(Condensation from an article in the 9/1/2006 issue of Medical Economics)
"Failure to diagnose" are three words that can be chilling to doctors who are charged with them. Although failure to diagnose has long been a leading cause of malpractice suits, a growing legal threat has raised the stakes creating even greater liability for doctors.
Under traditional malpractice rules, the doctor can only be held liable if the jury finds that the diagnostic failure was a "substantial" factor in the patient's injury or death. However, in an increasing number of states, courts have adopted a controversial doctrine called "lost chance of survival". Under this doctrine, a doctor can be held liable if his failure to diagnose a potentially fatal condition deprived the patient of a significant "chance" of survival. A plaintiff must still prove that the defendant physician breached the applicable standard of care.
The growing acceptance of the lost chance doctrine represents a real threat to primary care physicians, who are often the first line of defense in diagnosing serious medical conditions. It also provides an alternative means of compensation for malpractice plaintiffs whose cancer or other conditions should have been diagnosed earlier.
Whether or not your state's courts have adopted the "lost chance of survival" doctrine, the key issue in any malpractice defense is the question of negligence. Did the defendant physician fail to follow the accepted standard of care? Insurance industry studies of failure-to-diagnose cancer cases found that an alarmingly high percentage of paid claims involved defendants who simply didn't adhere to basic standards of practice.
"Preventing patient injuries and resulting litigation does not require physicians to take extraordinary measures", according to risk management consultant David Karp, "or to practice the kind of "defensive medicine" that most consider unnecessary.
Research indicates the importance of taking an adequate medical history, properly monitoring a patient's progress, ordering appropriate tests, managing medications and clearly documenting all treatment in the patient's chart. These standard risk management techniques still offer the best protection for patients and are the foundation for a successful malpractice defense.
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