The Need for Close Monitoring in Hyponatremia: Osmotic Demyelination Syndrome
In reviewing closed malpractice claims, The Doctors Company identified mismanagement of sodium levels during correction of severe hyponatremia as a serious problem that can result in catastrophic permanent neurological injury due to osmotic demyelination syndrome (also known as central pontine myelinolysis). This article highlights the importance of close monitoring of sodium levels during correction of severe hyponatremia, with a slow and controlled pace of sodium correction. Contributing factors discussed include clinical judgment with regard to rate of rise of sodium levels, patient monitoring, choice of practice setting, and communication between providers, especially at points of transition in care.
Risky Practices: Hidden Liabilities Identified by Medical Office Assessments
Office practice assessments by The Doctors Company's patient safety risk managers uncover hidden liability risks, often exposing areas where patients can "fall through the cracks" and leave the practice vulnerable to a malpractice claim. Our Practice Risk INSIGHT, an assessment tool customized by specialty, zeros in on problematic areas. The assessments have been completed across a range of practice environments around the country—from small offices to practices that are part of large integrated delivery systems. In this course, we analyze the results of the Practice Risk INSIGHT assessments, highlight problem-prone areas and offer strategies to minimize liability.
Jun 18, 2021
Study of Emergency Department Diagnosis Case Type Malpractice Claims: Abstract
A study of diagnosis-type closed medical malpractice claims from care that occurred in the ED from 2014 through the second quarter of 2019 using closed coded claims from The Doctors Company.
Jun 14, 2021
Should You Offer Your Services as a Paid Medical or Dental Expert?
Consider these key questions before deciding to accept the role of paid expert witness. Functioning as an expert witness is not a role to be entered into lightly.
Telehealth: Review Your Service Components
Many practices implemented telehealth overnight in response to pandemic restrictions on elective care. Practices already using telehealth saw huge increases in volume. This program presents a roadmap for practices to evaluate their telehealth implementation using the best practice tips identified herein and their own lessons learned.
Jun 08, 2021
Coping with Litigation: Tips for Medical and Dental Professionals
The first step in alleviating the stress and uncertainty created by an allegation of medical or dental malpractice is to understand the litigation process and the defendant’s role during each step.
Breast Cancer Claims – A Review in Gynecology
Breast cancer medical negligence claims are reviewed over a ten-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.
Pain Management - A Closed Claim Analysis Looking at Risks and Lessons Learned
For the first time, The Doctors Company has published an analysis of lawsuits and claims filed against pain management physicians. This study completed in 2020 provides quantitative and qualitative information that a physician who practices pain management, including interventional approaches to treatment would find useful in mitigating the risks of unintended outcomes or harms. This study breaks down where most patient injuries occur, what those injuries are, and the lessons learned from those claims.
Apr 19, 2021
Why It’s Vital to Choose a Doctor-Owned Medical Malpractice Insurer
Choosing a medical malpractice insurer involves more than just reviewing the cost of premiums—physicians must consider which insurer has their best interests at heart. Consolidation in the industry has led to shareholder-owned companies acquiring doctor-owned companies and vice-versa. When an acquisition brings a doctor-owned company into the hands of shareholders, physicians have a prime opportunity to ask: Is this the type of insurer I want protecting my reputation?
A Deep Dive into Managing Orthopedic Risks (FORPG)
This course identifies the systems and processes that present risks for patient harm and have significant impact on patient outcomes in the orthopedic practice. The course draws from the results of the Orthopedic Office Practice Self-Assessments completed by The Doctors Company, members of the Florida Orthopedic Risk Purchasing Group, and from other orthopedic practices who are members of The Doctors Company.
Apr 09, 2021
Malpractice Claims from the COVID-19 Pandemic: More Questions Than Answers
The pandemic has raised pressing questions around preventive measures, vaccines, and safe treatment, but it has also obscured one key lingering uncertainty for medical professionals: Where are all the medical malpractice claims?
Interventional Radiology: Analysis of Closed Malpractice Claims
Studying interventional radiology malpractice claims provides an understanding of drivers of lawsuits and patient injuries that result. By analyzing these claims and identifying the contributing factors involved, risk mitigation strategies can be developed and implemented reducing adverse patient outcomes and increasing patient safety.
Video Mar 09, 2021
How Will COVID-19 Impact the Severity of Malpractice Claims?
Richard E. Anderson, MD, FACP, chairman and chief executive officer of The Doctors Company and the TDC Group of Companies, examines how COVID-19 will impact the severity of medical malpractice claims.
TeamSTEPPS® Teamwork Training in the Office Practice
This course provides an overview of the evidence-based TeamSTEPPS® concepts, tools, and strategies based on the four areas of 1) leadership, 2) mutual support, 3) situation monitoring, and 4) communication. TeamSTEPPS training provides teachable/learnable skills that improve
communication and teamwork among healthcare professionals in both acute care and ambulatory care environments.
Jan 29, 2021
Pain Management Closed Claims Study
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 28, 2021
Missed Diagnosis of Spinal Epidural Abscess
Spinal epidural abscess requires prompt diagnosis and treatment to prevent serious neurological complications.
Jan 26, 2021
Laparoscopic Lysis of Adhesions Leads to Missed Bowel Perforation: Case Study
Experts opine on the case of a patient who suffered a bowel injury during laparoscopic surgery. The discussion includes strategies for recognizing patients who might be at increased risk.
HIPAA Fundamentals: 2021 Edition
This on-demand program provides an orientation to the basic requirements of the Health Insurance Portability and Accountability Act (HIPAA). HIPAA gives patients many rights with respect to their health information.
HIPAA for Managers: The High-Level View
The program explores and defines HIPAA policies and procedures, business associate agreements, security assessment and analysis, training requirements, HIPAA compliance requirements, breach events, and informed consent.
Prevention of Diagnostic Error in Primary Care
Diagnostic errors occur often in primary care settings and can impact over 12 million outpatients annually. This is a top patient safety concern and a global burden. Significant patient harm can occur due to treatment delay, testing, or misdiagnosis. This course is an opportunity to promote awareness and visibility by identifying where these errors occur most often in the diagnostic process of care framework.
Dec 14, 2020
Before COVID-19, Outlier Medical Malpractice Verdicts Were Rising—What’s Next?
Severity—the average cost of a medical malpractice claim—continues its relentless increase. Though severity has been rising since at least the 1970s, in recent years we have seen a sharp increase in outlier verdicts, which exceed common policy limits and often set records for their venues. Before the pandemic, nearly all states had seen these extraordinarily large awards, but whether the pace of these awards will be affected by the pandemic is unknown. Some U.S. states have adopted limited liability protections for physicians during COVID-19, but those protections may be tested in the courts.
It's the Little Things: An Introduction to Enhancing Patient Relations and Reducing Risks
It's the Little Things is designed to assist medical practices 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.
Spotlight on Diagnosing PE/DVT
The overall incidence of venous thromboembolism (VTE) —including both deep vein thrombosis (DVT) and pulmonary embolism (PE) —is one case per 1000 patient years. Accurate and timely diagnosis of VTE can be improved with the use of diagnostic guidelines such as Wells criteria and scoring for both DVT and PE.
Nov 12, 2020
Cardiology Closed Claims Study
This review of 210 cardiology malpractice claims identifies the most common patient allegations and the specific factors contributing to patient injury.
Nov 06, 2020
Interstate Licensure for Telehealth Can Fuel Medical Practice Growth
Licensing restrictions have been eased to facilitate care during the COVID-19 pandemic, and the new normal of greater state-to-state cooperation for access to care may persist after the pandemic. Still, the savvy physician knows that many restrictions apply, and that understanding them reduces risk.
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. Approved by the Florida Board of Medicine—Controlled Substance Prescribing.
Prevention of Medical Errors: CME Risk Management Course for Florida Practices
This activity is specific to Florida statutes and reflects regulations effective February 2020. 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, Ob/Gyn related conditions, gastroenterology conditions, cardiology issues, neurological issues, and adverse drug events—that will serve as the focal point of this patient safety and risk management course.
Oct 13, 2020
COVID-19 Administrative and Medical Record Documentation: Prepare for Future Lawsuits
For months, physicians and practice managers have been in crisis mode due to COVID-19 and have faced daunting challenges daily. What the future holds relative to the evolution of COVID-19 remains unknown, but it is certain that litigation for COVID-related claims is on the horizon and will impact physicians in all medical specialties and practice models.
Oct 02, 2020
Oncology Closed Claims Study
The Doctors Company conducted a review of medical and surgical oncology claims that closed between 2012 and 2018. This study was based on claims and lawsuits filed against the more than 500 oncologists insured by The Doctors Company.
Cauda Equina Syndrome: A Failure to Diagnose
Failures of systems often prevent physicians from making timely diagnoses. Failures may result when patient assessments are incomplete, having a narrow diagnostic focus, or diagnostic test issues. Other factors that hinder timely diagnoses include failure to appreciate signs and symptoms, lack of consults, and failure to respond to repeated patient concerns/symptoms.
Sep 23, 2020
Advocacy Update: COVID-19 Medical Liability Protections
During the COVID-19 crisis, The Doctors Company has continued to advocate broadly for comprehensive liability protections for healthcare providers and facilities. Our advocacy efforts include protections for healthcare providers treating COVID-19 patients (or suspected COVID-19 patients) and for providers who have had to change the way they practice in response to emergency orders.
Sep 22, 2020
COVID-19 Is Changing Liability Risks and Litigation in Healthcare
Across the spectrum of care, healthcare delivery is changing as the COVID-19 pandemic continues, creating additional pressures to maintain patient safety and shaping new liability risks for hospitals, group practices, and solo physicians.
Sep 14, 2020
Hospitalist Closed Claims Study
This review of 238 closed hospitalist claims identifies top allegations and factors contributing to patient injury.
Telemedicine to Telehealth: Trends and Emerging Risks
This course explores challenges and risks such as privacy and security, licensure, and technology concerns that might instigate a malpractice claim. The risks overlay the inherent challenge of replicating the interaction of a traditional, in-person encounter between a provider and a patient, without compromising the standard of care. It also provides resources for clinicians and practice managers to consider when making decisions about deploying telehealth services or to improve existing services.
Diagnostic Cardiology Closed Claims Study: An Expert Analysis of Medical Malpractice Allegations
The specialty of cardiology is complex and has underlying vulnerabilities that can put patients at risk of injury and can increase liability for cardiologists and other clinicians who treat heart patients. Understanding common areas of liability and risk exposure are a valuable way to make effective practice improvements.
Jul 24, 2020
Medical Liability Protections for Healthcare Professionals Benefit Us All
Physicians and other healthcare providers who have made good-faith efforts to provide the best possible care under crisis conditions should be able to continue focusing on their patients and not have to live under the shadow of potential unwarranted litigation. While many states have extended targeted medical liability protections to healthcare providers, federal protection is essential.
Jul 24, 2020
COVID-19 Highlights Regulatory Impact on Practice of Medicine
Practically overnight, the practice of medicine was dramatically changed, both by the exigencies imposed by the COVID-19 global pandemic and by the governmental response to the medical crisis.
Making an Informed Consent an Informed Choice: Training for Healthcare Leaders
This activity is designed for healthcare professionals in leadership positions. It covers the principles of informed consent, crafting and disseminating an informed consent policy, and building systems to improve the informed consent process.
Making an Informed Consent an Informed Choice: Training for Healthcare Professionals
This activity, designed for doctors, nurses, and other providers, examines problems with the process of healthcare informed consent. It describes the principles of informed consent and highlights the benefits gained from a good informed consent process.
Jun 15, 2020
The Defensible Medical Record
Medical records play a pivotal role in the delivery of healthcare and serve a critical function in routine clinical operations.
Jun 04, 2020
Top 7 Insurance and Legal Questions for Resuming Medical Practice During COVID-19
We’ve heard from physicians that they are concerned about the risks involved in reopening their practices, resuming elective procedures, or otherwise resuming something closer to their usual patient interactions.
Physician-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 a physician-patient relationship, as well as the concerns which may result in the need for the physician to consider terminating the physician-patient relationship. Additionally, the concepts of providing patient centered care will be presented for the learner’s consideration.
May 18, 2020
New York Leads the Way in Providing Liability Protections to Health Care Workers
New York has taken the lead through executive and legislative action to protect its health care workers. These actions should serve as a model for other states to follow.
May 13, 2020
Did Emergency Department Provider Fatigue Contribute to This Patient’s Death?
Provider fatigue and the rush to get things done when staffing levels are inadequate can lead to mistakes and poor outcomes for patients.
General Surgery: Miscommunication and Inaccurate Documentation
Failures of systems often prevent physicians from making timely diagnoses. Failures may result when documentation is inconsistent or not thoroughly read. Other factors that hinder timely diagnosis include inadequate hand-offs or referrals.
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.
Analysis of Medical Oncology Claims
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.
Internal Medicine: When Personal Relationships Interfere with the Standard of Care
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
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 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.
Jul 18, 2019
How the Medical Malpractice System Influences Care
Richard E. Anderson, MD, FACP, The Doctors Company chairman and CEO, discusses how the medical malpractice system often burdens good physicians with years-long lawsuits—and shows how the cost of defensive medicine affects us all.
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.
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 Sep 27, 2018
Future of Healthcare: Physicians Won't Recommend Their Profession
The Future of Healthcare Survey of over 3,400 doctors shows physicians are disenchanted with practicing medicine, largely because of technologies and payment models they say are interfering with the doctor-patient relationship and their ability to provide quality care. Despite continuing volatility in the industry and resulting dissatisfaction, one of the predominant themes captured in this survey is the concern physicians share for their patients and the quality of the care they receive.
Video Sep 04, 2018
What to Expect from Litigation: Dr. Gupta's Perspective
Adverse outcomes sometimes occur even when physicians follow the standard of care and do all they can for their patients. This video, the third in a series showcasing actual claims experiences, highlights the stress and worry that accompany a medical malpractice lawsuit. Emergency medicine physician Dr. Malkeet Gupta recounts how being sued for medical malpractice affected him.
Video Aug 13, 2018
What to Expect from Litigation: Dr. Del Zotto's Perspective
This video, the second in a series showcasing actual claims experiences and providing physicians with insight about what to expect if they are sued for malpractice, features Dr. Thomas A. Del Zotto. He discusses the claim that was made against him and how the support of his insurer, his attorney, and expert witnesses helped him win his case.
Video Aug 05, 2018
What to Expect from Litigation: Dr. Nye's Perspective
Dr. Elizabeth R. Nye, an obstetrician and gynecologist in Chicago, describes how she defended herself against a medical malpractice lawsuit involving a complicated delivery that led to the death of the infant. Dr. Nye recounts the emotional impact of the lawsuit.
Video Jul 30, 2018
What to Expect from Litigation: Dr. Go's Perspective
This video features cardiologist Darlene M. Go. Dr. Go discusses the malpractice claim that was made against her and how the support of her insurer, her attorney, and expert witnesses helped her win her case.
Video Jul 06, 2018
Surviving the Medical Malpractice Litigation Process
Litigation Education Retreats, for members of The Doctors Company, help doctors facing lawsuits deal with the stress of litigation and become more effective and assured in court.
Jun 22, 2018
Sexual Harassment Allegations in Healthcare: Rising Risks
Healthcare providers are not immune from the growing number of reported incidents of alleged sexual harassment in the workplace. This article provides tips on how to protect physician practices from sexual harassment lawsuits.
Video Mar 21, 2018
What to Expect from Litigation: Dr. Wuest's Perspective
Thomas K. Wuest, MD, MMM, an orthopedic trauma surgeon in Eugene, Oregon, describes his experience defending himself against a medical malpractice suit involving a man who fell over 20 feet from a utility pole and sustained multiple injuries.
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.
Video Feb 23, 2018
What to Expect from Litigation: Dr. Johnson's Perspective
Dr. Jeffrey D. Johnson, a family physician in Corpus Christi, describes his experience defending himself against a medical malpractice suit involving a young man who committed suicide using prescription medication.
Video Feb 10, 2018
What to Expect from Litigation: Dr. Michelin's Perspective
Dr. David P. Michelin, a gynecologic oncologist in Traverse City, Michigan, relates his experience with a malpractice suit involving a hysterectomy and staging for uterine cancer.
Video Feb 04, 2018
Malpractice Case Studies: What Went Wrong? (Episode 1)
In these cautionary tales, attorneys discuss medical malpractice cases that went awry—and how physicians can protect themselves.
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.
Jan 24, 2018
You’ve Been Served: Lawsuit Survival Tips for Physicians
Although it’s a reality that the majority of physicians will face a medical malpractice claim in, few are prepared when served with a lawsuit.
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.
Oct 19, 2017
Overcoming the Stress of Malpractice Litigation: Solutions to Help Physicians Stay Healthy and Engaged
A malpractice lawsuit will generate an array of negative emotions, from self-doubt to high levels of stress and anxiety. But there are steps doctors can take to ease the strain.
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
Video Feb 08, 2017
What Doctors Need to Know About Being Sued (Episode 4)
Attorneys share their insight on how doctors can provide successful testimony and avoid inadvertently assisting the plaintiff's attorney.
Video Feb 08, 2017
What Doctors Need to Know About Being Sued (Episode 2)
Many physicians find it difficult to cope with the stress of a medical malpractice claim. In this video, attorneys provide tips for remaining focused during the litigation process.
Video Feb 08, 2017
What Doctors Need to Know About Being Sued (Episode 1)
The vast majority of doctors will face a medical malpractice lawsuit at some point in their career. Legal experts provide tips on how physicians can prepare to be an effective member of their own defense team.
Video Feb 08, 2017
What Doctors Need to Know About Being Sued (Episode 3)
This video explains why it's vital for physicians facing a medical malpractice claim to become an integral part of the defense team. Claims defense is most effective when the physician and attorney work together as a team—the attorney relies on the physician to be the medical expert, just as the physician should rely on the attorney to be the legal expert.
Sep 23, 2016
The Perils of Printing an Electronic Health Record
A design flaw in an electronic health record system led to a malpractice claim against our insured cardiologist.
The Doctor’s Advocate