Family Medicine/Primary Care Resources
Get risk management/patient safety resources and free accredited education opportunities for family medicine/primary care clinicians.
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Professional Education
Prevention of Medical Errors 2024 to 2026 (National)
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.
Professional Education
Prevention of Medical Errors 2024 to 2026 (Florida)
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. This course includes content specifically for Florida licensed practitioners.
Feb 27, 2025
Cognitive Assessments in Primary Care: Preparation and Tools May Mitigate Diagnosis Risks
As practices care for the increase in older patients and take advantage of the CMS billing rules, successfully integrating cognitive evaluations into a practice’s workflow without magnifying liability risks takes some preparation.
Jan 30, 2025
Off-Label Use: Patient Safety Implications
Once authorized, a drug product may be prescribed by a licensed healthcare practitioner for any use deemed appropriate based on the practitioner’s professional opinion. The governing standard is what other similarly trained practitioners would do—not what the manufacturer of the medication or product recommends.
Jan 15, 2025
Job Shadowing: Observers, Volunteers, and Students in Clinical Settings
Create guidelines to prevent practice risks, eliminate patient harm, and protect patient privacy.
Dec 17, 2024
Reduce Patient Safety Risks With Vaccinations
Take time to assess the vaccine administration protocols in your practice.
Dec 09, 2024
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.
Dec 05, 2024
Incidental Findings Can Lead to Malpractice Claims: Practice Protocols Can Help
If the ordering practitioner does not follow up, an incidental finding may lead to patient harm and result in a malpractice claim. The Doctors Company has completed a new analysis of medical malpractice claims against our members in which an incidental finding was identified as a contributing factor.
Dec 02, 2024
Wernicke’s Encephalopathy: An Underrecognized Risk of Using Semaglutide Medications
The explosion in the use of appetite-suppressing semaglutide medications has created rising concerns about a potential upsurge in cases of Wernicke’s encephalopathy.
From
The Doctor’s Advocate
Nov 15, 2024
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.
Nov 04, 2024
Mental Health Practitioners: Balancing Privacy With Public Welfare
Societal tension and an increase in demand for mental health services have resulted in unexpected consequences for healthcare practitioners.
Oct 21, 2024
Dispensing Sample Medications: Risk Management Strategies
If not carefully managed, sample medications can create issues that place patients and the practice at risk.
Oct 04, 2024
Detecting and Addressing Incidental Findings: Medical Malpractice Claims
With the use of current imaging technology, it has become more common to find abnormalities, or “incidental findings,” that are unrelated to the reason the imaging was ordered. This review of closed claims from The Doctors Company examines factors that contribute to missed incidental findings and offers strategies to improve follow-up and prevent patient harm.
Aug 27, 2024
Adjusting Medications for Patients With Kidney Disease: Case Study
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 02, 2024
Practitioner Refusal to Treat Vaccine-Hesitant Patients in the Office Setting
We offer expert strategies to help practitioners address patients who refuse or delay vaccines.
Professional Education
Alzheimer's 8: Dementia Update for PCPs: Disease-Modifying Medications Risks and Benefits
A panel of dementia specialists provide up-to-date information on new disease-modifying medications receiving FDA approval, but with specific candidate criteria. Practitioners will learn how these medications work, which of their patients may benefit, how to identify and address risks, and how to effectively communicate with patients and family members. [1.50 AMA PRA Category 1 Credits™, 1.50 Contact Hours (ANCC)]
Mar 01, 2024
Burnout and Litigation Against Primary Care Providers: Where Do They Overlap?
Certain trends in primary care suggest potential avenues for investigation into malpractice allegations. These include a worsening shortage of primary care physicians, an association between burnout and patient safety concerns, and the rise in both the number of women physicians and the rate of burnout among women physicians.
Jan 26, 2024
Q&A: Dr. Bob Wachter and Dr. Michael Chernew on Bolstering Primary Care and Making U.S. Healthcare Spending More Sustainable
Robert Wachter, MD, spoke with healthcare economist Michael Chernew, PhD, to discuss the economic and political forces impacting healthcare costs.
Jan 22, 2024
Fulfilling the Growing Need for Primary Care
Laura Kline, MBA, CPCU, Senior Vice President, Business Development, The Doctors Company and TDC Group, discusses how advanced practice clinicians are part of the solution to addressing the physician shortage.
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 21, 2023
Medical Malpractice and the Volunteer Team Physician
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.
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.
Professional Education
Safe Opioid Prescribing for Physicians and Dentists
This enduring activity meets controlled substances requirements for a national audience (not state-specific). Opioids play an important role in pain management—both in the acute and the chronic setting, but a variety of causes have contributed to an opioid-related epidemic leading to addiction and death. There has also been substantial misuse of opioids by prescription and by diversion. With the spotlight on the epidemic guidelines, regulations, studies, and solutions are emerging, including recommendations from the Centers for Disease Control and Prevention (CDC) that can address the epidemic and allow for effective and appropriate use of these drugs.
Professional Education
Safe Opioid Prescribing for Physicians and Dentists: Florida Edition
This enduring program meets current Florida-specific controlled substance requirements. Opioids play an important role in pain management—both in the acute and the chronic setting, but a variety of causes have contributed to an opioid-related epidemic leading to addiction and death. There has also been substantial misuse of opioids by prescription and by diversion. With the spotlight on the epidemic guidelines, regulations, studies, and solutions are emerging, including recommendations from the Centers for Disease Control and Prevention (CDC) that can address the epidemic and allow for effective and appropriate use of these drugs.
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.
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.
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.
Jul 25, 2023
Pediatrics: Consider Car Window Hammers for Your Office Emergency Response Kit
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
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.
Jun 14, 2023
Medical Malpractice and Preparticipation Sports Physicals
Physicians should be aware of liability risks associated with preparticipation sports physicals.
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.
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.
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.
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 24, 2023
Childhood Obesity: Communication Strategies for Healthcare Practitioners
Conversations about weight between healthcare professionals and pediatric patients and their parents can have profound, long-term effects on a child or adolescent.
Apr 01, 2023
Lessons in Preventing Button Battery Injuries
This article by Patti L. Ellis, RN, CPHRM, Patient Safety Risk Manager II, The Doctors Company, discusses important lessons learned and risk prevention strategies for button battery ingestion in children.
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 07, 2023
Primary Care Innovations Can Deepen the Specialty
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
Primary Care: Innovations for In-Depth Practice
Primary care is facing a physician shortage. How clinicians approach the evolution of primary care will determine whether it becomes a touch-and-pass specialty or whether it can remain a deep specialty built on strong relationships with patients. In this CME program, Megan Mahoney, MD, MBA, highlights practice redesign strategies to help meet the shortage with team-based care and the mindful application of new technologies.
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.
Jan 05, 2023
Five Key Concerns of Medical Professionals Post-Roe
In the wake of the Supreme Court ruling in Dobbs v. Jackson, which overturned Roe v. Wade, state restrictions are colliding with clinical judgment in ways unfamiliar to many medical professionals. Physicians and other healthcare providers are facing confusion and concern about how recent legal shifts affect them and their patients.
Dec 15, 2022
The Clinician Voice Post-Roe: Speaking Up for Standards of Care
The spillover effects of the Supreme Court’s Dobbs decision, which overturned Roe v. Wade, mean that many clinicians face uncertainty regarding which treatment practices are still legal in their state. Accordingly, they may be unsure how to communicate with patients, or uncertain regarding their role in their institution’s planning conversations.
Dec 13, 2022
Increased Risks of Delayed Care Post-Roe: Clinician Perspectives
In the wake of the Dobbs decision, which overturned Roe v. Wade, rapid changes in hospital protocols have at times amplified confusion over what is legally allowed when responding to ectopic pregnancy, miscarriage, or other obstetric complications. Clinicians in some states may feel pinned between their obligation to care for the patient and their obligation not to break the law.
Video Nov 18, 2022
What to Expect from Litigation: Dr. Grollo's Perspective
Dennis Grollo, MD, a family physician, describes a malpractice case against him involving a long-time patient and allegations of using an out-of-state pharmacy. Dr. Grollo worked as a team with his attorney and The Doctors Company claims specialist to provide a strong defense with the support of medical and phone records. In the end, the jury exonerated him.
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.
Professional Education
Delayed Diagnosis of Sepsis (Claims Corner CME)
In reviewing closed malpractice claims, The Doctors Company has identified delayed diagnosis and treatment of sepsis as a serious problem that can result in significant morbidity and mortality. This article highlights the importance of timely recognition of symptoms that point to a diagnosis of sepsis, and the need for quick initiation of treatment. Factors contributing to the delayed diagnosis and treatment of sepsis are discussed, including clinical judgment errors such as failure to note the importance of significant clinical symptoms, failure to seriously consider sepsis as high on the differential diagnosis, failure to use a sepsis recognition tool as an adjunct to the exam, failure to order appropriate tests to rule out sepsis before assuming another diagnosis, and failure to admit the patient to the hospital for treatment.
Professional Education
Alzheimer's 7: Questions and Answers - What Physicians Ask About Diagnosing and Treating Dementia
This course focuses on the common concerns and questions expressed by clinicians about dementia and cognitive impairment. Practitioners will learn more about 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. Experienced clinicians engage in conversation on how they handle delicate and difficult conversations with patients and their family members. Program participants will become knowledgeable of warning signs of dementia, gain proficiency in screening and evaluating adults for cognitive deficits, confidently disclose a diagnosis of dementia, and communicate next steps to patients and family caregivers, including safety issues, medications, and community resources. [1.50 AMA PRA Category 1 Credits™, 1.50 Contact Hours (ANCC)]
Professional Education
Alzheimer's 6: Pharmacological Management of Behavioral and Psychological Symptoms of Dementia
Join our self-paced educational program to learn to distinguish dementia symptoms from other psychiatric issues and treat them with pharmacological interventions. Improve recognition of behavioral problems in Alzheimer's and dementia patients, use the DICE psycho-behavioral model for medication decisions, and create treatment plans with behavioral and pharmacological strategies to refine your best practices for individuals with dementia. [1.50 AMA PRA Category 1 Credits™, 1.50 Contact Hours (ANCC)]
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. [1.75 AMA PRA Category 1 Credits™, 1.75 Contact Hours (ANCC)]
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.
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.
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
Delay in Diagnosing Breast Cancer: A Case Summary and Tips to Reduce Risk
A delay in diagnosing breast cancer may result when a patient doesn’t follow through with diagnostic recommendations.
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.
Aug 25, 2020
Distracting Devices in Healthcare: Malpractice Implications
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
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.