Mutual Matters

Recent enforcement actions by the US Food and Drug Administration (FDA) and the US Department of Justice (DOJ) highlight ongoing government scrutiny regarding the sources of prescription drugs and medical devices dispensed by healthcare providers. Importantly, this scrutiny is not limited to distributors: federal regulators have pursued criminal and civil actions against physicians and physician practices that receive drugs and devices from unauthorized sources. Accordingly, healthcare providers should take proactive steps to avoid obtaining drugs and devices from unauthorized sources, particularly foreign entities (e.g., online retail pharmacies based in foreign countries). 

A recent Emergency Medical Journal article[1] 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.

Self-Care as a Path to Resilience

Resilient persons typically engage in positive thinking and are willing to face challenges. They seldom get frustrated when problems arise and they usually rebound from adversity. Although some people believe resilience is innate, this trait can be developed using a number of techniques. Self-care is a central component of

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[1] 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.

Series Part Two: Fostering Resilience

Although medicine is a stressful profession, many physicians are able to practice medicine without experiencing burnout. Developing resilience increases the likelihood of avoiding burnout. Resilient individuals typically have a more optimistic outlook, remain calm in a crisis, have a good sense of humor and are less daunted by challenges. An individual could be naturally resilient but persons who are not resilient by nature can develop habits that increase their resilience.

On March 15, 2017, the FDA issued a drug safety warning that Viberzi (eluxadoline), a drug used to treat irritable bowel syndrome with diarrhea (IBS-D), should not be used in patients who do not have a gallbladder. The FDA found that when used in patients without a gallbladder there is an increased risk of developing serious pancreatitis that could result in hospitalization or death.  Patients who are taking Viberzi (eluxadoline) who do not have a gallbladder should stop taking the drug immediately and contact their physician.

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. 

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.