Internal Medicine
Dec 21, 2023
Suicide Prevention: Primary Care Is a Crucial Setting for Identifying Risk
At any given time, some of your patients are having thoughts of suicide. Effective suicide prevention requires a comprehensive approach.
Dec 05, 2023
Telehealth From the Field: Case Study Involving Remote Monitoring Problems
Remote patient monitoring technologies offer many benefits, but they also create potential malpractice risks.
Nov 15, 2023
Alzheimer’s Disease and Dementia: What Healthcare Practitioners Need to Know
Alzheimer’s disease, the most common cause of dementia, is the seventh-leading cause of death in the U.S. Early diagnosis provides important benefits to diagnosed individuals and their loved ones, caregivers, and society.
Professional Education
Missed Medical History Leads to Adverse Outcome (Claims Corner)
The Doctors Company has identified patient assessment issues and communication failure between providers as key contributors to malpractice claims. This dental case study describes how inadequate patient history taking and poor communication can lead to an adverse patient outcome. The lessons learned in this course are applicable to all healthcare professionals.
Oct 30, 2023
Off-Label Use: Patient Safety Implications
The standard for appropriate off-label use of medications and other products is what other similarly trained physicians would do, not what the manufacturer of the medication or product recommends.
Professional Education
Loss Lessons: Lithium Toxicity, Fine Tuning Medications Used in Behavioral Health
Lithium therapy can be used for bipolar affective disorders and in depressive disorders where other antidepressants have been unsuccessful. It is considered a “high-risk” drug due to its narrow therapeutic range and potential for overdose toxicity. This case illustrates the pitfalls that occurred resulting in litigation. It is followed by a discussion of the problems that could have been avoided by following safety guidelines for prescribing lithium.
Oct 01, 2023
Suicide and Crisis Lifeline: Call or Text 988
The National Suicide Prevention Lifeline is now 988, an easy-to-remember number for 24/7 crisis care.
Aug 02, 2023
Noncompliant Patients Increase Liability Risks for Practitioners
Practitioners face potential liability when patients do not follow up as instructed or refuse at-home help.
May 22, 2023
Laboratory and Diagnostic Test Tracking in Ambulatory Practice
Managing patient test results in ambulatory practices can pose a significant challenge. Establishing a standardized workflow to track results is a successful strategy for avoiding missed or delayed diagnosis that can lead to patient injury.
Apr 26, 2023
Curbside Consultations: Patient Safety and Legal Risks
Informal consultations are tempting to busy healthcare practitioners because they are convenient and speedy, but these situations also include inherent liability risks for the consulting practitioner.
Apr 25, 2023
Nonadherent and Noncompliant Patients: Overcoming Barriers
Nonadherent or noncompliant patient conduct (whether intentional or inadvertent) can adversely affect clinical outcomes, undermine the practitioner-patient relationship, and disrupt the operation of practice.
Apr 14, 2023
Postpartum Malpractice Claims: Understanding Preventable Harms and Socioeconomic Factors
Investigators reviewed 43 closed postpartum medical malpractice claims to develop clinical recommendations to decrease the risks of postpartum morbidity and mortality.
Mar 22, 2023
Remote Patient Monitoring: Considerations for Telehealth Care
Remote patient monitoring is advancing the safety and accuracy of telehealth by filling in some gaps and increasing the types of care that can safely be provided in the home.
Mar 13, 2023
Patient Safety Strategies for Gastroenterologists
Gastroenterologists can reduce potential liability with strategies that include conducting a thorough preprocedure patient evaluation and matching the facility and setting to the patient.
Professional Education
Prevention of Medical Errors (2023–2025 Edition)
Few medical errors are attributed to faulty medical judgment. More commonly, they are attributed to system failures inherent in healthcare delivery. By drawing on our professional liability closed claims data, we have identified common performance and diagnostic errors. We analyzed loss prevention measures in tandem with the elements necessary to conduct a credible and thorough root cause analysis to reduce system failures, respond to sentinel events, prevent medical errors, and improve patient safety. The purpose of this program is to provide clinicians with the most current information regarding the prevention of common performance and diagnostic errors.
Oct 24, 2022
Why Medical Clearance Is Really a Preoperative Evaluation
The goals of the preoperative evaluation are to determine the patient's level of risk and to identify opportunities to mitigate it.
Oct 20, 2022
Job Shadowing: Observers, Volunteers, and Students in Clinical Settings
Create guidelines to prevent practice risks, eliminate patient harm, and protect patient privacy.
Professional Education
Reducing the Risk of a Malpractice Claim
This enduring program is designed to assist physicians, dentists, and advanced practice clinicians, improve patient safety by providing information on how to implement a root cause analysis (RCA2) when a near-miss, or injury has been identified. Real cases serve as examples of how sustainable change can minimize human and environmental factors while decreasing system failures and reducing the risk of a malpractice claim.
Sep 16, 2022
Reduce Patient Safety Risks With Vaccinations, Including COVID-19
Vaccine administration is usually regarded as a simple office procedure, often performed without the direct supervision of the physician or a licensed professional. Although vaccinations are a routine procedure, physicians and staff should remain vigilant about patient safety considerations. Whether you’re seeing children for COVID-19 vaccinations or adults for travel abroad or general disease prevention, take time now to assess the vaccine administration protocol in your practice.
Professional Education
Alzheimer's 7: Questions and Answers - What Physicians Ask About Diagnosing and Treating Dementia
This activity consists of eight videos and is the seventh in a series of courses that seek to educate clinicians on standardized screening, evaluation, and disease management of Alzheimer's and related dementia. This course focuses on the common concerns and questions expressed by physicians about dementia and cognitive impairment. This course covers making the initial observation of cognitive decline and beginning a conversation with older adult patients, overcoming common barriers to making a definitive diagnosis of dementia, and managing the ongoing clinical needs of patients experiencing dementia.
Aug 26, 2022
Dispensing Sample Medications: Risk Management Strategies
If not carefully managed, sample medications can create issues that place patients and the practice at risk.
Professional Education
Alzheimer's 6: Pharmacological Management of Behavioral and Psychological Symptoms of Dementia
This is the sixth in the series of on-demand webinars training on screening, evaluation, and management of dementia. This webinar details how to discern the signs and symptoms of dementia from other psychiatric issues, and how to effectively treat these symptoms with pharmacological interventions.
Professional Education
Alzheimer's 5 : Use of Pharmacotherapy for Patients with Major Neurocognitive Disorder
This activity includes video lectures and is the fifth in a series of courses that seek to educate clinicians on standardized screening, evaluation, and disease management of Alzheimer's disease and related dementias. This fifth course focuses on the most frequently used and FDA-approved prescription medications for Alzheimer's disease and dementias, the current research regarding its use, and guidelines for prescribing and discontinuing medication. The program will incorporate cultural values and beliefs when creating and sharing the pharmacological care plan.
Jul 28, 2022
Defensible Medical and Dental Records
Patient records, which serve a critical function in healthcare delivery and routine clinical operations, can provide key evidence in the event of a professional liability action.
Professional Education
Preventing Diagnostic Error in Primary Care: Strategies for Advanced Practice Clinicians
Diagnostic errors occur often in primary care settings and can impact over 12 million outpatients annually. This is a top patient safety concern and a global burden among advanced practice clinicians (APCs). Significant patient harm can occur due to treatment delay, testing, or misdiagnosis. This course is an opportunity to promote awareness and visibility by identifying where these errors occur most often in the diagnostic process of care framework. Examples of some best practices for the diagnostic process involves a timely and accurate diagnosis, patient engagement, effective system processes, active follow up, and communication. The information in this course will focus heavily on prevention strategies related to the primary care setting.
May 31, 2022
The Role of the Medical Assistant in Your Office Practice
A medical assistant (MA) can be a valuable addition to an office practice, but MAs should not perform tasks outside their scope of practice.
Apr 01, 2022
Analysis of Cerebrovascular Accidents and Malpractice Claims
Because cerebrovascular accidents can happen at any time and in any location, it is imperative that all members of the healthcare team are able to recognize and respond to symptoms in a timely manner.
Professional Education
Burnout: Spotlight on System Changes
There is a national movement to address the systemic causes of clinician burnout. Read the article "Clinician Burnout: From a Crisis to a Movement" to learn ways that clinicians can create system change in their own work environments.
Nov 29, 2021
The Evolving Landscape of Diagnostic Errors—Challenges and Opportunities
Internationally recognized healthcare leader David E. Newman-Toker, MD, PhD, presents a compelling case example and shares key insights into transforming diagnostic accuracy.
From
The Doctor’s Advocate
Nov 15, 2021
To Measure and Reduce Diagnostic Error, Start With the Data You Have
Chief Medical Officer David L. Feldman, MD, MBA, FACS, recaps important recommendations by diagnostic safety expert Hardeep Singh, MD, MPH, for measuring and reducing diagnostic error.
From
The Doctor’s Advocate
Professional Education
Clinical Presentations Cause Delays: Failure to Diagnose Myocardial Infarction
In reviewing closed malpractice claims, The Doctors Company identified missed or delayed diagnosis of myocardial infarction (MI) in the ambulatory internal medicine setting as a reoccurring problem. This course highlights the importance of recognizing the varying clinical presentations of MI and contributing factors associated with failure to diagnose and treat. Assumptions, lack of a thorough history and physical, communication failures, and failure to recognizing atypical signs and symptoms are highlighted in this case study.
Professional Education
Delayed Diagnosis of Stroke
In reviewing closed malpractice claims, The Doctors Company identified diagnostic failure as a reoccurring problem and one of the top three leading allegations that result in malpractice claims. This failure often leads to a delay in treatment and causes significant harm to patients. The following highlights the importance of recognizing the signs and symptoms of a stroke.
Professional Education
Alzheimer's 4: Addressing Patients' and Families' Needs through the Disease Stages of Dementia
This activity includes seven video lectures and is the fourth in a series of four courses that seek to educate clinicians on standardized screening, evaluation, and disease management of Alzheimer’s disease and related dementias. This fourth course covers life planning through disease stages, assessing and assisting caregivers, improving communications, utilizing community resources, and end of life decision-making. These sensitive conversations with patients. The course finishes with a focus on dementia resources, effective communication strategies, and understanding when it is time to make a referral to a specialist.
Professional Education
Alzheimer's 2: Evaluation and Diagnosis of Alzheimer’s Disease and Related Dementias
This activity includes eight video lectures and is the second in a series of four courses that seek to educate clinicians on standardized screening, evaluation, and disease management of Alzheimer’s disease and related dementias. This second course introduces the Alzheimer’s project evaluation algorithm and evaluation instruments and focuses on differential diagnoses. Finally, the course discusses how to prepare and engage in a sensitive dementia diagnosis disclosure with patients and caregivers.
Professional Education
Alzheimer's 3: Addressing and Managing Behavioral and Environmental Symptoms of Dementia
This activity includes eight video lectures and is the third in a series of four courses that seek to educate clinicians on standardized screening, evaluation, and disease management of Alzheimer’s disease and related dementias. This third course focuses on using the DICE method to assess behavioral symptoms of dementia and create and evaluation treatment plans. This course also covers the careful use of medication during disease management as wells as common behavioral issues with dementia patients including tools for management of these behaviors.
Professional Education
Alzheimer's 1: Screening for Dementia Among Adults with Cognitive Decline
This activity includes eight video lectures and is the first in a series of four courses that seek to educate clinicians on standardized screening, evaluation, and disease management of Alzheimer’s disease and related dementias. This first course focuses on introducing the Alzheimer’s Project and highlighting the increasingly important role of primary care providers in dementia care. This course also introduces the Alzheimer’s Project cognitive impairment screening algorithm and screening instruments and covers addressing reversible conditions that may present similar symptoms to cognitive impairment.
Sep 29, 2021
Getting Sued for Breast Cancer Malpractice
Our closed claims data reveal that suits involving breast cancer are the most common type of cancer-related claim. This article lists the issues that most often lead to claims.
Aug 04, 2021
Cognitive Assessments in Primary Care: Preparation and Tools May Mitigate Diagnosis Risks
Recent reimbursement changes by the Centers for Medicare and Medicaid Services (CMS) allow primary care providers to meet their patients’ mental health needs and help build their practices by performing cognitive assessments.
Professional Education
The Need for Close Monitoring in Hyponatremia: Osmotic Demyelination Syndrome
In reviewing closed malpractice claims, The Doctors Company identified mismanagement of sodium levels during correction of severe hyponatremia as a serious problem that can result in catastrophic permanent neurological injury due to osmotic demyelination syndrome (also known as central pontine myelinolysis). This article highlights the importance of close monitoring of sodium levels during correction of severe hyponatremia, with a slow and controlled pace of sodium correction. Contributing factors discussed include clinical judgment with regard to rate of rise of sodium levels, patient monitoring, choice of practice setting, and communication between providers, especially at points of transition in care.
Professional Education
Risky Practices: Hidden Liabilities Identified by Medical Office Assessments
Office practice assessments by The Doctors Company's patient safety risk managers uncover hidden liability risks, often exposing areas where patients can "fall through the cracks" and leave the practice vulnerable to a malpractice claim. Our Practice Risk INSIGHT, an assessment tool customized by specialty, zeros in on problematic areas. The assessments have been completed across a range of practice environments around the country—from small offices to practices that are part of large integrated delivery systems. In this course, we analyze the results of the Practice Risk INSIGHT assessments, highlight problem-prone areas and offer strategies to minimize liability.
Professional Education
Telehealth: Review Your Service Components
Many practices implemented telehealth overnight in response to pandemic restrictions on elective care. Practices already using telehealth saw huge increases in volume. This program presents a roadmap for practices to evaluate their telehealth implementation using the best practice tips identified herein and their own lessons learned.
Mar 29, 2021
Is Your Patient a Victim of Human Trafficking?
Although trafficking victims rarely find opportunities to interact with others, a visit to a physician or dental practice may provide an opportunity for a victim to receive help. Learn to recognize the signs of human trafficking and know what steps to take.
Mar 08, 2021
Patient Safety Strategies for Dermatology
Take steps to reduce risks in dermatology by reviewing your practices and systems and implementing these strategies.
Jan 20, 2021
Implicit Bias Against Obesity: An Opportunity to Improve Patient Safety
Many patients with obesity delay seeking medical care because of previous negative experiences with healthcare providers.
Professional Education
Prevention of Diagnostic Error in Primary Care
Diagnostic errors occur often in primary care settings and can impact over 12 million outpatients annually. This is a top patient safety concern and a global burden. Significant patient harm can occur due to treatment delay, testing, or misdiagnosis. This course is an opportunity to promote awareness and visibility by identifying where these errors occur most often in the diagnostic process of care framework.
Jun 15, 2020
Overview of Obesity-Related Malpractice Claims
The Doctors Company continues to see an increase in lawsuits involving patients with obesity.
Aug 27, 2019
Electronic Health Records Continue to Lead to Medical Malpractice Suits
We analyzed 216 medical malpractice claims that closed from 2010 to 2018 in which EHRs contributed to patient injury. The pace of these claims grew, from a low of seven cases in 2010 to an average of 22.5 cases per year in 2017 and 2018. As EHRs approach near-universal adoption, they may become a more prevalent source of patient safety risk.
Mar 20, 2019
Study of Malpractice Claims Involving Children
The Doctors Company analyzed 1,215 claims filed on behalf of pediatric patients that closed from 2008 through 2017. The study is based on the claims filed against physicians in 52 specialties and subspecialties and includes an overview of the most common types of claims, expert insights into the specific elements that led to patient injury, and risk mitigation strategies.
Video Feb 23, 2018
What to Expect from Litigation: Dr. Johnson's Perspective
Dr. Jeffrey D. Johnson, a family physician in Corpus Christi, describes his experience defending himself against a medical malpractice suit involving a young man who committed suicide using prescription medication.