Medical Malpractice: A Physician’s Sourcebook

From our beginning nearly 30 years ago, The Doctors Company’s mission has been clear: to defend the rights of physicians as we protect the practice of good medicine. Today, we remain at the forefront of that debate, our success due in large part to the insight and commitment of our board members.

Four of our board members—Richard E. Anderson, M.D., F.A.C.P., Mark Gorney, M.D., F.A.C.S., Ann S. Lofsky, M.D., and David B. Troxel, M.D., F.C.A.P.––recently lent their expertise to a new resource for physicians, which we describe below:

Last quarter’s issue of The Doctor’s Advocateincluded the introduction to Medical Malpractice: A Physician’s Sourcebook, a comprehensive new book on the issues facing physicians today. This quarter, we’ll focus on the contents of the book and what makes it a valuable source of information for anyone concerned about the future of medicine.

Today’s doctors face challenges that those of a generation ago never imagined. As the medical liability crisis deepens, the constant threat of malpractice allegations has become an increasingly heavy burden for every physician. What is behind the crisis, and what can be done to alleviate it? What can physicians do to prevent being targeted? And what should they do if they are sued?

Medical Malpractice: A Physician’s Sourcebookbrings together a panel of physicians, attorneys, academics, researchers, and insurance industry experts to explore the origin, nature, and consequences of today’s crisis and to find solutions and alternatives to failures in the current system.

This ambitious project could not have come to fruition without Dr. Anderson’s multiple roles as editor, contributor, and collaborator and without contributions by Drs. Mark Gorney, Ann Lofsky, and David Troxel, who all provided key chapters.

Advocatereaders are familiar with Dr. Gorney’s column The Director’s Chair. A founding board member and the company’s medical director, he is professor emeritus of Plastic and Reconstructive Surgery at Stanford University. For Medical Malpractice: A Physician’s Sourcebook, Drs. Anderson and Gorney collaborated on “Insuring the Practice of Medicine,” a chapter that provides an overview of the fundamental principles of medical malpractice insurance.

Dr. Gorney’s chapter “Communication and Patient Safety” helps the reader understand the dangers of ineffective communication and recommends ways to minimize or avoid it altogether. In “Medical Liability in Plastic and Reconstructive Surgery,” Dr. Gorney outlines the procedures that most commonly generate plastic surgery claims and details the surgeon’s responsibilities for careful patient selection, preoperative disclosure, and documentation.

Ann S. Lofsky, M.D., a practicing anesthesiologist at Saint John’s Hospital in Santa Monica, California, is also a regular Advocatecolumnist with Case Closed!For Medical Malpractice: A Physician’s Sourcebook, Dr. Lofsky contributed “Anesthesiology,” a chapter on the leading causes for anesthesiology-related malpractice claims and newly identified risks. She addresses ways to prevent patient injuries and outlines ways to make anesthesia claims more defensible. This chapter also reviews advances in anesthesiology over the last 20 years and discusses how the anesthesiologist’s role has changed in recent years.

David B. Troxel, M.D., F.C.A.P., clinical professor of Health and Medical Sciences at the University of California, Berkeley, is secretary/treasurer of the Exchange. Drs. Anderson and Troxel worked together on “Breast Cancer Litigation,” the most common diagnosis in malpractice claims in the United States. This chapter details the factors that contribute to high claims frequency and includes a discussion of pathology claims involving breast biopsy and fine-needle aspiration.

Dr. Troxel also provides “Pap Smear Litigation,” a chapter that reviews The Doctors Company’s experience with cervical cytology claims and discusses recommended strategies for limiting Pap smear liability.

Dr. Anderson’s chapter, “The Case for Legal Reform,” will serve as a comprehensive reference in today’s debates over reform in medical malpractice litigation.

More than 15 authors, each recognized as an authority in his or her chosen field, contributed chapters covering:

• The ways a physician can successfully defend a medical malpractice lawsuit
• The physician’s role as expert witness or defendant
• The process of discovery and deposition
• How a plaintiff’s attorney views risk reduction
• The case for legal reform with suggestions for changes in medical-legal jurisprudence
• Broader problems of our health care system
• Public policy debate
• The threat to health care access
• Possibilities for legal reform

Medical Malpractice: A Physician’s Sourcebookis divided into four sections for easy reference:

Contents

Part I. Insurance

	1.	Insuring the Practice of Medicine, Mark Gorney and Richard E. Anderson

Part II. Legal

	2.	What Every Doctor Should Know About Litigation: A Primer on How to Win Medical Malpractice Lawsuits, Fred J. Hiestand
	3.	Risk Reduction From a Plaintiff Attorney’s Perspective, David Wm. Horan
	4.	The Physician As a Witness, Joel A. Mattison
	5.	The Judicial Process: Discovery and Deposition, Jonathan I. Epstein

Part III. The Clinical Face of Litigation

	6.	Communication and Patient Safety, Mark Gorney
	7.	E-Medicine in the Physician’s Office, Edward Fotsch
	8.	Risk Management for the Family Physician, Malcolm H. Weiss
	9.	Emergency Medicine, Michael Jay Bresler
	10.	Anesthesiology, Ann S. Lofsky
	11.	Malpractice and Medical Practice: Obstetrics and Gynecology, Jack M. Schneider
	12.	Breast Cancer Litigation, Richard E. Anderson and David B. Troxel
	13.	Pap Smear Litigation, David B. Troxel
	14.	Medical Liability in Plastic and Reconstructive Surgery, Mark Gorney

Part IV. Legal Reform and Health Care

	15.	The Case for Legal Reform, Richard E. Anderson
	16.	Health Policy Review: Medical Malpractice, David M. Studdert, Michelle M. Mello, and Troyen A. Brennan
	17.	New Directions in Medical Liability Reform, William M. Sage