Mutual Matters

Developing Resilience and Avoiding Physician Burnout

Posted by Marshaleen King, MD on Mar 21, 2017 12:00:00 PM

Introduction

Physicians seldom receive training on time management and/or self-care at any point in their career. As a result, many physicians have difficulty creating balance in their lives or incorporating self-care into their schedules. Persons who do not care for themselves are less effective at providing optimal care for others. Approximately 50% of physicians report burnout and the suicide rate among physicians is significantly higher than observed for the general population. In addition, burnout exposes physicians to the risk of medical errors and litigation. In recent decades, the role of physician fatigue in causing medical errors has led to the implementation of duty hours for physicians in training. There is now growing attention to the need for patient safety strategies to prevent and treat fatigue/burnout among practicing physicians. 

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Topics: Patient Safety

The Opioid Epidemic: It’s Still a Problem

Posted by Bill Kanich, MD on Mar 16, 2017 4:34:42 PM

An Overview of Guidelines and Resources Available

Drug overdoses are the No. 1 cause of accidental deaths in the U.S., surpassing deaths by motor vehicle accidents. Many drug overdose deaths involve prescription medications, predominantly opioids. Even greater by orders of magnitude are those patients and their families affected by opioid dependence and addiction.

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Topics: Patient Safety

Accessing and Amending Medical Records

Posted by Bill Kanich, MD on Mar 9, 2017 3:27:31 PM

 Case Study #1

During an exam, Mr. Smith admits to his doctor that he used alcohol heavily in the past. The doctor notes this in the patient’s progress note. Subsequently, Mr. Smith applies for life insurance and learns that he is denied on the basis of the doctor’s note. Mr. Smith is upset and contacts his doctor to request an amendment of his medical record.

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Topics: Healthcare Industry, Practice Management

Communication in Healthcare: When We Don’t Talk Our Patients Suffer

Posted by Marshaleen King, MD on Mar 2, 2017 2:15:00 PM

Case 1

A 72 year-old man was taken to the emergency room (ER) by his wife after falling due to sudden onset of right sided weakness. His ER evaluation included a head CT, reported to be negative for a stroke. He was assessed as having a TIA and hospitalized for observation. Serial neurological exams were performed and two hours after admission he was noted to have worsening right sided weakness and slurring of his speech.

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Topics: Patient Safety

Top Ten Hard to Diagnose Diseases

Posted by Bill Kanich, MD on Feb 23, 2017 12:15:00 PM

Failure to diagnose and delay in diagnosis are some of the most common allegations of medical liability claims that we see at MagMutual. There are several known disease processes that are notoriously difficult to diagnose either because they mimic other, milder disease processes or their presentation leads the practitioner away from the correct diagnosis. Frequently this delay or misdiagnosis can lead to devastating consequences.

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Topics: Patient Safety

Claims Lesson: Closing the Loop, Communication and Tracking Errors

Posted by Bill Kanich, MD on Feb 16, 2017 12:30:00 PM

Claims Lesson

A 29-year-old male was seen at Best Health Clinic, a family medicine clinic, for the first time by Dr. Smith in April 2009. The patient’s main problem was bronchitis, which was evaluated and treated appropriately. The patient also mentioned a new mole on his right arm and he was set up for a biopsy in May 2009. The biopsy was performed and sent to Bestpath. The biopsy report was never seen in the clinic. It was either not forwarded or received and not attached to the chart.

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Topics: Patient Safety

Claims Lesson: Perioperative Medication Errors

Posted by Bill Kanich, MD on Feb 9, 2017 2:00:00 PM

Case Study

Jane Smith was admitted for an elective laparoscopic cholecystectomy at an outpatient facility. She received midazolam in preoperative holding, and was brought to the operating room and received propofol and a general inhalational anesthetic. She also received a muscle relaxant and fentanyl. The case appeared to proceed without incident, but in the recovery room, the patient recounted that she felt pain, had difficulty breathing, and was able to recall specific conversations during the procedure. Upon review, it appeared that the syringes for the medications were mislabeled, leading to the medication error and intraoperative recall. A lawsuit was subsequently filed for PTSD and emotional distress.

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Topics: Patient Safety

Lessons Learned on Neurological Injuries

Posted by Bill Kanich, MD on Feb 2, 2017 1:05:00 PM

Because of the rise in the number of claims involving neurologic injury, we formed a task force looking at these claims. We examined 22 cases that were closed during the years of 2006 to 2013 to develop some claims lessons. The average total incurred costs per claim were 3.33 times higher than the average amount of all other claims over the same time period.

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Topics: Patient Safety

The Non-Adherent Patient

Posted by Bill Kanich, MD on Jan 26, 2017 1:00:00 PM

How to Approach Situations When Patients Don’t Follow Your Advice

Most physicians are familiar with patients who don’t always follow the advice given to them. For example, up to 30 percent of prescriptions are never filled, and another 30 percent are taken in an inconsistent matter. Providers often order tests or make recommendations and then may not be aware of whether or not the patient is following through. 

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Topics: Hospital Management, Patient Safety, Practice Management

Case Studies: Pain Management with Opioids

Posted by Bill Kanich, MD on Jan 19, 2017 1:00:00 PM

Case Study #1

A 34-year-old male presented to a family medicine physician for chronic low back pain. The physician is comfortable prescribing opioids and has many patients on scheduled drugs. The patient has had chronic pain for many years and undergone multiple treatments including physical therapy, steroid injections and many medications. On presentation, the patient was on Robaxin and oxycodone (four times a day). His past history is positive for hypertension and alcohol abuse, although he stated he hasn’t drank in the past year. He works as a laborer.

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Topics: Patient Safety