a recent graduate from residency: “When doctors weren’t very busy, they kept patients in the hospital for roughly the same average time no matter how many years of experience they had. But when they did have a …

Physician voices

Why physicians are clueless about malpractice implications of DVTs

Angry Orthopod, MD

July 29, 2011Jul 29, 2011

A medical malpractice attorney and an orthopaedic surgeon are on a golf trip. This sounds like the worst joke of all time, but it’s actually the story of my brother and I 20 years ago. Amidst the rough, he laid…

A medical malpractice attorney and an orthopaedic surgeon are on a golf trip. This sounds like the worst joke of all time, but it’s actually the story of my brother and I 20 years ago.

Amidst the rough, he laid some serious philosophy on me. In most families, that might be about life and love and whatnot. Not in our family. We were engaged about deep venous thrombosis (DVT) and …

Physician voices

People accuse doctors of not doing enough, or doing too much

Doctor Grumpy, MD

July 28, 2011Jul 28, 20112

Medicine is never an easy field. People accuse doctors of not doing enough, or doing too much. There are no easy answers. We're caught between doing what's best, without putting the patient through too much, and doing what's needed to…

Medicine is never an easy field. People accuse doctors of not doing enough, or doing too much.

There are no easy answers. We’re caught between doing what’s best, without putting the patient through too much, and doing what’s needed to protect ourselves from legal action.

Let’s take Mrs. Summer. She’s a nice 78 year-old lady I saw in the office last week.

Earlier this month she hurt her back. So she saw …

Physician voices

What is defensive medicine in obstetrics?

Amy Tuteur, MD

July 26, 2011Jul 26, 20113

Consider the explosion in the rate of C-sections and inductions. They satisfy the requirements of assurance behavior. Reducing adverse outcomes? Check. Deterring medical malpractice claims? Check. Pre-empting liability? Check. Consider the precipitous decline in the rate of VBAC. That's avoidance…

Consider the explosion in the rate of C-sections and inductions. They satisfy the requirements of assurance behavior.

Reducing adverse outcomes? Check.
Deterring medical malpractice claims? Check.
Pre-empting liability? Check.

Consider the precipitous decline in the rate of VBAC. That’s avoidance behavior: malpractice insurers have forced providers and hospitals to refuse to participate in VBACs.

There’s an important subtext that undergirds defensive medicine that often goes unrecognized and therefore unanalyzed. Defensive medicine is driven …

Health policy

Medical malpractice doesn’t address patient safety

David Williams

July 24, 2011Jul 24, 20112

Medical malpractice reform is one of the few health care policy issues where there is a real possibility of agreement between the White House and Congress. A common refrain is that the fear of lawsuits leads physicians to practice defensive medicine, ordering too many tests just to cover their behinds in case of a lawsuit. It drives up costs without creating benefits. There’s some truth to this argument, …

Physician voices

Do non-compliant patients really sue their doctors?

Jock Hoffman

July 14, 2011Jul 14, 201137

The non-compliant patient who sues his physician for an adverse clinical outcome is a storied malpractice bogeyman. After failing to follow a screening regimen, show for appointments, undergo recommended tests, make health-related lifestyle changes, or take their medications, these patients…

Are they real?

Yes and no. Not every “difficult” patient is a potential …

Physician voices

Pro-actively improve quality, rather than reacting to liability concerns

Charles A. Pilcher, MD

June 16, 2011Jun 16, 20112

Over the past year I have been involved in many discussions with doctors, healthcare executives, elected officials, plaintiff and defense attorneys and others about healthcare reform. Bottom line: There is no consensus what the future holds. There is no question…

There is no question that reform is necessary to avoid absolutely bankrupting the country. However, the recent legislation is a work in progress, not yet an achievement. A change in congressional leadership could derail, …

Physician voices

The Golden Moment in medical malpractice

Kathleen Clark, PhD

June 12, 2011Jun 12, 201113

As Kevin Pho pointed out in his piece, "How malpractice hurts doctors and their future patients," physicians who have been through trial are often never quite the same. Physicians who have been sued in medical malpractice case are often referred…

As Kevin Pho pointed out in his piece, “How malpractice hurts doctors and their future patients,” physicians who have been through trial are often never quite the same.

Physicians who have been sued in medical malpractice case are often referred to as the “Second Victim,” a term that says it all. When a mistake is made and a patient is injured, the physician also suffers, often in silence and …

Malpractice and medical liability

Articles, page 22

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