Question

Discuss how physician malpractice suits can be decreased. How can a doctor be sued for malpractice? What current practices do doctors perform in order to avoid law suits? What are the impacts of these practices? How can one check for any malpractice suit against a doctor?

Answer 1

Greetings of the day!

Answer:

PHYSICIAN MALPRACTICE SUITS CAN BE REDUCED :

As a physician, the fear of a malpractice lawsuit will always be present. But knowing you are doing all you can to prevent one from occurring can help set your mind at ease. Providing excellent clinical care can, of course, reduce the likelihood of an error that leads to a lawsuit, but the clinical side is not the only area to focus on.

For more insight into the non-clinical risk-management strategies every practice and physician should follow, we asked experts to weigh in. Here are four ways you can decrease your risk of a lawsuit.

PRIORITIZE PHYSICIAN COMMUNICATION

Great communication between physicians and patients can reduce malpractice risks in many ways, says Jeffrey D. Brunken, president of physician insurer MGIS. When you have a trusting rapport with patients, studies show that they are more likely to disclose all of their relevant medical information. Of course, that reduces the risk of a diagnostic error or misstep that could lead to a lawsuit.

Perhaps even more important to risk management, great communication fosters a strong relationship with patients, which, also, according to several studies, reduces the likelihood a patient will sue if a problem arises, says Brunken. "Errors are always going to happen," he says. "Generally, reducing risk involves, 'How do you reduce the risk when bad things do happen?'"

Here are a few key communication strategies Brunken says physicians should employ when interacting with patients:

• Don't dismiss (or appear to dismiss) the patient's concerns.

• Listen carefully.

• Set realistic expectations.

• Provide clear answers.

"Those things are always to let the patient know, 'Hey, I'm listening to you. I'm hearing you. You can trust me. Tell me more,'" says Brunken.

Sue Larsen, president and director of education at Astute Doctor Education, Inc., which provides online education and resources specializing in physician interpersonal skills, says physicians should also be aware of, and actively avoid, four communication missteps that increase the likelihood of a lawsuit. She says avoid interactions that make the patient feel: devalued, misunderstood, deserted, or misinformed.

For tips on how to avoid each of these scenarios, see sidebar, "Interactions that Lead to Lawsuits."

ASK STAFF TO STEP UP

Just as physicians' interactions with patients are critical, so are staff members' interactions with them, says Larsen, noting that poor customer service leads to poor patient satisfaction, which increases the likelihood of a lawsuit. "It's highly important that every interaction provides an interaction that leads to patients feeling that they are going to somewhere that is highly competent and values their contribution," she says.

Here are four ways to ensure that your staff is not putting you at risk:

1. Require excellent professional etiquette. Staff members need to be cognizant that their conversations with other staff, such as discussions about kids, TV shows, and so on, may be overheard by patients, says Robin Diamond, an attorney and registered nurse who serves as the chief patient safety officer at malpractice insurer The Doctors Company. Those conversations, especially if inappropriate, can be very off-putting to some patients.

2. Make sure staff members explain delays. Long waits, with little or no explanation, are very frustrating to patients. To reduce the frustration, staff should explain delays to patients and share regular updates, says Larsen.

3. Provide training on difficult patient encounters. Angry or demanding patients may dish out their frustration on staff, so they play a big role in whether these situations are handled appropriately. Diamond recommends holding training sessions in which staff and physicians role play difficult patient encounters so that everyone is comfortable with and knowledgeable about how to handle these situations.

4. Ask staff to serve as your eyes and ears. Front-desk staff should observe patient reactions and emotions as they are leaving your practice. If patients leave upset, staff should inform the physicians and/or managers, who can then call the patient later to check in, says Brunken. That check- in call, he says, could be the difference between a damaged patient relationship, and a more positive one.

HAVE STRONG POLICIES AND PROCEDURES

Policies and procedures can mitigate malpractice risks in two ways: one, if properly followed, they can prevent a problem from occurring that could lead to a lawsuit; and two, if you are sued, they can reduce the likelihood the lawsuit will be successful. "Demonstrating that you followed the procedure or the policy, regardless of what it is, shows good faith," says Brunken. "I think that that applies to several areas of the practice."

Here are five policies the experts say every practice should have in place:

1. Policies related to employee expectations. In addition to encouraging staff to practice great customer service, have a policy that addresses expectations regarding staff teamwork, attitude, etiquette, and so on, says Diamond.

2. Policies related to EHR use. These policies should cover initial and ongoing staff and physician training, rules regarding the migration of paper records to electronic, and so on, says Brunken. This will help reduce the risk of an error, and, if a lawsuit does occur, this will help you demonstrate good faith, he says.

3. Policies related to scope of practice. Document scope of practice for every type of clinician within your practice, says Diamond. This documentation should include tasks each individual can perform, the type of patients they can see, and the supervision required.

4. Policies related to care protocols. These policies should include protocols for follow-up on patient tests and referrals, for calling in new prescriptions and prescription renewals, for handling appointment cancellations and no-shows, for handling patient complaints, for ensuring patient privacy, and so on, says Brunken.

5. Policies related to telephone triage. These policies should cover who can answer what type of questions and how to document those questions and answers, says Diamond, adding that telephone care missteps often crop up in malpractice cases.

A few more tips on policies and procedures:

Create "tip sheets" for staff so that they can quickly review the key elements of policies and procedures when necessary, says Diamond. Also, ask staff and physicians to review any changes or updates to policies and procedures, and require them to initial or sign that they have reviewed the changes, says Jonathan B. Stepanian, a healthcare litigation attorney at McQuaide Blasko, a Pennsylvania-based law firm.

HAVE GREAT DOCUMENTATION

Similar to policies and procedures, great documentation (and policies regarding it) can help reduce the risk of lawsuit. Documentation can also help support a successful defense if a patient does sue you, says Stepanian. "In a legal setting ... the record is used to prove what did or didn't happen with regard to a patient's care," he says. "So when you think about the record in that kind of context ... I think it alters your perspective on what exactly you're going to document and how much you're going to document." Stepanian says physicians should always try to document just as they would if they were teaching a first-year resident to do so.

Here are a few key documentation areas to consider:

• Documentation of informed consent. Familiarize yourself with your state's informed consent laws and adhere to them closely, says Stepanian, adding that you may want to take this a step further. "Our suggestion is that physicians [adhere to informed consent laws] not only for procedures that require informed consent, but even those procedures that don't," he says. "Tell patients about the risk of the procedure and the likely outcomes, and document that they reviewed those things."

• Documentation of consideration of prior medical history. Be sure to document that you have collected and evaluated the patient's prior medical history and prior medical visits, says Brunken. Also, note how you considered the prior medical history in the making of your diagnosis. "If you've got somebody that came in a year ago with some sort of complaint, it's important to document that you've got that in the system, and that the physician considered that during the current visit," he says.

• Documentation of patient instructions. In the patient's record, retain copies of all instructions for care that you provided, says Larsen. "... In a number of malpractice cases the doctor will say, 'Look, I know that I explained it to the patient,' but if there's no record of it, it's as if it didn't exist," she says. "It's really important that any information that is discussed with a patient is documented in the note, and also what the patient's response was to that."

Also, since the top claim in malpractice lawsuits is missed or delayed diagnosis, regularly conduct random samplings of patient charts to ensure that all tests, referrals, and so on, are followed-up on appropriately, says Diamond. If you have an EHR, you may be able to set the system to automatically send you notifications or triggers if follow-up care is not documented or completed, says Diamond. "... If the EHR is not tracking this itself, then someone has to do that and make sure that these follow-up appointments aren't falling through the cracks."

A well-trained staff can reduce your malpractice risks. Here are six training sessions every practice should provide, according to risk management experts:

• What a malpractice case is, how the standard of care is proven, and how a case progresses

• "Soft skills," such as those related to customer service, communication, dealing with difficult patients, and professional etiquette

• Proper documentation

• How to handle cross-cultural communication, language barriers, and literacy issues

• All policies and procedures, and training on how noncompliance could raise malpractice risks

• Risk reduction strategies based on lessons learned from malpractice cases against physicians in similar practices.

HOW CAN A DOCTOR BE SUED FOR MALPRACTICE?

INDIAN PENAL COURT LAWS (you can refer the medical malpractice laws of your country, India is just an example.)-

No human being is perfect and even the most renowned specialist could make a mistake in detecting or diagnosing the true nature of a disease. It has been held in different judgments by the National Commission and by the Honorable Supreme Court that a charge of professional negligence against a doctor stood on a different footing from a charge of negligence against a driver of a vehicle.The IPC describes in following sections below regarding this difference:

• IPC Section 52: (Good faith). Nothing is said to be done or believed in “good faith” which is done or believed without due care and attention. Good faith implies genuine belief on the part of the doctor that his/her act of omission or commission would be in the best interest of the patient. The onus lies on the defendant (doctor) to prove that not only the good intentions but also a reasonable skill and care are exercised for the discharge of duty.
• IPC Section 80: (Accident in doing a lawful act). Nothing is an offense which is done by accident or misfortune and without any criminal intention or knowledge in the doing of a lawful act in a lawful manner by lawful means and with proper care and caution. Accident implies without the prior knowledge or intention of causing the evil effect.
• IPC Section 88: (Act not intended to cause death, done by consent in good faith for person's benefit). Nothing which is not intended to cause death is an offense by reason of any harm which it may cause, or be intended by the doer to cause, or be known by the doer to be likely to cause, to any person for whose benefit it is done in good faith, and who has given a consent, whether express or implied, to suffer that harm, or to take the risk of that harm. The section highlights the importance of acting on good faith and with informed consent of the patient.
• IPC Section 89: It is similar to IPC Section 88 with the point of view of consent in case of children below 12 years and persons with a mental disorder where a guardian is authorized to give consent.
• IPC Section 92: (Act done in good faith for benefit of a person without consent). Nothing is an offense by reason of any harm which it may cause to a person for whose benefit it is done in good faith, even without that person's consent, if the circumstances are such that it is impossible for that person to signify consent, or if that person is incapable of giving consent and has no guardian or other person in lawful charge of him/her from whom it is possible to obtain consent in time for the thing to be done with benefit. In all such cases, it is prudent to involve another senior colleague in making the decision and recording in detail the justification or circumstances under which the decision was taken.
• IPC Section 93: (Communication made in good faith) No communication made in good faith is an offense by reason of any harm to the person to whom it is made if it is made for the benefit of that person. However, the doctor would be prudent enough to ensure that the communication is based on verifiable facts of the case, in a good faith for the benefit of the person it was made and in view of the delicacy of the matter, conveyed appropriately in the presence of spouse/relative/guardian.
• Criminal Procedure Code Section 174: This section does not preclude the right of aggrieved relatives of a deceased patient to prosecute the doctor for criminal liabilities under IPC Section 304A (whoever causes the death of any person by doing any rash or negligent act not amounting to culpable homicide shall be punished with imprisonment of either description for a term, which may extend to 2 years, or with fine, or with both), it prevents doctors from being arrested immediately after the unfortunate death of a patient. It also offers doctors an opportunity for being assessed by their peers for any of the alleged professional lapses.

Immunity of Government Doctors

The National Commission by its judgment and order has held that persons who avail themselves of the facility of medical treatment in government hospitals are not “consumers” and the said facility offered in the government hospitals cannot be regarded as service “hired” for “consideration.” It has been held that the payment of direct or indirect taxes by the public does not constitute “consideration” paid for hiring the services rendered in the government hospitals. It has also been held that contribution made by a government employee in the Central Government Health Scheme or such other similar scheme does not make him a “consumer” within the meaning of the act.

Media trials

In the current situation, media is often referred as the fourth pillar of the democracy. However, it has no right to present the facts of a case in an unfair and prejudicial manner. A doctor cannot become a victim of malicious or defamatory reporting. A doctor should not be silent and should rebut the allegations. The doctor can take help of their professional association to convey the facts and support to resist a trail by media.

Prevention of harassment of doctors

Taking the judicial notice of incidents where the doctors are being harassed by the police in the guise of investigation and unnecessary delay in the medical evidence by way of frequent adjournments or by cross-examination, the court held that unnecessary harassment of the members of the medical professional should be avoided. They should not be called to the police station to unnecessarily interrogation or for the sake of formalities. The trial courts should not summon medical person unless the evidence is necessary, even if he/she is summoned, an attempt should be made to see that the people in this profession are not made to wait and waste time unnecessarily, the law courts have to respect for the people in the medical profession.

The Supreme Court has warned the police officials not to arrest or harass doctors unless the facts clearly come within the parameters laid down in Jacob Mathew's case. Even a threat was given to the police officers that if they did not follow these orders they themselves have to face legal action. The Supreme Court went on to say ” To prosecute a medical professional for negligence under criminal law it must be shown that the accused did something or failed to do something which in the given facts and circumstances no medical professional in his ordinary senses and prudence would have done or failed to do. The hazard taken by the accused doctor should be of such a nature that the injury which resulted was most likely imminent.”The Supreme Court has attempted to remove apprehension that prevents medical people from discharging their duty to a suffering person.

common reasons :

• Misdiagnosis or failure to diagnose: 33%. This includes misdiagnosis, and delayed diagnosis. If the patient does not receive the proper medical care for their condition, it may become worse and lead to death. According to the Institute of Medicine, most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences.
• Surgical errors: 24%. Preventable medical errors such as wrong-site surgery, leaving tools inside of a patient, operating on the wrong patient, anesthesia errors can be the result of many factors including negligence, miscommunication among the medical team, fatigue, or incompetence.
• Treatment errors: 19%. Treatment for a medical condition or injury may include prescribing the appropriate medication, radiation treatments, physical therapy and countless other treatments. When a physician deviates from the standard of care in the treatment of a disease or injury it may result in illness or further injury for the patient.
• Obstetrics errors: 11%. From the failure to perform prenatal tests, failure to monitor pregnancy and delivery, birth injuries such as cerebral palsy or other brain injury, labor and delivery medical negligence pose an enormous risk to both the mother and her baby at what should be a happy time for the family.
• Medication errors: 5%. According to the Institute of Medicine, more than 1.5 million Americans become sickened injured or die because of an error in prescribing, dispensing and taking medications.
• Monitoring patients: 3%. A significant part of a physician’s role is to monitor their patients when they are under anesthesia, when a woman is in labor, when a patient is undergoing surgery or receiving some other medical treatment the doctor or other medical professional must watch for signs of complications.
• Other: 5%. There are many other types of preventable medical errors that can result in serious injury or death of a patient such as inadequate taking of the patient’s medical history, inattentive follow-up, inadequate record keeping and miscommunication or lack of communication among the members of the medical team. (Full medical malpractice payout analysis )

other reasons :

Sparsely Completed Medical Records

Doctors and other healthcare providers must keep detailed records of a patient’s condition and treatment. Failing to do so can result in a malpractice lawsuit. If your medical records lack information about your doctor’s rationale for critical decisions, feature errors or omissions, are illegible, or include questionable alterations, you could have a case. Evidence of an altered record almost always guarantees a winnable case.

Inadequate Intake

When you visit a doctor or you are admitted to the hospital, someone must conduct an intake interview to collect your medical history. You are asked about family medical history, allergies, drug use, the names of your other doctors, and several other questions that alert doctors to any potential problems. Without written proof these questions were asked and answered, doctors could face legal action.

Lack of Follow-up

There are times when doctors take a wait-and-see approach to a medical problem, which often is the best option. However, if your doctor fails to observe and monitor a condition, or fails to document the reasons for being less assertive with treatment, it can result in serious consequences and subsequent legal action.

Failure to Obtain Informed Consent

Doctors must explain to you or the person responsible for your medical decisions the risks, alternatives, and expected outcomes of potential treatments. You or your medical guardian must sign a release form, but this form is virtually worthless without proof the doctor personally obtained consent through explanation of the procedure. Often, handwritten or dictated notes are more useful in a doctor’s defense than the standard consent form. The same is true if a patient refuses medical care. Doctors must explain the risks of refusing treatment, creating informed refusal and protecting the doctor against any consequences.

Mishandled Lab Studies

Many patients undergo lab and imaging tests prior to medical procedures. These must be assessed by a doctor in a timely manner and there must be some way to prove the doctor did review the material – such as a signature or initialed document.

Communication Problems

Miscommunication between doctors can result in mistreatment of a patient. Doctors must keep track of referrals and keep records regarding conversations with patients and colleagues, in order to prove there were no miscommunications concerning a patient’s care.

Medication Problems

Prescriptions and refills must be adequately documented. Failure to do this that results in patient injury leaves a doctor vulnerable to a medical malpractice lawsuit. To prevent problems, make sure charting is done properly and medication control records are easily accessed and reviewed.

Lack of Patient Education

It is a doctor’s responsibility to educate patients about their condition and treatment options. In addition to oral education, you should also receive written information about your medical options. Doctors must also document they have provided you with this information.

Lack of a Sound Doctor-Patient Relationship

Medical malpractice lawsuits are sometimes the result of a poor relationship between doctors and medical staff, and patients. Something as simple as poor phone etiquette or inattention to a patient’s concerns can result in a lawsuit.

Doctors and their staff need to treatment patients with respect. Though complaints about bedside manner, etiquette, and general treatment might not result in a successful medical malpractice award, it could shine light on other mistakes that could potentially result in scrutiny and legal action.

Common Errors by Medical Professionals-

Patients sue because of a feeling that they were not heard, that their needs were not attended to, and that nobody seemed to care, and as a result, a bad outcome resulted due to a mistake or negligence. Some of the instances where errors do happen by medical professionals are as follows:

1. Avoidance -Compassionate gestures count. If a hospitalized patient has a bad outcome, some physicians may avoid making rounds in the presence of relatives. It is important to let the patient and their caregivers to know that as a treating doctor their problems are understood. It is a good practice to maintain eye contact while addressing the patient and put a comforting hand on the individual's arm (comforting touch).
2. Defensive medicine- It is better to avoid practicing defensive medicine. Particularly when affordability is an issue, victim is very likely to complain. Moreover, it amounts to medical malpractice (a medical practitioner intentionally advising unwanted investigation).
3. Failure to communicate - Communicate clearly and effectively. Take time to ensure your patient understands their diagnosis, treatment, and medication plans, and then check their understanding by asking them to explain it back. This ensures instructions are properly followed and demonstrates your care toward patient.
4. Failure to diagnose -Failure to diagnose is the number one reason a physician gets sued for medical malpractice. A techno-savvy patient may give/explain/ask more information or psychologically less sophisticated patient may withhold the information and make diagnosis difficult.
5. Failure to identify a complication - If a certain complication is a known risk, it should be on the consent form for the medical procedure. However, the consent form need not list every single complication that has ever occurred for that procedure. Often there are mistakes in communicating the complications. If, for example, the complication is known to occur 10% of the time during a given procedure but the consent form states that it occurs only 1% of the time, then the consent form was wrong.
6. Inadequate follow-up - There are instances when tests results are not received by the ordering physician. On other occasions, patients do not follow through with tests as directed or the results come in are filed away before the physician reviews them, and the patient is not briefed about the findings. It is essential that physicians and their staffs are able to track the status of these orders to make sure that none are overlooked or forgotten. Another aspect of care needing better follow-up involves referrals to specialists. Every step has to be documented not only for preventing medico-legal issues but also for good patient care as well.
7. Patient time- The time spent allowing the patient to fully explain his/her concern determines the physician's ability to show concern, empathy, and likeability. The longer the quality time a physician spends with the patient, the less likely will that physician be sued.
8. Prescribing errors - Before prescribing any medication, a physician should be aware of all medications the patient is taking, including over-the-counter drugs and alternative medicines. Physicians should reinforce the importance of taking the medications only as prescribed. Patients should be advised that if they feel any medication is not having its intended effect, they should immediately contact their physician. An important way to prevent inadvertent drug interactions is by working in concert with hospital pharmacists. Avoid handwriting prescriptions and utilize instead electronic medical recording with electronic prescribing.
9. Prevention of medical negligence- In recent times, medical science has witnessed exponential technological progress. However, health-care delivery remains very much a human endeavor. Evidence shows that errors are often the result of not from a lack of knowledge but from the mindless application of unexamined habits and the interference of unexamined emotions.
10. Asset protection and indemnity- It is vital to the survival of physicians to develop an asset protection plan, in addition to professional medical liability insurance. Not only does a malpractice lawsuit reduce the physician's ability to make a living in medicine but also it can adversely impact or devastate both earned and invested assets. There are two categories of professional indemnity such as personal or individual: This takes care of the risk of liability of the doctor and his qualified assistant. Errors and omissions policy: This covers an institution, nursing home, or hospital along with its staff members. If a doctor is the owner of a hospital/institution, it is recommended to take both individual and error policy as the hospital/institution is a separate legal entity and often can be made a party to medico-legal case.
11. Burden of proof -The court has held the opinion that medical negligence has to be established and cannot be presumed. In cases of medical negligence, the patient must establish her/his claim against the doctor. The burden of proof is correspondingly greater on the person who alleges negligence against a doctor. A doctor can be held liable for negligence only if one can prove that she/he is guilty of a failure that no doctor with ordinary skills would be guilty of if acting with reasonable care. The burden of proof of negligence, carelessness, or insufficiency generally lies with the complainant. The law requires a higher standard of evidence than otherwise to support an allegation of negligence against a doctor. In Bimalesh Chatterjee case, it was held that the onus of proving negligence and the resultant deficiency in service was clearly on the complainant.When the damage is too remote, it is not considered as an immediate result of medical negligence.
12. Change in attitude- Change is the unchangeable truth in human life. A readiness to change can prevent medical errors and improve the quality care of a doctor. Self-awareness and attitudinal changes have been found to be beneficial and recommended. They are as follows:
13. Always to do the best- A treating doctor should not let fatigue or anything else gets in the way of doing your work. While no one is perfect, many medical mistakes that end up in malpractice suits can be avoided by being conscientious.
14. Apology - When physicians are honest about medical errors and apologize to the patient, the overall cost of medical malpractice is reduced in the end. However, it depends on the type of error (gross and real), motive of the victim (non mischievous), and situational influences (indefensible).
15. Blaming others- One should refrain from blaming other health-care providers for adverse outcomes. The latter can happen despite everyone providing reasonable care. They can be called for evidence either as a witness or as an expert.
16. Clinical guidelines - Adherence to clinical guidelines is an effective way to improve quality care and reduce variation in care. Clinical guidelines have been systematically developed nationally and globally to assist clinical decision-making (practice of evidence-based medicine). In medical negligence claims and in court, these guidelines may act as a source of information, provided they are the product of a recognized body and are deemed reliable. They can be seen as normative standards and are used as explicit standards of care at the time of the index clinical event and also to assess the degree to which a questionable practice was in line with accepted standards.
17. Documentation - If the treating doctor does not document something happened, it is difficult to prove it occurred. Charting accurately and thoroughly can help to understand what happened to the patient. In addition, it will help in answering the questions raised about duty of care when called for a deposition months or years after an event has occurred. One cannot rely on their memory for the facts. Regardless of the system used, the purpose of documentation, from a legal perspective, is always to accurately and completely record the care given to patients, as well as their response to that care. Documentation has legal credibility when it is contemporaneous, accurate, truthful, and appropriate.
18. Empathy - Patients want to believe they are the most important person that doctor will see that day and the doctor focuses 100% on them. While this is not feasible, taking time to think like a patient and understand the condition from their perspective can help in becoming more empathetic physician and build a better relationship. People are less likely to sue a physician with whom they have a positive relationship, even if something goes wrong.
19. Expectations - Medical malpractice lawsuits are not quick. It could take years after an incident for a malpractice case to be resolved. Malpractice cases have to go through a long process including discovery, which is the investigation process. It could take months for this phase alone. While in the midst of a malpractice case, one needs to stay focused on other areas of your life. The support system needs to be mobilized and obsessing over the case should be avoided. The medical malpractice stress syndrome is real. It is experienced to some degree by all physicians who are sued.
20. Hospital policies - If the physician follows hospital policy regarding treatments and protocols, they are less likely to get into trouble. If the physician diverts from regulations and hospital rules in managing the patient, the facility is less likely to defend.
21. Keeping updated - While most physicians stay up to date with the latest continued medical education programs/conferences/workshops/symposia, increasing advances in healthcare make it important to know what is happening in the world of medical news. Often medical news is reported in consumer publications and the Internet. Often patient may discuss what is in the social media, the ability to discuss about those news with your patients will reinforce their confidence even though they may not be practiced by the treating doctor.
22. Merit of the case - Not everyone who sues has a case. There are many instances where a doctor is served with a lawsuit and the case either never goes to trial or the doctor wins and is not found negligent.
23. Potential litigant - A reasonable doctor should consider every patient as a potential litigant. It is to keep a doctor in constant awareness to stick to a prescribed standard of care and avoid any adventurous attempt. A doctor should not ignore any allegation in any form (oral or written) and should be able to handle allegations with clear and firmness in an intelligent and sympathetic manner.
24. Risk management - When a doctor is working for a hospital, the defendant doctor should notify risk management department of the hospital whenever a notice is served. Risk management employs lawyers who specialize in medical malpractice. The lawyer will help the defendant doctor through the process. Moreover, becoming educated and understanding (preparedness) what will happen help reduce anxiety.
25. Contributory negligence - When a patient by his/her own want of care, contributes to the damage caused in the process of treatment then they are said to be guilty of contributory negligence. For example, if the patient refusing to carry out the remedial treatment recommended by the doctor or indulging in activities forbidden by the doctor further exacerbates the damage. When there is negligence of two or more persons toward the patient resulting in a particular damage, it is called composite negligence. They are jointly or severally held liable for the damages.
26. Informed consent - Informed consent means that the patient specifically consents to the proposed medical procedure. Informed consent is more than just consent. For a patient to give informed consent to a medical procedure, the health-care provider must inform the patient about all of the risks and complications that may reasonably occur during that procedure, however, minor they may be. Furthermore, the treating doctor should mention about alternatives treatments available and what happens if no treatment is done. Only after a patient is truly informed about the potential risks of a medical procedure can a patient give informed consent to the procedure.The treating doctor should understand that the patient has given consent to the procedure and not to all medical errors while on treatment. The failure to obtain informed consent can be a form of medical negligence or may give rise to a cause of action for medical battery.

AVOID LAWSUITS: HOW DOCTORS PREVENT MALPRACTICE:

Be Informed
Sometimes the procedures a doctor conducts most often or considers the simplest are the ones that go awry towards a malpractice situation. That’s because the physician, knowledgeable as he or she is about the course of action being taken, doesn’t know the latest information on it, having failed to stay current with new studies and medical literature.

Devour as much up-to-date information about your specialty as possible to be fully informed on the specs of every procedure rendered in your office and protect yourself from problem incidents.

Document It All
When recording a patient visit into a chart or EHR, physicians often leave a lot out. It’s a given that you can’t document an encounter in its entirety, but don’t skip details that could help cover you down the road in the event of a poor outcome. Always be sure to answer the question “why?”

“We most often fail to see a discussion of why you made a particular decision,” say healthcare law attorneys Patrick T. O’Rourke and Kari M. Hershey. “As you know, physicians often have a broad range of treatment choices. Including information about why you selected a particular course of treatment—in light of the available data—makes the record more understandable.”

Communicate
The answer to that question “why?” is important for your patient to know, too, as are the risks inherent to any procedure being performed. A patient who’s informed and aware is less likely to become litigious.

This is true even when things go wrong, which is why directness and honesty are critical in the event of medical error. As I’ve written before, a friend of mine chose not to sue after suffering a life-threatening medical mistake because her physician took complete responsibility for the error. Healthcare lawyers agree that timely, clear communication is critical to avoiding lawsuits.

Be Nice
Don’t just communicate professionally; communicate courteously. Unless they’re in your office for a routine check-up, your patients are in a vulnerable position when seeking your care. The more kindness they feel from you, the more likely they are to see you as a trusted partner in their health, rather than a future legal adversary.

The credo to be kind falls on your entire care team and staff, whose behavior reflects back on you in a patients’ overall perception of your practice.

Be Consistent
The same level of care should be administered to each and every patient that comes to your office. When procedures are administered, that rule becomes especially critical. Failing to follow protocol by missing just a few steps of your normal process can result in an error or variation of usual outcome.

A few seconds can make the difference between getting a patient out the door healthy and getting hit with a malpractice suit. Never skip steps, never rush through a procedure and never cut corners. Use checklists to ensure that you and your team execute each care episode properly.

Embrace & Use Feedback
Have multiple patients informed you that a specific procedure hurts more than they thought it would? Incorporate that into your consultative discussion with the next patient you’ll render it to. Did another individual seem to really appreciate the follow-up call you made the day after surgery? Consider picking up the phone every time you perform it.

Administer surveys, put out a suggestion box and have your staff ask patients about their experiences, then put the feedback to good use. This cycle engages patients in a dialogue that invests them in the healthcare process with your practice and gives you an opportunity to notice areas where you can improve your performance.

Know It Can Still Happen
Despite good intentions and good care, you may still get served with a suit at some point in your career, so keep that in mind even when you’re focused on staying malpractice-free. Protect yourself properly with insurance and have good counsel available to lessen the impact a lawsuit could have on your practice.

Ways used by doctors to prevent/avoid malpractice lawsuits and their impacts :

1. Establish Good Patient-Caregiver Relationships

Your patients expect to receive quality medical care from you—it’s what brought them through your doors. They also expect to be treated with true concern, kindness and respect.

As the caregiver, it’s your job to help your patients feel comfortable—something many of us aren’t when it comes to discussing our bodies and our health in general. Respect and empathy go a long way in helping patients be forthcoming about their overall health, specific ailments and how they feel about treatments that may be necessary.

Open and honest communication, rooted in kindness and respect, is vital to fostering positive patient-caregiver relationships. It also helps you get to know your patients better, and helps their family members gain a good understanding of care and procedures. It all adds up to earning the trust of your patients. And when you have a patient’s trust, they are less likely to bring a lawsuit against you if something goes wrong.

2. Be Clear & Consistent

In addition to being compassionate, it’s important to communicate clearly and on the patient’s level. Most of your patients won’t understand the technical medical terminology you use when conversing with colleagues. They’ll more easily understand common terms explained in simple ways. Illustrations can be useful tools to help a patient visualize their diagnosis or show how a medication or treatment will improve a condition.

Being consistent in your care is equally important. The same level of care and protocol should be administered to each patient you see.

3. Getting Informed Consent

Before you engage in dialogue about a patient’s health and the care you’ll be giving, it’s crucial to get your patients’ informed consent. Informed consent means you discussed the advantages and the risks of the care you will provide and gives the patient the opportunity to discuss alternatives. Most health care facilities obtain the informed consent of their patients by way of a signed agreement that is completed with enrollment paperwork. It’s a simple task, and an important one that can defend you in a malpractice case.

4. Accurate and Complete Documentation

Making and keeping accurate records and documentation of patient visits is vital to a successful practice. In fact, documentation can make or break a malpractice lawsuit. In a case of negligence where no documentation is presented to back up the provider, a jury is very likely to side with a patient. Poorly-kept documentation fares no better. Good documentation—charts and records that are current, thorough and specific to the exact care given at every visit—can be very helpful in supporting a health care worker during a malpractice case.

5. Stay Current

To stay “in business” you’re required to maintain your license through continued education, training and testing. But there’s a whole world of medicine outside of your specialty, much of which is readily accessible to the public. Make sure to stay informed about the health care industry as a whole. You’ll be positioned to answer questions your patients may ask of you, building their confidence in you. Plus, you’ll be a well-versed representative in your medical community, something a jury will look upon with favor.

6. Be Prepared

Doctors and health care professionals are often seen as distant and rushed. However true that may be of your practice, you should never compromise the time you give to preparing for appointments. Do your very best to review your patients’ files before walking in the door for an appointment. It’s not only important to ensure you’re up-to-speed about a patient’s condition and care, but it’s also a simple matter of courteousness. Again, showing that level of consideration really is meaningful to your patients. When a patient feels like “just another patient,” he may be more likely to sue in a case of perceived negligence.

7. Follow Proper Procedures

We’ve mentioned how important it is to build positive patient-caregiver relationships. As important as those relationships are, they alone don’t trump the importance of following proper procedure and practice in your care. Policies are set for a reason, and they must be followed to ensure the best possible care is provided. This must be the case each and every time you see each and every patient. And again, consistency in your procedures is of utmost importance. The smallest infraction against a set policy or procedure can cause devastating effects—in the treatment outcome for the patient, and possibly, a subsequent malpractice lawsuit.

It’s important that as policies and procedures or treatments are amended or added to your practice, the official documentation used within your facility is also updated.

HOW TO FIND IF THERE IS A MALPRACTICE LAWSUIT AGAINST A DOCTOR?

Do a Background Search

The background search of a doctor's medical history takes time, so don't be discouraged if you don't get your answers immediately. In some cases, you may need to speak with someone on the phone; in others, you may find what you need online. To do a background medical search:

1. Go first to the Federation of State Medical Board's Physician Data Center website to check the doctor's basic information including, his or her board certifications, education, the list states where an active license is maintained, and any actions against the doctor.
2. Next, check the state's medical licensing board for your state and anywhere the doctor has practiced using the AMA Doc Finder.
3. If you find a doctor's license has been suspended, that generally means that there has been an actionable offense.
4. If you don't find any relevant information, leverage the information you have with an online search. Place quotation marks around the doctor's name to keep the phrase intact (such as "Dr. John Smith") and follow this with such keywords as "malpractice," "lawsuit," "sanction," "complaint," or "suspension." Start by using only one keyword at a time; this better filters the results. You can use more as you widen your search
5. Remember that there may be more than one doctor with the same name. Cross-reference whatever information you have to ensure you don't make a mistake.

It is important that you contact every state medical licensing board under which the doctor has practiced, not just your own. Malpractice suits and disciplinary actions do not always get transferred from one licensing board to the next.

The sad truth is that a doctor can amass a malpractice track record in one state, get licensed in a new state, and start again with a clean As such, you need to do your homework to ensure you get the fullest body of evidence possible.

Making a Qualified Judgment

Even when malpractice or disciplinary information can be found, it may require an explanation of terminology or circumstances. Judging a doctor simply on that doctor's malpractice track record may not provide the whole story.

For example, some of rankings websites may indicate that a surgeon is "successful." What they don't tell you is that some surgeons, in order to keep their ratings high, will not accept certain high-risk patients. A record that shows a higher failure rate doesn't always mean that a doctor is "less successful."2

The same applies to the uncovering of a malpractice suit. While it can steer you well away from a less-than-reputable doctor, it can also lead to wrong assumptions.

As much as a malpractice suit may be a red flag, it doesn't necessarily mean that it was justified. It is not unusual for a suit to be filed for a death or injury beyond a doctor's control. Be fair and speak with the doctor rather than making a wrong assumption.

The main thing is to be objective and goal-oriented. The goal is not to uncover dirt; it is to find you the best doctor, surgeon, or specialist for your needs and condition. To this end, don't hesitate to ask a doctor about a malpractice suit or other action you may find.

While you may not get the answers you need, you at least have the opportunity to make an informed judgment based on all of the facts you've received.

A Word From Very well

Upon completing a background search, don't be disappointed if you end up with scant information. It may mean that the doctor has a clean record, or it may be that an infraction has been legally removed.

For example, if a lawsuit has been settled out of court, it may be removed since the claim will have been withdrawn. It doesn't mean that the doctor was in the wrong (sometimes it's cheaper to settle than to incur expensive legal fees) and doesn't mean that the doctor is right.

If you don't have any information about a doctor, go the direct route and simply ask if he or she has ever been hit with a malpractice suit, civil action, or disciplinary action. It's your right to know. Be respectful and simply let your instinct tell you what makes sense and what doesn't.