Practicing Medicine in Difficult Times: Protecting Physicians from Malpractice Litigation / Edition 1

by Marjorie O. Thomas, Christine J. Quinn, Geraldine M. Donohue

Overview

There are multiple approaches within the reach of the physician which will increase the satisfaction of both the physician and the patient, and will also prevent lawsuits. Practicing Medicine in Difficult Times: Protecting Physicians from Malpractice Litigation focuses on protecting physicians from medical malpractice litigation. This essential resource includes multiple strategies physicians can employ to protect themselves from lawsuits which will positively impact the physician/patient relationship by enriching it and ultimately keeping patients safer. Each chapter includes case studies and real-life examples from experienced physicians and attorneys who defend physicians involved in medical malpractice cases.

Product Details

ISBN-13:	9780763748562
Publisher:	Jones & Bartlett Learning
Publication date:	07/10/2008
Edition description:	1E
Pages:	280
Product dimensions:	5.90(w) x 9.10(h) x 0.80(d)

About the Author

Senior Vice President, Risk Management & Underwriting, AFP


Vice President of Risk Management Services, AFP


Associate Director, Risk Management Education, AFP

Table of Contents

About the Authors     ix
Contributing Authors     xi
Acknowledgments     xiii
A Note from the Authors     xv
The Power of Prevention   Anthony J. Bonomo     1
Overview of Medical Malpractice Crisis: How Did We Get Here?     2
How Are Insurance Rates Determined?     3
Why Are Medical Malpractice Premiums So High?     3
Why Do Patients Sue Their Physicians and Other Healthcare Providers?     6
Many Things Are Not in Your Control     9
The Best Lawsuit to Defend Is the One That Never Happens     12
It's Not Just About Avoiding the Lawsuit   Gerald Dolman   Marjorie O. Thomas     15
The Fear of Litigation     15
What Can We Learn from the Data?     16
Let Us Consider the Causes     19
Defensive Practices: Do They Help or Hurt?     20
What Are Some Constructive Responses?     21
What Then?     23
Professional Responsibility   Howard D. Kolodny   Marjorie O. Thomas     29
The Formation of the Responsible Physician     31
Out of the Cocoon     35
Risk Management as Physician Responsibility     38
The ResponsiblePhysician and the Patient's Safety     40
The Responsible Physician and Life-Long Learning     42
Moving Forward     43
Communication Is Crucial   Barry F. Schwartz   Geraldine M. Donohue     47
The Influence of the Healthcare Crisis     48
The Power of the Therapeutic Relationship     50
The Impact of Medical Training     52
When the Patient Becomes Routine     55
The Challenges of Nonverbal Communication     58
Follow the Patient Home     59
Dispelling the Myth of the "Uncaring" Physician     61
The Bad News Must Be Told, But How?     62
Overcoming Barriers to Effective Communication     65
Communication and Litigation     67
The Bond That Sustains     69
The Difficult Physician-Patient Relationship   Mary Jo Fink     73
The Practice of Medicine in the 21st Century     74
Communication and the Art of Medicine     75
Difficult Encounters for Patients and Doctors     77
The Making of a Doctor     83
Toward a Transformative Doctor-Patient Relationship     85
Hallmarks of a Successful Practice   Victor R. Klein     89
Ability      90
Affability     99
Availability     101
Affordability     103
Things You Didn't Learn in Medical School   Christine J. Quinn     105
First Impressions Are Important     106
Delegate Responsibilities with Care, Thought, and Confidence     107
Effective Tracking Systems for Tests and Consults Are Essential for Every Practice     110
Ensure All Incoming Reports Are Reviewed     112
When It Comes to Test Results, Adopt a Policy That "No News Is No News"     114
Have a Procedure for Missed Appointments     115
What Does It Mean When a Patient Misses an Appointment?     116
How Does a Patient Become Lost to Follow-Up?     117
Implement a Patient Safety Program in Your Practice     119
The Challenge of the Patient in Transition   Marjorie O. Thomas     123
Upon Admission     125
At Discharge     127
In Consultation     132
Finding a Better Way     135
Don't Put Your Head in the Sand   Philip A. Robbins   Christine J. Quinn     141
Why Did This Physician Not Consider Other Diagnostic Options?     143
What Can We Learn from This Case That Can Help Prevent Other Cases?      144
How Can You Mitigate the Risk of a Malpractice Lawsuit If a Patient Has a Complication?     152
Disclosure   James W. Tuffin   Geraldine M. Donohue     159
A Changing Culture     161
Ethical Reasons for Disclosure     162
Legal Reasons for Disclosure     163
Will Disclosing an Error Affect My Malpractice Insurance?     165
What About HIPAA?     165
Managing Disclosure     166
The Impact of the Event     167
What Do Patients Want to Know?     167
The Significance of Timing and Setting     168
Who Should Be Included?     168
The Disclosure Conversation     169
A Case of Wrongful Death     169
A Case of a Lap Burn     173
In Closing     174
Apology and Forgiveness   Geraldine M. Donohue     177
The Arc of Apology and Forgiveness     178
Rooted in Rearing and Culture     181
When Things Go Wrong     184
The Healing Power of Apologies     186
Essential Elements of an Effective Apology     186
The Shared Experience     188
Lessons Learned: A Physician's Perspective   Seth Goldberg   Christine J. Quinn     191
Adequate Documentation Is Part of the Standard of Care     192
You Are Responsible for Care Provided Under Your Supervision     193
Even Considered Departures from Standards of Care Are Difficult to Defend     195
Ensure That Your Fail-Safe Systems Work     197
There Is No Substitute for a Complete History     199
If You Provide Specialty Care, You Are Held to the Standard of the Specialist     202
Record Alteration Changes the Focus of the Case     203
Ineffective Communication Between Physicians Can Result in Injuries to Patients     205
Lessons Learned Defending Physicians: The Attorney's Perspective   Roy F. Kaufman   Marjorie O. Thomas     211
Juries Are Audiences     212
You're Not "Preaching to the Choir"     213
Juries Watch Everything     214
Juries Love Visual Evidence     215
Honesty Counts     216
Cases Don't Always Settle     218
Expert Testimony Is Not Always Needed     219
Kiss Your Defense Goodbye     220
Greed Causes Grief     223
It's All About the Communication     224
Documentation Does Make a Difference     227
Where We Began     228
The Emotional Impact of a Medical Error   Stephen Deckoff   Geraldine M. Donohue     231
A Shattering World     232
An Absence of Outlets: Unspoken Grief     236
Facing Your Fears     240
The Hope of a Just Culture     246
Return to Normalcy     248
Narrative Medicine: Healing the Divides   Rita Charon     253
Routine Practice     255
The Nature of Narrative Medicine     257
Narrative Medicine and Medical Error     260
Narrative Bridges Between Doctor and Patient     261
A Narrative Life     267
Index     271