A recent Emergency Medical Journal article examined the relationship between empathy and litigation. The authors enrolled two groups of patients into a randomized, double-blind controlled trial. The subjects watched simulated discharge discussions between physicians and standardized patients; half of the videos differed only by the inclusion of two brief empathy statements. These verbalizations included: 1) a reflection on the patients' concerns about their symptoms, and 2) a reflection on their health awareness.
On May 12, 2016, the FDA released an announcement advising that the serious side effects associated with fluoroquinolone antibacterial drugs generally outweigh the benefits for patients with acute sinusitis, acute bronchitis, and uncomplicated urinary tract infections who have other treatment options. For patients with these conditions, fluoroquinolones should be reserved for those who do not have alternative treatment options.
NEJM Study shows 1% of physicians accounted for one-third of all paid claims
A study in the January 2016 New England Journal of Medicine analyzed paid medical liability claims, (an indemnity payment made to an injured party), and the physician’s name was reported to the National Practitioner Data Bank (NPDB) to determine if the characteristics of claim-prone physicians could be identified.
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.
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.
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.
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.
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.
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.
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.