#Thread on Risk Management as regards Medical malpractice:
A few years ago, I was invited by the American Dental Association to speak on this topic. A few salient features of my talk follows. Please note not all may apply to India but at the end people are people everywhere!
A few years ago, I was invited by the American Dental Association to speak on this topic. A few salient features of my talk follows. Please note not all may apply to India but at the end people are people everywhere!
The most common reason patients consider legal action against dentists are:
1) Negative comment made by one dentist about work done by another dentist.
2) Patient feeling neglected and unable to reach the dentist for post operative issues, during or after office hours.
1) Negative comment made by one dentist about work done by another dentist.
2) Patient feeling neglected and unable to reach the dentist for post operative issues, during or after office hours.
3) Being chased for money owed for treatment that was unsatisfactory.
Points to learn:
1) Unless you were involved at every step pre, mid and post treatment refrain from passing negative judgement about other doctors. There is no way for anyone to know for sure what happened.
Points to learn:
1) Unless you were involved at every step pre, mid and post treatment refrain from passing negative judgement about other doctors. There is no way for anyone to know for sure what happened.
2) Always have a way for patients to reach you or someone covering you for 24-48 hours post procedure. Better still call them yourself to check on them. Have a second SIM card purely for practice use if needed.
3) Finances should be clearly discussed and mode of payment agreed
3) Finances should be clearly discussed and mode of payment agreed
on before the procedure, unless it’s an emergent situation. The worst thing to have to do is try to collect dues of the outcome has been very short of what was promised!
3a) Don’t over promise. Set realistic goals. Discuss worst case scenarios. Adverse outcomes. Plan B.
3a) Don’t over promise. Set realistic goals. Discuss worst case scenarios. Adverse outcomes. Plan B.
One tricky situation is when you find something after opening up that was not detected earlier (totally normal) and the patient has not given consent for the same. Discuss this possibility and set proactive measures to address it if needed.
A big myth is that a signed consent is like a shield which protects you from all possibilities listed on it. That’s FAR from the truth!
ANY patient can sue any doctor. The signed consent is basically a piece of paper. But without that, you have no defense!
ANY patient can sue any doctor. The signed consent is basically a piece of paper. But without that, you have no defense!
Sit down wirh the patient and one or more family members and discuss every point on that! Encourage questions and answer each one. Ask questions to ensure they have understood. Specially the really serious ones!
Most patients merely sign the paper and don’t really process it!
Most patients merely sign the paper and don’t really process it!
Patients are less likely to sue a doctor they like as a person and more likely to sue one whom they perceive in a negative light. Regardless of the outcome or treatment. So bedside manners, clear patient communication and simplicity of language are key!
Once again be there for
Once again be there for
your patient after the procedure and even after that! Make that visit or phone call! Sit down, look into their eyes and speak in a calm, clear soft voice!
Notes: they need tobe comprehensive, concise and thorough without rambling on.
Notes: they need tobe comprehensive, concise and thorough without rambling on.
Use the SOAP technique. (ncbi.nlm.nih.gov/books/NBK48226…)
Clearly mention the area of operation, diagnosis, treatment options, pros and cons, prognosis and then detailed description of the procedure.
Documenting follow up is very important!
Documenting non compliance of
Clearly mention the area of operation, diagnosis, treatment options, pros and cons, prognosis and then detailed description of the procedure.
Documenting follow up is very important!
Documenting non compliance of
Recommendations and communication to follow up is even more important! A cardiologist in Philadelphia was sued by an expired patient’s family. He had advised a stress test which the patient never got done. He died of a heart attack! He was sued for not following up on the lack
of the stress test! A simple call and email is usually sufficient. May be one more email a month or so later or whatever is average ok wait time.
Take time to understand your malpractice policy. Know steps to be taken if you suspect a lawsuit. Phone number to call, person to
Take time to understand your malpractice policy. Know steps to be taken if you suspect a lawsuit. Phone number to call, person to
ask for. Don’t wait for the actual lawsuit. Often they can prevent one too!
Remember patients are placing the ultimate trust in us! Whether it’s with a tooth or their heart! They want to feel assured you took proper care of them without being impersonal or commercial!
Remember patients are placing the ultimate trust in us! Whether it’s with a tooth or their heart! They want to feel assured you took proper care of them without being impersonal or commercial!
This is a full day lecture which I have tried to compress into a thread! Hope each one of you got something out of it! If you did, please share and tag those whom you feel will benefit from this! Feel free to reach out with questions!
At the end,we are blessed to do what we do!
At the end,we are blessed to do what we do!
I certainly consider myself very fortunate when people sit in my chair and say “Doctor I trust you. Do what’s best for me!”
Nothing can come close to that in terms of work satisfaction!
#riskmanagement #malpractice #lawsuits #InformedConsent #documentation
Nothing can come close to that in terms of work satisfaction!
#riskmanagement #malpractice #lawsuits #InformedConsent #documentation
