The one thing doctors want to avoid like the plague is a lawsuit — a medical malpractice lawsuit. To be sued means the doctor loses precious time from work, endures emotional personal and family distress and is unable to fully invest oneself in providing the very best medical care possible. It is a dark cloud that hovers over the majority of physicians at least once in their lives. Some medical specialties, in fact, see a higher clip of lawsuits than others (i.e., OB/GYN, orthopedics, radiology, oncology, and anesthesiology to name a few). Here, I will discuss ten ways you, as the patient’s doctor, can get sued and my suggestions on how to avoid most of them. I am framing this discussion this way because I believe it is important to view this from the physician’s perspective. 1. A patient claims that you could have reached the diagnosis much sooner. As such, the patient would have suffered from less physical and emotional distress, and most of all, there would be a better prognosis and health outcome. This is always the hardest lawsuit for a physician to be hit with because no matter how careful a doctor is in documentation and discussions with the patient, a lawsuit can still happen. 2. Failure to communicate with the patient and the family. Any updates to a patient’s condition should be told to the patient and any present family members. And document these discussions. If you didn’t document, it didn’t happen. 3. Repeat visits for the same ole’ complaint. If Mr. Smith keeps coming in for headaches, and you continue to write it off as being due to stress from work, this is a lack of due diligence on your part. Tell the patient to seek a second opinion if you really cannot figure out the answer. Or, refer the patient to a medical provider that specializes in the field of interest (e.g., referring Mr. Smith to a neurologist). 4. You leak out PHI, protected health information, which includes a patient’s name, demographics, and medical history. For instance, Dr. X shares PHI with another doctor via e-mail or absentmindedly chats with someone in a crowded elevator. PHI is so important because protecting PHI means you are protecting the patient’s right to privacy (as it relates to HIPAA). No one should be aware that your patient is in the hospital except yourself, your team, auxiliary staff that interacts with the patient, and the patient’s family and friends as allowed by the patient. So, what’s the solution? Be mindful and cautious when you are communicating with any individual at all times of the day. 5. Abnormal results and findings. A radiologist comments on a patient’s MRI scan of small, potential lesions, but you, as the primary doctor, do not take these comments seriously nor inform the patient about them. These end up becoming life-threatening brain lesions, and the diagnosis was ultimately delayed. At all times, no matter how serious and no matter how seemingly benign a result or finding is, you must always review everything in its entirety and explain to the patient what it all means in words that they can understand. 6. Medication side effects. Remember those TV drug commercials advertising the newest diabetic drug? Or the latest sleeping pill? And the narrator firing off a rapid word slaw of side effects? In truth, all medications have them ranging from a few to several. As the doctor, you must be in the habit of routinely explaining side effects to patients and to document in their charts when they start experiencing them (and to make appropriate changes to their medication regimens). 7. Prescription errors. Choosing the wrong medication dosage in your patient’s EMR or writing the wrong number on a prescription pad (e.g., forgetting the period after the zero and typing 200 mg instead of 20.0 mg) can, in a worst-case scenario, lead to a medication overdose, hospitalization, and even your patient’s death. Be vigilant whenever it comes to numbers. They are crucial, and that extra zero when you didn’t mean it can be a causal link to irreversible changes in your patient’s medical status. 8. Medical device malfunction. This is in regards to a physician signing off for a patient to get a pacemaker implanted, a new insulin pump installed, etc. At every visit, you should always ask your patient if they notice any problems with their device, and if so, recommend changing it out for a new one or discontinuing it if the device is no longer medically necessary. 9. Incomplete discharge summaries. Depending on how many patients a physician sees, discharge summaries can be pesky to complete as you have to ensure these are done while simultaneously seeing new patients. Vital items can be omitted from these summaries, including pending lab and imaging results, not indicating who the patient should follow up with, etc. Likewise, assuming the patient will be able to read and understand the discharge summary once you hand it to your patient is dangerous. This is true for any and every patient. It is not safe to assume that someone who speaks English can read English (this has happened to me twice before when seeing patients). Even more, if you are seeing a patient who speaks a language besides English, you need to assess the patient’s reading ability. 10. Decisions based in large part on financial reasons. Financial concerns may at times strongly influence the choice of a particular treatment plan, but the chosen plan may not be the best (or even the safest) for the patient. To provide patients the best medical care possible is of the utmost importance. Always. As the patient’s primary doctor, it is your responsibility to document any and all patient discussions in the EMR, and to be the patient’s advocate when it comes to pushing for the best treatment plan possible regardless of financial obstacles. Ton La, Jr. is a medical student. Source
