Advanced Practice Clinicians

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Sep 09, 2024
Shoulder Dystocia Documentation: Implementing a Protocol
Pamela Willis, BSN, JD, Senior Patient Safety Risk Manager, The Doctors Company, Part of TDC Group
Shoulder dystocia claims have traditionally been among the most problematic to defend.

Aug 27, 2024
Adjusting Medications for Patients With Kidney Disease: Case Study
Melissa Nelson, RN, Senior Patient Safety Analyst, The Doctors Company
Strategies from our case examination can help practitioners ensure that patients with poor kidney function receive appropriately adjusted medication doses.
From The Doctor’s Advocate

Jul 31, 2024
Midwives, Are You Covered? 5 Questions to Ask About Professional Liability Insurance
Ginger Breedlove, PhD, CNM, FACNM, FAAN, Founder and Principal Consultant of Grow Midwives LLC and Member, TDC Group APC Advisory Board
Midwives face distinct, significant, and long-lasting liability risks, and providing excellent care is not enough to mitigate them. Careful consideration of liability coverage options is essential for midwives to protect their licenses, reputations, professional and geographic mobility, and long-term financial health.

Video Jul 10, 2024
Increasing APC Responsibilities Lead to New Care Models: How TDC Group Provides Support
In a time of worsening physician shortages, new approaches to primary care, home care, and elder care are essential. Thoughtful structuring of care teams can assist many specialties in maintaining or expanding access to care while containing costs, relieving burdens for physicians, and continuing to provide high-quality and attentive care. Learn more about these new care models and how TDC Group provides support from Laura Kline, Senior Vice President of Business Development for TDC Group.

Jul 02, 2024
Practitioner Refusal to Treat Vaccine-Hesitant Patients in the Office Setting
Patti L. Ellis, RN, CPHRM, Patient Safety Risk Manager II, The Doctors Company, Part of TDC Group
We offer expert strategies to help practitioners address patients who refuse or delay vaccines.

Video May 24, 2024
What Is One of the Keys to Alleviating the Physician Shortage?
The Association of American Medical Colleges (AAMC) predicts demand for medical services in the U.S. will grow much faster than physician supply, leading to an estimated physician shortage of between 54,100 and 139,000 by 2033. In primary care relief is coming for overburdened physicians, as APCs are among the fastest growing professions.

Professional Education
Healthcare AI: Peril or Paradigm?
This program provides nurses with an overview of the range of artificial intelligence models that can potentially be applied in healthcare, examples of regulatory and ethical AI guidance documents, and evidence-based discussions of risks and strategies to address the risks of using AI in healthcare.
1.5 credits

Mar 14, 2024
Simulation-Based Training Prepares Practitioners for High-Risk Events
Pamela J. Chambers, DNP, EJD, MSN, CRNA, CPPS, FAANA, Assistant Professor, Nurse Anesthesia Program, Rosalind Franklin University; Recent Two-Term Member, Board of Directors, National Board of Certification and Recertification for Nurse Anesthetists; Member, TDC Group APC Advisory Board
SIM-based learning benefits clinicians in a variety of specialties, but it is especially important for those who work in high-acuity, high-risk areas like anesthesia.

Jan 30, 2024
Patient Safety Strategies for Surrogate Births
Pamela Willis, BSN, JD, Senior Patient Safety Risk Manager, The Doctors Company, Part of TDC Group
Surrogate pregnancies present unique challenges that require planning and clear communication.

Dec 21, 2023
Suicide Prevention: Primary Care Is a Crucial Setting for Identifying Risk
Debra Davidson, MJ, CPPS, Senior Patient Safety Risk Manager, The Doctors Company
At any given time, some of your patients are having thoughts of suicide. Effective suicide prevention requires a comprehensive approach.

Dec 21, 2023
Medical Malpractice and the Volunteer Team Physician
Michael C. Koester, MD, Slocum Center for Orthopedic and Sports Medicine
Community physicians have long served as local high school team physicians. Michael C. Koester, MD, discusses the potential liability risks.
From The Doctor’s Advocate

Professional Education
Preventing Errors in Preoperative Clearance (Claims Corner)
Primary care providers (PCPs) routinely manage complex elderly patients with multiple comorbidities who require elective surgery. Errors can occur when providers are rushed, there is a lack of effective interoffice communication, and the patient has a low health literacy. Communication and care coordination issues are commonly noted among PCPs and consulting specialists. The Doctors Company has analyzed closed claims where PCPs have been held responsible for failures in surgical mismanagement, specifically preop clearance. This program will highlight the contributing factors identified in malpractice claims involving medical clearance and provide practice strategies for reducing liability risk.
0.5 credit

Professional Education
Cardiology–Business of Medicine: Lessons from Medical Malpractice Claims
This educational activity is from an article that was originally published in Cardiology Magazine in June 2023. The article explains the Three Ps—Prevent, Preclude, and Prevail—as key elements to reduce clinician risk related to malpractice litigation. This article reviews an actual cardiology closed claims lawsuit and applies the analysis of the Three Ps. It concludes by explaining the reasons the lawsuit was settled for a nominal amount.
0.5 credit

Professional Education
Shoulder Dystocia Clinician-Patient Disclosure
This enduring activity is designed to assist physicians and advanced practice clinicians (APCs) in enhancing their communication skills when disclosing a shoulder dystocia injury to patients and family members. This type of injury to the infant may, unfortunately, occur despite the best of care; however, effective physician-patient communication is an integral part of clinical practice and has been shown to positively influence outcomes by increasing patient understanding and trust.
0.5 credit

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.
0.5 credit

Oct 30, 2023
Off-Label Use: Patient Safety Implications
Kim Hathaway, MSN, CPHRM, Patient Safety Healthcare Quality and Risk Management Consultant, and Richard Cahill, JD, Vice President and Associate General Counsel, The Doctors Company
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.
0.2 credit

Professional Education
Cardiology Medical Malpractice Case Study: A Lesson in 'Three P' Analysis
Clinicians, such as primary care and cardiologists, who routinely evaluate and treat patients with cardiac conditions, may benefit from insight from a real cardiology closed claims lawsuit and what factors contributed to it. They will learn the concept of the “Three P” analysis as a strategy to minimize the risk of professional liability litigation. This educational activity explains the various issues that led to the filing of the lawsuit and why it was dismissed, such as good documentation, which is often a prevailing factor in successfully defending a professional liability lawsuit.
0.5 credit

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.

Professional Education
Empowering Patients Through Open Clinical Notes
This course focuses on the 21st Century Cures Act mandate for interoperability to support patients’ access to their health information. To comply with the information blocking rule, healthcare providers must ensure that they are not engaging in practices that constitute information blocking, such as restricting access to patient electronic health information, imposing unreasonable fees for EHI access, or failing to respond to requests for EHI in a timely manner.
0.5 credit

Professional Education
Patient Termination
This brief audio presentation will give healthcare providers information on how to mitigate their risk when terminating a patient relationship. The key topics covered include establishing patient expectations, what to do when expectations aren’t being met, special circumstances to consider prior to termination, and finally, the elements of the termination notice.
0.5 credit

Professional Education
HIPAA Fundamentals 2024 Edition
This on-demand program provides an orientation to the basic requirements of the Health Insurance Portability and Accountability Act (HIPAA) and resources for valuable staff training. HIPAA gives patients many rights concerning their health information. This program provides timely information on the HIPAA Privacy, Security, and Breach Notification Rules, such as the type of information that is protected, who must comply with the rules, and how patient information can be used and disclosed.
1.5 credits

Aug 01, 2023
Advanced Practice Clinicians: A Preventive Action and Loss Reduction Guide
Depending on the state, an APC may be permitted to practice autonomously, as part of a collaborative agreement, or under the supervision of a physician. Regardless of an APC’s practice status or employment arrangement, however, all individuals can be held liable for their own acts of negligence. Our preventive action and loss reduction guide can help APCs in every practice environment.

Aug 01, 2023
Obstetrics and Gynecology: Frequently Asked Patient Safety Questions
Pamela Willis, BSN, JD, Senior Patient Safety Risk Manager, The Doctors Company
Our experts answer questions about topics in obstetrics and gynecology, including cesarean delivery on maternal request and screening mammograms.

Jul 25, 2023
Pediatrics: Consider Car Window Hammers for Your Office Emergency Response Kit
Patti L. Ellis, RN, CPHRM, Patient Safety Risk Manager II, The Doctors Company
Seconds count if an infant, toddler, or young child is accidentally locked inside a hot vehicle. A car window hammer can be a lifesaving tool to include in an emergency response cart or kit.

Professional Education
Failure to Diagnose Congenital Asplenia Results in Tragic Patient Outcome (Claims Corner CME)
Referral process system failures can contribute to delayed diagnosis of serious conditions which can lead to severe consequences for patients. Problems can arise when referral is needed but is not initiated properly or timely, when the specialist does not ensure their recommendations are fully and clearly communicated back to the referring clinician, when the referring clinician does not understand or act on the specialist’s recommendations, or when the referring office fails to track their open referrals to ensure they have received all consultation reports. This program will examine a malpractice case involving all the above referral-related deficiencies, leading to a catastrophic result for the patient and significant liability for the involved clinicians. Risk management strategies will be provided for any practice to improve the referral process and to prevent similar tragedies from occurring.
0.8 credit

Professional Education
Prevention of Medical Errors Florida (2023–2025 Edition)
This activity is specific to Florida statutes and reflects regulations effective February 2022. 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 that reflect on the most common issues identified by Florida: wrong site surgery, surgery complications, cancer, gastroenterology conditions, cardiology issues, neurological issues, and adverse drug events, which will serve as the focal point of this patient safety and risk management course. 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 educational activity is to provide physicians with the most current information regarding the prevention of common performance and diagnostic errors.
2.0 credits

Professional Education
Risk Management 101 for Healthcare Professionals: Malpractice, Patient Relations, and Documentation
This is an introductory level course about basic risk management for practicing clinicians focusing on malpractice, patient communication, and documentation. Healthcare professionals new to practice and more experienced will learn the legal elements of a malpractice claim that must be proven for a plaintiff to prevail. We share communication strategies to enhance patient understanding, compliance, and satisfaction while reducing the risk of abandonment when ending patient relationships. We address the importance of documentation, share open notes strategies for success, and strategies to demonstrate quality of care and reduce risk. Documentation examples are provided, as are tips for electronic health record (EHR) and telehealth documentation.
1.5 credits

Jun 14, 2023
Medical Malpractice and Preparticipation Sports Physicals
Michael C. Koester, MD, Slocum Center for Orthopedic and Sports Medicine
Physicians should be aware of liability risks associated with preparticipation sports physicals.

Jun 13, 2023
Patient Safety Tips for Obstetrics and Gynecology
Pamela Willis, BSN, JD, Senior Patient Safety Risk Manager, The Doctors Company
These strategies can help you keep your patients safe and reduce potential liability. The tips highlighted here include tracking test results, documenting prenatal records, discussing birth plans, and managing noncompliant patients.

Professional Education
Loss Lessons: Practicing Out of Bounds
Unlicensed staff are vital to efficient patient flow in medical practice. Healthcare organizations have many tasks that are safely and effectively carried out by skilled unlicensed support staff every day. To reach such efficiencies with safety and reliability, careful attention must be given to scope of practice and state and local statutes regarding delegation and supervision. Policies and protocols that outline the scope of practice for unlicensed staff to follow independently, and when they must consult with licensed staff, help even the most talented of your staff understand their boundaries. This case illustrates how informal verbal guidelines can blur the lines and cause well-meaning staff to cross the boundary lines of their scope leading to misdiagnosis and death.
0.2 credit

Professional Education
Failure to Rescue a Recurring Post-Surgical Event (Claims Corner CME)
Claims arising from the perioperative experience are frequent, often preventable, and some of the costliest claims for physicians. One study of surgical claims conducted by The Doctors Company noted that about two out of three general surgeons have been involved in a medical malpractice suit.  Malpractice data consistently finds that the most serious and common post-operative complications are unrecognized intestinal puncture or perforation. Diagnostic error by surgeons involving unrecognized intestinal puncture or perforation of an organ can quickly lead to septic shock and death.
0.5 credit

Professional Education
You Have Been Served with a Malpractice Lawsuit or a Regulatory Action Notice: Now What?
Malpractice litigation and government regulatory and licensing oversight are inherent aspects of licensed healthcare professionals. The concern regarding malpractice litigation is well-founded, and regulatory and licensing actions can pose significant challenges. Therefore, clinicians must be prepared and knowledgeable about navigating legal notices and taking appropriate steps to ensure compliance. By participating in this program, they can effectively mitigate the impact of claims, complaints, or regulatory actions and safeguard their practice.
0.5 credit

May 22, 2023
Laboratory and Diagnostic Test Tracking in Ambulatory Practice
Dana Faber, MS PSL, RN, Senior Patient Safety Risk Manager, The Doctors Company
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.

May 17, 2023
Did Emergency Department Provider Fatigue Contribute to This Patient’s Death?
Lisa McCorkle, MSN, MBA, Senior Patient Safety Risk Manager, Department of Patient Safety and Risk Management
Practitioner fatigue and the rush to get things done when staffing levels are inadequate can lead to mistakes and poor patient outcomes.

Apr 25, 2023
Nonadherent and Noncompliant Patients: Overcoming Barriers
Richard Cahill, JD, Vice President and Associate General Counsel, The Doctors Company
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.

Mar 22, 2023
Remote Patient Monitoring: Considerations for Telehealth Care
Sue Boisvert, BSN, MHSA, Senior Patient Safety Risk Manager, The Doctors Company
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 07, 2023
Primary Care Innovations Can Deepen the Specialty
Megan Mahoney, MD, MBA, Professor and Chair, UCSF Department of Family and Community Medicine and Member, The Doctors Company Board of Governors
Dr. Megan Mahoney outlines ways that team-focused innovations in care models and technologies can help preserve depth in primary care, even as it faces a physician shortage.
From The Doctor’s Advocate

Professional Education
Loss Lessons: Recognition of Wernicke Encephalopathy
Wernicke encephalopathy (WE) is a syndrome commonly seen in patients with alcohol use disorder who do not take adequate thiamine. WE should be suspected in any patient with conditions that may lead to malnutrition in combination with any of the following symptoms: altered mental status ophthalmoplegia, ataxia, delirium, and hypotension. Considered a medical emergency, it must be reversed to prevent permanent deficits. This case illustrates a cascade of errors which led to permanent disability. Some practical interventions to quickly recognize and reverse the condition are offered following the case presentation, which will be helpful for gastroenterology/gastroenterologists, ophthalmology/ophthalmologists, and neurology/neurologists.
0.5 credit

Professional Education
Errors in Anticoagulation Management in the Dermatology Office (Claims Corner CME)
In reviewing closed malpractice claims, The Doctors Company has found an increased risk of claims in patients taking direct acting oral anticoagulants that undergo office-based dermatologic procedures. This case study highlights the factors contributing to the improper management of these patients, including errors in clinical judgment, anticoagulant management, and communication.
0.5 credit

Professional Education
Anesthesia Care: Preventing Dental Injury
Dental injury claims continue to make up almost a quarter of all anesthesiology claims (22 percent) with over 30 percent of tooth damage claims resulting in indemnity payments to the plaintiff. Due to the frequent occurrence of dental injury claims, anesthesia professionals must be aware of dental injury causes, preventive measures, and steps to take if injury occurs.
0.8 credit

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.
2.0 credits

Oct 20, 2022
Job Shadowing: Observers, Volunteers, and Students in Clinical Settings
Kim Hathaway, MSN, CPHRM, Patient Safety Healthcare Quality and Risk Management Consultant, The Doctors Company
Create guidelines to prevent practice risks, eliminate patient harm, and protect patient privacy.

Oct 18, 2022
Moderate or Conscious Sedation in the Office Setting
Julie Brightwell, JD, RN, Director, Healthcare System Patient Safety, Department of Patient Safety and Risk Management
Prevent patient injury when providing moderate sedation in the office by incorporating these patient safety and practice improvement strategies.

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.
1.0 credit

Sep 22, 2022
Mental Health Providers: Balancing Privacy With Public Welfare
Richard F. Cahill, JD, Vice President and Associate General Counsel, and Robert Morton, MAS, CPPS, Assistant Vice President, Department of Patient Safety and Risk Management, The Doctors Company
Since spring 2020, patients have reported ideation of harm with increasing frequency. These encounters create a moral dilemma for mental health providers, who must maintain provider-patient privilege while adhering to legal reporting obligations for protecting the public welfare.

Professional Education
Test Tracking and Referrals: Strategies for Advanced Practice Clinicians
Tracking of tests and consults is critically important in preventing diagnostic errors and preventing patient harm. The risk factors triggering an alleged malpractice claim were primarily related to the breakdown in clinical systems for test result management. Failures of systems often prevent providers from making timely and accurate diagnoses. Testing failures included test performance issues, misinterpretation of studies, receipt, and transmittal problems. Follow-up failures included lack of physician follow-up with the patient, referral management, inadequate provider to provider communication and patient noncompliance.
0.8 credit

Sep 16, 2022
Reduce Patient Safety Risks With Vaccinations, Including COVID-19
Debra Kane Hill, MBA, RN, Senior Patient Safety Risk Manager, The Doctors Company
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
Delayed Diagnosis of Malignancy: Case Review for Advanced Practice Clinicians
In reviewing closed malpractice claims, The Doctors Company identified delayed diagnosis of a malignancy as a reoccurring problem. The following highlights the importance of recognizing a spinal abnormality and recommending further follow up of a lesion seen on imaging. Contributing factors include misinterpretation of radiologic studies, narrow diagnostic focus, lack of communication, and failure to establish a differential diagnosis.
0.5 credit

Professional Education
Medication Management: Strategies for Advanced Practice Clinicians
Medication management is by far the area providers can make the most impact within the professional practice arena. Data from closed claims shows that medication management is a risky area, most importantly the monitoring of medications. Monitoring and management begin when the patient receives the medication until the patient is no longer on the medication. An effective medication management process is essential for safe patient care. Having current patient medication information will assist with subsequent prescribing and a plan of care.
1.2 credits

Professional Education
Preventing Dictation Errors for Advanced Practice Clinicians
Emergency medicine providers are increasingly using voice recognition programs, such as Dragon Direct Voice Recognition Program, to document encounters. In reviewing closed malpractice claims, The Doctors Company identified dictation errors as a significant patient safety risk factor. The following case highlights the importance of timely recognition of dictation errors to ensure accuracy of the permanent electronic health record (EHR). This is particularly important when using a voice recognition program to document encounters in the busy emergency department. In this case, the voice recognition system was Dragon Direct Voice Recognition Program.
0.5 credit

Professional Education
Delayed Diagnosis of Stroke: Case Review for Advanced Practice Clinicians
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. Factors contributing to delay diagnosis and treatment included failure to recognize the window (“last known well time”) for tissue plasminogen activator-clot buster (tPA) failure to order a stat MRI and neurology consult, failed communication among providers regarding changes of recurring symptoms of ischemic stroke, failure to appreciate new signs and symptoms of a stroke, and poor or inconsistent documentation. The National Academy of Medicine (NAM) has identified the top three causes of serious harm from diagnostic failure. Number one is ischemic stroke.
0.5 credit

Jul 21, 2022
Effective Obstetrical Team Communication
Pamela Willis, JD, RN, Senior Patient Safety Risk Manager, The Doctors Company
Effective communication requires a team effort for the exchange of concise and relevant information.

Professional Education
Managing Patient Information: Strategies for Advanced Practice Clinicians
This program covers the patient information system, specifically documentation of patient information in the medical record. Many times, insufficient documentation results in the provider not being able to find information needed to guide clinical decision-making. Adequate documentation will enhance patient care by ensuring that patients receive the care necessary and may prevent a missed or delayed diagnosis.
0.5 credit

Professional Education
Diversity, Equity, and Inclusion in Healthcare for Advanced Practice Clinicians
Diversity, equity, and inclusion of all patients can lead to better health outcomes in the community in which we work. Creating a culture of inclusion and understanding our own biases, will help us improve patient care. It is important to understand how we are the same and how we are different in language, education, race, ethnicity, gender, gender identify, sexual orientation, age, social class, physical ability, religion, political beliefs, and morals. Providers may not be aware of how diversity, equity, and inclusion problems can hinder their care and relationships with patients. Some states are requiring all clinical professionals to have continuing education on cultural and linguistic competency and implicit bias.
0.5 credit

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.
0.8 credit

Professional Education
Cervical Cancer Claims: A Review for Advanced Practice Clinicians
Cervical cancer medical negligence claims are reviewed over a 10-year period to identify the major case types in which the advanced practice clinician (APC) is the responsible party. The factors that contributed to those claims as identified by plaintiff and defense provider experts are discussed through case examples with learner questions. Risk mitigation strategies are identified to guide gynecologists in further providing the safest patient care and thereby improving their risk profile.
1.0 credit

Professional Education
Breast Cancer Claims: A Review for Advanced Practice Clinicians
Breast cancer medical negligence claims are reviewed over a 10-year period to identify the major case types in which the gynecologist is the responsible party. The factors that contributed to those claims as identified by plaintiff and defense physician experts are discussed through case examples with learner questions. Risk mitigation strategies are identified to guide gynecologists in further providing the safest patient care and thereby improving their risk profile.
1.0 credit

Professional Education
Hidden Liability Risks Identified by Medical Office Reviews: Risky Practices for Advanced Practice Clinicians
Office practice assessments by TDC Group'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 for advanced practice clinicians (APCs).
1.5 credits

Professional Education
The Advanced Practice Clinician–Patient Relationship: When Does it Begin and When Does it End?
This enduring program will assist the participant in understanding the principles which form the establishment of an advanced practice clinician (APC)–patient relationship, as well as the concerns which may result in the need for the APC to consider terminating the APC-patient relationship. Additionally, the concepts of providing patient-centered care will be presented for the learner’s consideration.
1.0 credit

Professional Education
Administrative and Regulatory Actions: Protecting Your Practice
Healthcare practitioners, including physicians, dentists, and advanced practice clinicians, need to understand the roles of their professional licensing board and state and federal agencies to protect the public.
0.5 credit

Professional Education
Team Physicians: Mitigating Liability Risks
Physicians serving as volunteer team physicians for high school or other community sports programs are often unaware of potential liability risks.
0.5 credit

Professional Education
An Introduction to Enhancing Patient Relations and Reducing Risks for Advanced Practice Clinicians
This enduring program is designed to assist advanced practice clinicians (APCs) with improvements in patient interactions by looking at how incorporating hospitality as a focus makes a difference. It has been developed to improve multiple facets of patient interaction.
1.5 credits

Professional Education
Clinical Presentations for Advanced Practice Clinicians: Failure to Diagnose Myocardial Infarctions
In reviewing closed malpractice claims, TDC Group 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.
0.5 credit

Professional Education
When Personal Relationships Interfere with the Standard of Care for Advanced Practice Clinicians
The Doctors Company rigorously analyzed 988 claims* against internal medicine physicians that closed from 2009–2018. Regardless of the outcome, all cases that closed from 2009–2018 were included in this analysis—an approach that helps better understand what motivates patients to pursue claims and gain a broader overview of the system failures and processes that result in patient harm.
0.5 credit

May 31, 2022
The Role of the Medical Assistant in Your Office Practice
Debra Kane Hill, MBA, RN, Senior Patient Safety Risk Manager, The Doctors Company
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
Delay in Diagnosing Breast Cancer: A Case Summary and Tips to Reduce Risk
Lisa M. McCorkle, MSN, MBA, Senior Patient Safety Risk Manager, Department of Patient Safety and Risk Management, The Doctors Company
A delay in diagnosing breast cancer may result when a patient doesn’t follow through with diagnostic recommendations.

Feb 23, 2022
Pediatrics: Addressing Social Determinants of Health and Adverse Childhood Experiences
Marcie Ward, RN, Senior Clinical Consultant, Medical Advantage, and Patti L. Ellis, RN, CPHRM, Patient Safety Risk Manager II, The Doctors Company
The role of the pediatrician, which encompasses the management of a child’s physical, behavioral, and mental health, is critical in preventing and mitigating childhood adversity and trauma.

Sep 29, 2021
Getting Sued for Breast Cancer Malpractice
Richard E. Anderson, MD, FACP, Chairman and Chief Executive Officer, The Doctors Company and TDC Group
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.

Sep 23, 2021
The Malpractice Experience of Obstetricians with Shoulder Dystocia: Preparation May Mitigate Risks With This Unpredictable Event
Jacqueline Ross, RN, PhD, Coding Director, Department of Patient Safety and Risk Management, The Doctors Company, Part of TDC Group; Larry Veltman, MD, FACOG, DFASHRM, Director, National Perinatal Information Center; and Peter S. Bernstein, MD, MPH, Professor and Program Director, Department of Obstetrics and Gynecology and Women’s Health, Maternal Fetal Medicine, Albert Einstein College of Medicine
Shoulder dystocia (SD) is a rare complication of vaginal delivery. The purpose of this study was to better understand factors that may contribute to medical malpractice claims with SD and to offer recommendations to practicing obstetricians regarding the management of SD.

Mar 29, 2021
Is Your Patient a Victim of Human Trafficking?
Amy Wasdin, RN, CPHRM, Patient Safety Risk Manager II, The Doctors Company
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.

Jan 29, 2021
Pain Management Closed Claims Study
Jacqueline Ross, RN, PhD, Coding Director, and Michelle Swift, RN, JD, Senior Patient Safety Risk Manager
The Doctors Company reviewed medical malpractice claims that closed between 2008 and 2018 and involved pain management physicians as the primary specialty responsible in the claim. That criteria identified 273 claims and lawsuits.

Jan 20, 2021
Implicit Bias Against Obesity: An Opportunity to Improve Patient Safety
Jacqueline Ross, PhD, Coding Director, Department of Patient Safety and Risk Management, The Doctors Company
Many patients with obesity delay seeking medical care because of previous negative experiences with healthcare providers.

Aug 25, 2020
Distracting Devices in Healthcare: Malpractice Implications
Shelley Rizzo, MSN, CPHRM, Senior Patient Safety Risk Manager, The Doctors Company
Digital distraction in healthcare is a threat to patient safety and physician well-being. Personal electronic devices can create a digital distraction so engaging that it consumes awareness, potentially preventing healthcare providers from focusing on the primary task at hand—caring for and interacting with patients.

Jun 15, 2020
Overview of Obesity-Related Malpractice Claims
Paul Nagle, ARM, CPHRM, Director, Department of Patient Safety and Risk Management
The Doctors Company continues to see an increase in lawsuits involving patients with obesity.

Apr 29, 2020
Patient Safety in Anesthesia Care
Julie Brightwell, JD, RN, Director, Healthcare System Patient Safety, Department of Patient Safety and Risk Management
Anesthesiologists can reduce potential liability by taking risk management steps, such as obtaining separate informed consent for anesthesia care.

Aug 27, 2019
Electronic Health Records Continue to Lead to Medical Malpractice Suits
Darrell Ranum, JD, Vice President of Patient Safety and Risk Management
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
Darrell Ranum, JD, CPHRM, Vice President, Patient Safety and Risk Management
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.

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