Neurosurgery: Communications and System Failure Leading to Diagnostic Error (Claims Corner CME)
Failures of systems often prevent physicians from making timely diagnoses. Failures may result when needed equipment isn’t available or when access to a patient is difficult. System failures may result when there is a lack of coordination of appropriate care among providers, or when poor communication among providers leads to missed and delayed diagnoses.
Mar 11, 2020
Analysis of Medical Oncology Claims
We analyzed 101 medical oncology claims to examine common injuries, identify strategies for mitigating risk, and learn what drives claims.
The Doctor’s Advocate
Analysis of Medical Oncology Claims (The Doctor's Advocate CME)
An analysis of The Doctors Company's closed oncology claims reveals drivers related to diagnosis, care management, and medication management. In addition, the analysis identifies related drivers that are often the underlying reasons that patients file claims.
Feb 20, 2020
Anesthesiology Closed Claims Study
The Doctors Company studied 640 anesthesia medical malpractice claims that closed from 2007–2012 and 587 claims that closed between 2013–2018. These studies determined whether the number of patient injuries had decreased and to identify any new trends in claims involving anesthesia care.
Video Feb 04, 2020
Interventional Radiology Malpractice Claims Study
The Doctors Company analyzed 54 medical malpractice claims against interventional radiologists that closed from 2013 to 2018. Communication between patient and provider played a role in a quarter of these claims and was most often related to inadequate consent for invasive procedures. There was also a lack of consultation between physicians. The case in this video highlights these key issues.
Video Feb 04, 2020
Diagnostic Radiology Malpractice Claims Study
The Doctors Company analyzed 542 medical malpractice claims against diagnostic radiologists that closed from 2013 to 2018. Diagnosis-related claims were the most common case type, and malignant neoplasm of the breast was the most common missed diagnosis. The case in this video highlights these key issues.
Dec 20, 2019
Burnout Can Affect How Patients Communicate
If a physician appears burned out, patients may avoid asking questions for fear of adding to the stress.
Internal Medicine: When Personal Relationships Interfere with the Standard of Care (Claims Corner CME)
Physicians and dentists are often faced with the decision whether to treat friends and families without realizing the inherent risks in doing so. A review of one case will highlight some common circumstances and risks associated with the treatment of friends and family members.
Spotlight on Anesthesia Claims: Moving the Needle (The Doctor's Advocate CME))
In this course we will show how comorbidities complicated the delivery of good anesthesia care. And we will share how important a thorough history and physical is to identifying potential problems that occur in the administration of anesthesia care.
Dec 10, 2019
Analysis of Cerebral Vascular Accidents and Malpractice Claims
Physicians can improve patient prognosis by educating staff to recognize signs and symptoms of cerebral vascular accidents (CVAs).
Dec 02, 2019
Diagnostic and Interventional Radiology Closed Claims Study
The Doctors Company analyzed 596 medical malpractice claims against diagnostic and interventional radiologists that closed from 2013 through 2018, identifying the top allegations and factors contributing to patient injury.
Safe and Effective Opioid Prescribing - Georgia Edition
This three-hour learning activity provides instruction on controlled substance prescribing guidelines, recognizing signs of abuse or misuse of controlled substances, and controlled substance prescribing for chronic pain management, as delineated in Georgia Rule 360-15-.01. It also provides tools and resources to assist in educating staff and informing patients.
Prescribing Opioids Safely
Faced with an opioid-related epidemic that continues to bring addiction and deaths, it is important to define the role of opioids for both acute and chronic pain management. This activity spotlights the epidemic and presents the Centers for Disease Control and Prevention (CDC) guidelines, regulations, studies, and emerging solutions to address the epidemic and allow for effective and appropriate use of these drugs.
Safe and Effective Opioid Prescribing - Michigan Edition
This three-hour learning activity provides instruction on controlled substance prescribing guidelines, recognizing signs of abuse or misuse of controlled substances, and requirements delineated in Michigan’s law. It also provides tools and resources to assist in educating staff and informing patients.
Safe and Effective Opioid Prescribing - Florida Edition
The Doctors Company recognizes the opioid epidemic in this country. This course provides insights into the risks of opioid usage, as shown by malpractice claims, and how to reduce those risks both for your patient and for your practice. The course presents updated guidance from the Center for Disease Control and Prevention, Health and Human Services, and providers into clinical applications, tips and strategies which help you and your patients manage pain. The course covers alternatives to opioids but also recognizes that opioids have a place in medicine, for example in treating cancer patients. It covers lessons learned about their appropriate and safe use, how to reduce the dosage and duration of opioids to prevent addiction, and the patient education that is essential to ending the epidemic. The information contained in this CME activity applies to dentists.
Interventional Radiology: Communications and Assessments
Ensuring patient safety for any procedure requires communication between the diagnosing physician and the proceduralist. This includes ensuring all physicians are aware of pre-procedural testing that the proceduralist would need to adequately care for the patient and manage complications.
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.
Advanced Practice Providers Closed Claims: What Can We Learn?
A recent study by the Association of American Medical Colleges predicts that the U.S. would need an additional 95,900 doctors, 22,700 NPs, and 12,800 PAs immediately if healthcare use patterns were equalized across race, insurance coverage, and geographic location.
More understanding of the liability associated with APPs can help provide insight on the current situation and identify strategies that decrease risk, improve patient safety, and advance patient care.
Jul 10, 2019
Delay in Treatment of Fetal Distress
We studied claims alleging delay in treatment of fetal distress in the hope of reducing neonatal injuries.
Dementia Q&A: What Physicians Ask About Diagnosis and Treatment
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.
Physical Examination and Its Impact on Outcomes
Advancements in technology improve the timeliness and accuracy of many diagnoses but the technology does not replace a thorough physical examination. For some diseases, such as Parkinson’s disease, herpes zoster, cellulitis, and Bell’s palsy the PE is the only diagnostic tool available. This short course makes the case for reversing the downward trend for physical examinations.
Neurological Case Study: Management of the Surgical Patient
This Claims Corner examines a neurosurgical case that alleges several failures to assess and treat a patient in a timely manner. It also highlights the importance of communicating with physicians and advanced practice providers involved with post-surgical care.
Oral-Maxillofacial Surgery Informed Consent
Informed consent involves more than a patient signing a form. This activity explains how to enact an informed consent process based on best practices in dentistry and oral surgery.
Ob/Gyn: Telephone Communications
The most frequent inconsistent practice found in the Practice Risk INSIGHT assessments was telephone communication (22 percent not met). When appropriate and adequate systems are in place, the physician is less at risk for having a suit filed. This case-based study provides insights and risk management techniques to lessen the frequency and severity of such a claim.
Video Apr 09, 2019
Study of Malpractice Claims Involving Children
Patient safety risks when treating children vary depending on the patient’s age—but communication breakdowns between doctors and patients/families occur in malpractice claims for pediatric patients of ALL ages. Watch this important case study to learn more.
Psychiatry: Preventing Adverse Outcomes
The Doctors Company study of closed claims reveals areas of higher risk in outpatient psychiatry practices. Using this as a foundation, the course provides information to evaluate your practice and make changes to improve decisions about treatment, operational processes, reporting, and documentation.
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.
Jan 15, 2019
Maternal Injury and Death Closed Claims Study
Each year, 700 women die from complications related to childbirth in the U.S. This analysis of closed malpractice claims involving maternal injury and death identifies potential sources of patient injury and provides tools for enhancing safety in ob/gyn.
Video Jan 15, 2019
Postpartum Hemorrhage: Reduce the Risk of Maternal Death
Postpartum hemorrhage is the leading cause of maternal injury in medical malpractice claims. Darrell Ranum, JD, CPHRM, vice president of patient safety at The Doctors Company, explains how this condition results in injury or death and provides tips on how physicians and providers can reduce risks.
Video Jan 15, 2019
Preventing Maternal Deaths in the U.S.
Susan Mann, MD, discusses the three most common potentially preventable causes of maternal death identified by the CDC and the top factors that lead to patient injuries. She also provides tips for plans and precautions that all hospitals should put in place to prevent maternal death from postpartum hemorrhage, venous thromboembolism, and severe hypertension.
Video Jan 15, 2019
Preeclampsia/Eclampsia: Reduce the Risk of Maternal Death
Studying malpractice claims involving preeclampsia and eclampsia reveals the key factors leading to patient injury and steps that physicians and providers should take to reduce the risks of maternal injury or death. These results are shared by Darrell Ranum, JD, CPHRM, vice president of patient safety at The Doctors Company.
Saline Overdose Cases
This activity delivers insights from malpractice claims involving severe hyponatremia. The recommendations and strategies outlined here can help physicians avoid adverse outcomes when treating patients with this particularly difficult and complex condition.
Medical Error Prevention
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.
Nov 28, 2018
Plastic Surgery Closed Claims Study
We analyzed 1,438 malpractice claims against plastic surgeons to understand what motivates patients to pursue claims and gain a broader overview of the system failures and processes that result in patient harm.
Video Aug 29, 2018
Analyzing Malpractice Claims Improves Patient Safety
The Doctors Company Claims Analysis INSIGHT Service helps physicians figure out what is driving their medical malpractice claims, improve their ability to give better quality of care, and ultimately reduce claims. Pamela Willis, patient safety risk manager at The Doctors Company, and Tony Cardona, director of medical legal affairs for the Scripps Clinic/Scripps Medical Foundation, explain the process.
Prevention of Medical Errors
This activity is specific to Florida statutes and reflects regulations effective February 2018. It delves into the prevention of common performance and diagnostic errors including adverse drug events, wrong-patient/wrong-site/wrong-procedure, unintended retention of foreign objects, surgery complications, and sepsis. It also covers conditions related to respiratory, ob/gyn, cardiology, and cancer.
Video May 23, 2018
Hospital Obstetrics: Innovations in Patient Safety
Marcus Tower, MD, an obstetrician at the Cleveland Clinic’s Hillcrest Hospital in Cleveland, Ohio, describes important data and recommendations for patient safety revealed in The Doctors Company’s Obstetrics Closed Claims Study. The study helped the hospital adopt changes that address common pitfalls obstetrics professionals may face, including abnormal fetal heart rate tracings, postpartum and massive hemorrhage, and shoulder dystocia.
Video May 18, 2018
Obstetrics: Innovations in Patient Safety
Jay M. Berman, MD, FACOG, of the Wayne State University Physician Group in Detroit, Michigan, describes changes his practice made to improve patient safety based on the data and recommendations in The Doctors Company’s Obstetrics Closed Claims Study. The study provided a common understanding on which colleagues, hospital administrators, residents, and nursing staff were able to work collaboratively to make changes to reduce the risk of shoulder dystocia and obstetric hemorrhage.
Podiatry Risk Management
An analysis by The Doctors Company of closed podiatry claims revealed the prevalent risk factors that contributed to patient injury. The analysis showed that most claims result from errors in systems, rather than faulty medical judgment or performance. This activity helps podiatrists recognize risk exposures and take steps that reinforce a culture of patient safety in their practice.
Managing Orthopedic Risks
The activity examines the analysis of closed orthopedic claims from The Doctors Company and the Medical Professional Liability Association. Case studies highlight system errors and define strategies to prevent errors and reduce the risk of a malpractice claim.
Orthopedics: A Deep Dive into Managing Risks
This activity identifies the systems and processes that represent the highest risks for patient harm in an orthopedic practice. It reviews strategies known to reduce these risks and contribute to better patient outcomes.
Orthopedics: A Deep Dive into Managing Risks
This activity is designed for Florida Orthopedic Risk Purchasing Group (FORPG) members. Like our national version, it identifies the systems and processes that represent the highest risks for patient harm in an orthopedic practice. It covers the strategies known to reduce these risks and improve patient outcomes.
Mar 26, 2018
Nurse Practitioner Closed Claims: Risk Mitigation Strategies
Strategies to help nurse practitioners and physicians prevent patient injuries.
The Doctor’s Advocate
Video Mar 26, 2018
Nurse Practitioners and the Changing Delivery of Primary Care
Increasingly, the growing need for primary care services will be met with nurse practitioners. The Doctors Company studied nurse practitioner medical malpractice claims over a six-year period and compared them to claims against primary care physicians (family medicine and internal medicine) to identify risk management issues that may be unique to nurse practitioners.
Nurse Practitioner Closed Claims Study
The Doctors Company analysis of claims involving nurse practitioners revealed system failures and processes that result in patient harm. Nurse practitioners and physicians can examine risk mitigation strategies that, when applied, can improve patient safety and may prevent the injuries identified in the study.
Mar 09, 2018
Nurse Practitioner Closed Claims Study: Top Risks in the Changing Delivery of Primary Care
Our study of nurse practitioner medical malpractice claims, compared against family medicine and internal medicine claims, identifies the top patient safety risks that may lead to adverse events.
Orthopedic Risk Management
The activity is for members of the Florida Orthopedic Risk Purchasing Group (FORPG). Case studies highlight system errors and define strategies to prevent errors and reduce the risk of a malpractice claim.
Video Feb 12, 2018
Plastic Surgery: Innovations in Patient Safety
Phillip Haeck, MD, a plastic surgeon at the Polyclinic in Seattle, Washington, describes changes his practice made to improve patient safety based on the data and recommendations in The Doctors Company’s Plastic Surgery Closed Claims Study. The study revealed that 10 percent of claims against plastic surgeons involved a communication problem—miscommunication or failure to communicate between the doctor and staff or between the patient and doctor.
Spinal Epidural Abscess: A Case Study Review
Designed primarily for hospitalists and other physicians practicing in the hospital setting, this activity explores the problems associated with diagnosing and treating spinal epidural abscess. It defines the most frequent type of risk and the severity of losses, as well as strategies to overcome these risks.
Video Feb 04, 2018
Malpractice Case Studies: What Went Wrong? (Episode 2)
A malpractice attorney clearly explains why proper documentation is essential each time a physician sees a patient. Lack of documentation can lead to a lawsuit—don't make this mistake.
Video Jan 27, 2018
Why Doctors Get Sued: Malpractice Claims Trends (Episode 2)
Why do doctors get sued for malpractice? Defense attorneys share their insight on the leading causes of malpractice claims, and what physicians can do to protect themselves.
Video Jan 22, 2018
Internal Medicine: Innovations in Patient Safety
Howard Marcus, MD, an internal medicine physician in Austin, Texas, describes changes his practice made to improve patient safety based on the data and recommendations in The Doctors Company’s Internal Medicine Closed Claims Study. Thirty-nine percent of claims against internal medicine physicians are the result of a failure to diagnose. There are 8,000 possible diagnostic conditions, but the average primary care physician sees only about 400 per year—leaving a large number of diagnoses the physician sees only rarely.
Video Jan 12, 2018
Why Doctors Get Sued: Malpractice Claims Trends (Episode 1)
Defense attorneys share the biggest trends in medical malpractice claims: The physician-patient relationship is at risk, more claims are being brought against hospitals and institutions, and physicians are being deposed as fact witnesses in claims against hospitals.
Electronic Health Record Closed Claims Study
EHR-related claims have increased continuously over the past 10 years. This analysis of The Doctors Company's closed claims teaches doctors and their staff which factors related to EHRs lead to patient injuries and the steps to take to mitigate these risks.
Video Nov 27, 2017
Cardiology: Innovations in Patient Safety
Sandeep S. Mangalmurti, MD, JD, a cardiologist at Basset Healthcare in Cooperstown, New York, describes changes his practice made to improve patient safety based on the data and recommendations in The Doctors Company’s Cardiology Closed Claims Study. First, the study outlined the liability pitfalls of certain medications, particularly cardiovascular medications, which have inherent risks even when used correctly. As a result of the study, Dr. Mangalmurti seeks to manage anticoagulants more carefully and to be clear about who has responsibility for their administration.
Video Nov 06, 2017
How to Reduce the Safety Risks of EHRs
Don't just rely on technology. It is vital that you have processes in place for auditing, backing up, and cross-checking data in your electronic health record (EHR), according to Lily Talakoub, MD, FAAD, of McLean Dermatology and Skincare Center in McLean, Virginia, and The Doctors Company's EHR Closed Claims Study. Dr. Talakoub discusses the biggest risks identified in the study, including that imaging and labs are often not found or not followed up on in the EHR or errors with copy and paste, and shares the processes that her office uses to lessen these risks.
Obstetrics: Preventing Adverse Outcomes
This activity is based on The Doctors Company's guide to reducing patient safety risks in obstetrics and gynecology. It is intended to provide essential training for obstetricians, gynecologists, family practitioners, and advanced practice providers who are actively involved in delivering women’s healthcare.
Gastroenterology: Preventing Adverse Outcomes
This activity identifies the factors that contribute to patient allegations and injuries as revealed by closed claims involving gastroenterologists. It provides physicians with appropriate strategies for their practice that, if implemented, can improve quality and safety and positively affect patient outcomes.
Cardiology: Preventing Adverse Outcomes
This activity shares insights from an analysis of closed claims involving cardiology. It identifies the most common risks and the system and process improvements that enhance patient safety and mitigate factors that can lead to adverse events and lawsuits.
Video Oct 25, 2017
The Dangers of Templates in EHRs
The role of electronic health records (EHRs) as a contributing factor to malpractice claims has increased over the past three years—with incorrect use of templates being a top risk factor. This case study from The Doctors Company’s EHR Closed Claims Study illustrates that danger.
Oct 24, 2017
General Practitioners and Misdiagnosed Cardiovascular Disease
A study by The Doctors Company and CRICO Strategies found that a significant proportion of liability cases involving cardiovascular disease were due to errors of diagnosis and the real liability danger doesn’t come from unusual or ambiguous cases, but from the relatively straightforward ones.
Video Oct 23, 2017
The Dangers of Copy and Paste in EHRs
The role of electronic health records (EHRs) as a contributing factor to malpractice claims has increased over the past three years—with copy and paste errors appearing in 14 percent of these claims. These cases from The Doctors Company’s EHR Closed Claims Study illustrate that danger.
Plastic Surgery Closed Claims Study: Lessons Learned
The Doctors Company's analysis of 1,438 closed claims against plastic surgeons revealed what motivates patients to pursue claims. This activity helps physicians understand the system failures and processes that result in patient harm and implement strategies known to decrease the risk of injury and improve quality of care.
Internal Medicine Closed Claims Study: Lessons Learned
The Doctors Company analyzed 1,180 closed claims against internal medicine physicians to identify what motivates patients to pursue claims, where system failures and processes result in patient harm, and what strategies can be used to mitigate risk.
Hospitalist Malpractice Claims Study: Lessons Learned
The findings from The Doctors Company's study of 464 closed claims against hospitalists revealed what motivates patients to pursue claims, where system failures and processes result in patient harm, and what strategies can be used to mitigate risk.
Video Oct 03, 2017
Orthopaedic Trauma Surgery: Innovations in Patient Safety
Douglas W. Lundy, MD, MBA, an orthopedic trauma surgeon at Resurgens Orthopaedics in Atlanta, Georgia, describes changes his practice made to improve patient safety based on the data and recommendations in The Doctors Company’s Orthopedics Closed Claims Study. The study revealed that most claims against orthopedists do not reflect the quality of care, but the patient’s perception of the care. Many lawsuits stem from known complications of the procedure.
Video Sep 12, 2017
Emergency Medicine: Innovations in Patient Safety
Roneet Lev, MD, FACEP, chief of the emergency medicine department at Scripps Mercy in San Diego, California, describes changes her department made to improve patient safety based on the data and recommendations in The Doctors Company’s Emergency Medicine Closed Claims Study. The study identified the need for rapid recognition of stroke patients and treatment for tissue plasminogen activator (tPA).
Aug 28, 2017
Obstetrical Closed Claims: What Can We Learn?
These lessons learned from our analysis of closed obstetrical claims are part of our CME article series.
The Doctor’s Advocate
Aug 15, 2017
Objective Review of Potential Risks in a Medical Practice Can Be Beneficial
Ted Abernathy, MD, Managing Partner of Pediatric & Adolescent Health Partners discusses his experience with an assessment service offered by The Doctors Company which provided his practice with a comprehensive checkup of key areas and customized action plan.
Video Jul 11, 2017
Hospitalists: Innovations in Patient Safety
John R. Nelson, MD, an internal medicine hospitalist at Overlake Medical Center in Bellevue, Washington, describes important data and recommendations for patient safety revealed in The Doctors Company’s Hospitalist Closed Claims Study. The severity of injury is much higher in claims against hospitalists than those against other specialists.
Video Jun 13, 2017
Orthopaedics: Innovations in Patient Safety
Ralph A. Gambardella, MD, an orthopedic surgery and sports medicine specialist with the Kerlan Jobe Orthopaedic Clinic in Los Angeles, California, describes changes his practice made to improve patient safety based on the data and recommendations in The Doctors Company’s Orthopedics Closed Claims Study. Patient behaviors are a factor in over one-third of orthopedic claims.
Dec 29, 2016
Cardiology Closed Claims Study
This review of 429 cardiology malpractice claims identifies the most common patient allegations and the specific factors contributing to patient injury.
Video Sep 22, 2016
Why Plastic Surgeons Get Sued
Why do plastic surgeons get sued, and how do patients get injured? The Doctors Company’s study of 1,438 closed claims against plastic surgeons revealed the most common patient allegations and the most common factors that lead to patient injury.
Sep 21, 2016
Internal Medicine Closed Claims Study
This study of 1,180 internal medicine malpractice claims identified the most common patient allegations and the specific factors contributing to patient injury.
Video Sep 20, 2016
Why Internists Get Sued
Why do internists get sued, and how do patients get injured? The Doctors Company’s study of 1,180 closed claims against internal medicine physicians revealed the most common patient allegations and the most common factors that lead to patient injury.
Video Mar 03, 2016
Why Hospitalists Get Sued
A study of 464 claims against hospitalists that closed from 2007-2014 revealed leading patient allegations and the most common factors that lead to patient injury. The goals of the study were to alert hospitalists and patients to the most common risks and identify system weaknesses to encourage collaboration with hospital leadership to improve patient safety.
Mar 01, 2016
Hospitalist Closed Claims Study
This review of 464 closed hospitalist claims identifies top allegations and factors contributing to patient injury.
Aug 26, 2015
Orthopedics Closed Claims Study
The study of 1,895 orthopedics malpractice claims identified the most common patient allegations and the specific factors contributing to patient injury.
May 01, 2015
Tips for Reducing Medical Malpractice Claims in Obstetrics
The Doctors Company’s Obstetrics Closed Claims Study, a review of 882 obstetrical claims that closed from 2007-2014, revealed underlying vulnerabilities that place patients at risk and increase liability for doctors. These tips can help physicians address these risks.
May 01, 2015
Obstetrics Closed Claims Study
This review of 882 obstetrical claims identifies the most common patient allegations and the specific factors contributing to patient injury.
Apr 13, 2015
Emergency Medicine Closed Claims Study
The study of 332 emergency medicine malpractice claims identified the most common patient allegations and the specific factors contributing to patient injury. Download the study and the infographic.
Sep 19, 2012
Otolaryngology Closed Claim Study
A review of 211 otolaryngology claims to identify top allegations and factors contributing to patient injury.