When it comes to getting sued for medical malpractice, it is unfortunately more a case of “when” than “if.”
It’s no secret that physicians, especially primary care doctors, are at great risk of being sued by a patient sometime during their career. The good news is, doctors can take steps to reduce the risk of lawsuits, and improve the odds of a favorable outcome if they are sued.
The lifetime risk of a primary care physician getting sued is 75%, according to a recent study by researchers from the University of Southern California, Harvard University and the RAND Corp. While the frequency of claims and payments actually have declined over the past decade, primary care physicians still have about a one in five chance of making a payment, whether through a trial or settlement.
And there are events that occur every day in medical practices that may seem harmless on the surface, but can sow the seeds of a potential lawsuit. From adding an extra note to a patient’s chart after a visit to rushing through electronic health record (EHR) screens, a minute’s worth of an innocuous action can lead to months of a physician defending his or her actions in court.
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To help doctors protect their practices and professional reputations, Medical Economics consulted the experts to learn the five biggest malpractice hazards facing physicians and how to avoid getting tied up in a malpractice maze.
“Every doctor is taught that if you didn’t put it in the chart, you didn’t do it,” says Steven Fox, MD, an internist and assistant professor of clinical medicine at the Keck School of Medicine at the University of Southern California. If it’s not in the chart, you are deemed not to have done it for the purposes of malpractice litigation, he adds.
Fox, a fellow at the Leonard D. Schaeffer Center for Health Policy and Economics, advises documenting all conversations. This includes summarizing patient discussions, having patients verbalize their understanding of why something is important, explaining why any clinical alerts are dismissed and noting conversations with other providers or with family members. “Most physicians don’t do a thorough enough job, even if they fill in the appropriate boxes,” he says.
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Michael Ellenberg, JD, a malpractice attorney in New York City, advises physicians to note every action in the patient’s chart, even if it’s just to correct something accidentally entered in the wrong field. Include an addendum, but never delete or try otherwise to modify the existing record, he says. “That’s a recipe for disaster.”
It’s easy to tell whether an existing record has been altered, he adds, and it can raise suspicions among juries that other things may also be amiss. Without thorough documentation, and thus only memory to rely on, a doctor is more likely to lose the case, he says.