Ten Ways to Get Sued!

(A digest from Medical Economics, July 8, 2005)

Sometimes the non-clinical errors motivate more malpractice lawsuits than medical negligence.

Here's a list of 10 things that can get doctors sued!

1. Don't keep detailed records. The medical record is always your best defense, but if it's not accurate and detailed it can be your worst enemy. Show that your actions were reasonable with complete, unambiguous and legible records. If it's not in the record, juries may believe that it never happened.
2. Don't document informed consent discussions. Having a signed consent form is good, but a thorough informed consent discussion is the best protection provided that the discussion is recorded in the chart.
3. Fix records quickly when something goes wrong. Altering records after a patient is injured is an easy way to lose a malpractice suit. Record tampering can also be expensive, because many insurance policies exclude coverage when a physician has altered a record.
4. Trust the patient to follow through on referrals. Although the patient is responsible to comply with referrals, jurors may feel that the doctor should follow up to make sure the patient actually did comply. Develop a staff procedure to keep track of referrals, verify that appointments are kept and confirm receipt of the specialist's report. Failure of the patient to comply should result in a phone call to the patient and follow up with a certified letter all documented in the chart.
5. Don't track test results. Unreported test results are a frequent cause of delayed diagnosis claims. Create a mechanism for tracking the results of tests that you've ordered, making sure that you receive them and promptly notify the patient of the results.
6. Don't check the chart when ordering medication. Each patient's chart should highlight any allergies and adverse reactions to medications. Charts should be double-checked for such warned before ordering meds.
7. Diagnose over the telephone. Diagnosis without examination is extremely risky. This speaks for itself and includes prescribing medication over the phone.
8. Don't care whether patients like you. Interpersonal skills are crucial in preventing lawsuits. The quality of the relationship can determine whether or not a patient files a lawsuit. Doctors need to talk with the patients and take time to listen to them.
9. Assume each patient only needs a few minutes. Time management pressures are condensing the length of doctor visits. This can cause some patients to feel neglected. If something goes wrong, they'll sue "because you didn't take enough time with them". Schedulers need to assess the needs of each patient and schedule appropriate appointment times.
10. Don't say anything if something goes wrong. Many lawsuits are filed because patients want to find out why something went wrong. To prevent such litigation, your office should have a clear policy on dealing with patients who suffer adverse medical events. The doctor, not a staff member, should explain the rationale for the treatment, why complications may have occurred and how they will be managed. Remember if the patient can't get an answer from the doctor, he/she may seek out the answer in an attorney's office. However, when talking with a patient, avoid using words like "mistake", "error", or "accident", etc. Apology should not include an admission of liability.