General Surgery

APR 17, 2017
Prescribing Opioids Safely: How to Have Difficult Patient Conversations
Drug overdose is the leading cause of accidental death in the U.S., and opioids account for over 60 percent of those deaths. Building a strong doctor-patient rapport can help facilitate tough conversations with patients about opioid prescriptions and reduce risks that could lead to malpractice suits.

MAR 16, 2017
San Diego Death Diaries
Dr. Roneet Lev provides insights into the prescription opioid abuse epidemic.
From The Doctor’s Advocate

MAR 16, 2017
Analysis of Medication-Related Claims from The Doctors Company
Dr. David Troxel reviews 1,770 closed by The Doctors Company in which patient harm involved medication factors.
From The Doctor’s Advocate

FEB 23, 2017
Caring for the Hospitalized Obese Patient
By Paul Nagle, ARM, CPHRM, Director of Physician Patient Safety, and Shelley Rizzo, RN, CPHRM, Patient Safety Risk Manager II.
Hospitalists and facilities can reduce potential liability when caring for obese patients by taking risk management steps, such as additional monitoring for patients with OSA.

JAN 04, 2017
Patient Safety in Anesthesiology
Donald Wood, CRNA, CPHRM, Patient Safety Risk Manager II
Anesthesiologists can reduce potential liability by taking risk management steps, such as obtaining separate informed consent for anesthesia care.

OCT 25, 2016
Optimize the EHR: Better Workflow Means Better Work-Life Balance
There are tools that can streamline patient care and payment workflows in the electronic health record (EHR). By dedicating time and effort up front to optimize the EHR, physicians can get relief from administrative tasks, reduce duplicate entry of data, and save time by not having to search for records in multiple places.

SEP 20, 2016
Money Talks: Discussing Cost with Patients Before Treatment Is a Win-Win
The physician needs to be involved in making sure that the patient is informed and educated about the financial burden of surgical and medical treatments. Doing this before proceeding with treatment can help lower the risk of a malpractice claim even when the medical outcome doesn’t meet the patient’s expectations.

FEB 18, 2016
Are Decisions Shared?
Robin Diamond, JD, RN
There is a growing emphasis on patient-centered care and shared decision making in healthcare.
From The Doctor’s Advocate

OCT 26, 2015
Reducing the Risk of Retained Foreign Objects During Surgery
Medical RFI (radio frequency identification) chip technology is now available to track sponges and surgical towels used during a procedure.

SEP 03, 2015
Minimizing Surgical Errors
Jonathan Jones, MD
Guest author Jonathan Jones, MD, offers practical suggestions for avoiding surgical errors.
From The Doctor’s Advocate

SEP 03, 2015
Teamwork in the OR
Susan Shepard, MSN, RN
Susan Shepard, MSN, RN, describes the challenges of developing a high-functioning OR team.
From The Doctor’s Advocate

JUN 08, 2015
MAC/Sedation Fires Increasing
Susan K. Palmer, MD
Dr. Susan Palmer offers strategies for preventing MAC/sedation fires. Author: Susan K. Palmer, MD
From The Doctor’s Advocate

APR 20, 2015
Mid-level Practitioner Liability—Preventive Action and Loss Reduction Plan
This booklet can help practitioners avoid liability risks when hiring or working with mid-level practitioners.

MAR 14, 2015
Analyzing Bowel Perforation Claims
Darrell Ranum, JD, CPHRM, Vice President, Patient Safety and Risk Management
Darrell Ranum outlines findings from a recent analysis of bowel perforation claims. Author: Darrell Ranum, JD, CPHRM
From The Doctor’s Advocate

FEB 01, 2015
Patient Selection for Elective Procedures
Susan Shepard, MSN, RN
The patient selection process is a valuable tool for loss control, because many claims occur with patients who are not appropriate candidates for a procedure.

DEC 10, 2014
Editorial Comment on Maintenance of Certification
David B. Troxel, MD
Dr. Troxel suggests ways to restructure the MoC examination process to adapt it to changes in the healthcare delivery system.
From The Doctor’s Advocate

DEC 02, 2014
Diagnostic Error in Medical Practice by Specialty
David B. Troxel, MD
This closed claim review focuses on the variance between specialties in the incidence of diagnosis-related error.
From The Doctor’s Advocate

SEP 04, 2014
Conflicting Guidelines on Mammograms Can Pose Risks
Breast cancer screening guidelines issued by national organizations and medical specialties have inconsistent recommendations about mammogram screening ages and intervals, which can create potential liability for delayed or missed diagnoses. Learn how to reduce these mammography risks.

DEC 20, 2013
Interactive Guide to Patient Safety for Office Practices
This interactive guide is designed to help you uncover areas of potential malpractice exposure in your practice.

NOV 21, 2013
Medical Clearance Does Not Clear the Patient or Physician of Risks
"Medical clearance" is when a surgeon requests clearance before performing surgery on a patient. The goals of the assessment are to determine the level of risk and to identify opportunities to mitigate risk, with an exchange of information between the surgeon and the assessing physician.

OCT 03, 2013
Medical Clearance
Susan L. Marr, MSA, CPHRM
Medical clearance should involve an exchange of information between the surgeon and the assessing physician to mitigate risk to the surgical patient.

SEP 20, 2013
Avoid Missed or Delayed Diagnosis by Being Aware of Risks for BRCA-Based Breast Cancer
Physicians should be aware of the risk factors for BRCA gene-based cancer in order to identify those who need testing and to avoid delayed or missed diagnosis.

OCT 30, 2012
It Hurts: The Patient with Noncancer Pain
Susan Shepard, MSN, RN, and Howard Marcus, MD, FACP
Physicians who treat acute and chronic pain need to be comfortable and secure in their competency and cognizant of the correct dosing guidelines, which may have dramatically changed in the past decade.

DEC 20, 2011
A Complication Involving Laparoscopic Lysis of Adhesions
David B. Troxel, MD
Allegations in this case involving laparoscopic lysis of adhesions included negligent performance of surgery and mismanagement of postoperative care.

JUL 20, 2011
Keys to Patient Safety for Dermatology
Susan L. Marr, MSA, CPHRM
Doctors can reduce potential liability in dermatology by taking risk management steps, such as avoiding verbal prescription orders.

DEC 20, 2010
Fire Safety in the Surgical Suite
Susan K. Palmer, MD, and Ernest E. Allen
Besides conducting annual fire drills that include what to do if a fire occurs on a patient, it is also wise to review fire risks in high-risk procedures prior to the start of the surgical procedure.

JUN 22, 2010
Dilaudid-Related Morbidity and Mortality from Respiratory Depression
Howard Marcus, MD, FACP
Patient safety organizations and the FDA are focusing on ways to reduce patient harm from opioids.

JUN 01, 2006
Scar: The Trigger to the Claim
Mark Gorney, MD, FACS
A discussion with the patient about scarring is an important part of the preoperative disclosure process that helps prevent claims.

FEB 01, 2004
Surgery: Foreign Object Retention
John K. Cherry, MD, FACS
The retention of a foreign object within a patient's body cavity or incision after an operation is a source of avoidable litigation for surgeons and facilities.

MAY 01, 2000
Removing a Pigmented Skin Lesion
David Charles, MD
When considering treatment for any pigmented skin lesion, there is no substitute for accurate microscopic pathological confirmation prior to definitive treatment. The range of error in clinical as opposed to microscopic diagnosis can be as high as 50 percent.

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