Obstetrics and Gynecology
Professional Education
Safe Opioid Prescribing for Physicians and Dentists
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.
Oct 26, 2021
Identifying Malpractice Risks for Surgical Practices
Factors contributing to surgical claims are often related to assessment, communication, and documentation. Surgeons can improve outcomes by evaluating their supporting systems in the office and the locations where they operate.
Professional Education
Cervical Cancer Claims: A Review in Gynecology
Cervical 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.
Sep 29, 2021
Getting Sued for Breast Cancer Malpractice
Our closed claims data reveal that suits involving breast cancer are the most common type of cancer-related claim. This article lists the issues that most often lead to claims.
Sep 23, 2021
The Malpractice Experience of Obstetricians with Shoulder Dystocia: Preparation May Mitigate Risks With This Unpredictable Event
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.
Professional Education
Patient Relations: Spotlight on Challenging Situations
The Doctors Company’s dedicated patient safety risk managers deliver a wide range of expert services and resources to our members—including personal telephone consultations to help guide members through challenging situations. A recent review of our call data shows that “patient relations” and “patient termination” consistently appear as the top reasons that members request assistance. The following strategies can help prevent challenging patient situations and provide guidance if one occurs.
Jul 16, 2021
Obstetrics and Gynecology: Frequently Asked Patient Safety Questions
Our experts answer questions about topics in obstetrics and gynecology, including cesarean delivery on maternal request and screening mammograms.
Professional Education
Risky Practices: Hidden Liabilities Identified by Medical Office Assessments
Office practice assessments by The Doctors Company's patient safety risk managers uncover hidden liability risks, often exposing areas where patients can "fall through the cracks" and leave the practice vulnerable to a malpractice claim. Our Practice Risk INSIGHT, an assessment tool customized by specialty, zeros in on problematic areas. The assessments have been completed across a range of practice environments around the country—from small offices to practices that are part of large integrated delivery systems. In this course, we analyze the results of the Practice Risk INSIGHT assessments, highlight problem-prone areas and offer strategies to minimize liability.
Jun 11, 2021
Conflicting Guidelines on Screening Mammography Can Pose Risks
Breast cancer screening guidelines issued by national organizations and medical specialties have inconsistent recommendations about mammogram screening ages and intervals, which can create potential liability for delayed or missed diagnoses. Learn how to reduce these mammography risks.
Professional Education
Telehealth: Review Your Service Components
Many practices implemented telehealth overnight in response to pandemic restrictions on elective care. Practices already using telehealth saw huge increases in volume. This program presents a roadmap for practices to evaluate their telehealth implementation using the best practice tips identified herein and their own lessons learned.
May 18, 2021
Patient Safety Tips for Obstetrics and Gynecology
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
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.
Mar 29, 2021
Is Your Patient a Victim of Human Trafficking?
Although trafficking victims rarely find opportunities to interact with others, a visit to a physician or dental practice may provide an opportunity for a victim to receive help. Learn to recognize the signs of human trafficking and know what steps to take.
Professional Education
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 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.
Professional Education
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.
Professional Education
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.
Professional Education
Prevention of Diagnostic Error in Primary Care
Diagnostic errors occur often in primary care settings and can impact over 12 million outpatients annually. This is a top patient safety concern and a global burden. Significant patient harm can occur due to treatment delay, testing, or misdiagnosis. This course is an opportunity to promote awareness and visibility by identifying where these errors occur most often in the diagnostic process of care framework.
Professional Education
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.
Dec 08, 2020
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.
Professional Education
Medical Error Prevention
The purpose of this monograph and continuing medical education activity is to provide physicians with the most current information regarding the prevention of common performance and diagnostic errors.
Professional Education
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.
Professional Education
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.
Professional Education
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.
Professional Education
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.
Aug 28, 2020
Dispensing Sample Medications: Risk Management Strategies
If not carefully managed, sample medications can create issues that place patients and the practice at risk.
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.
Aug 06, 2020
Effective Obstetrical Team Communication
Effective communication requires a team effort for the exchange of concise and relevant information.
Professional Education
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.
Professional Education
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.
Jul 16, 2020
Delay in Diagnosing Breast Cancer: Case Summary
A delay in diagnosing breast cancer may result when a patient doesn’t follow through with diagnostic recommendations.
Jul 07, 2020
Weekend Call Presents Unique Challenges with Surrogate Birth
Communication among healthcare providers, patients, and adoptive parents is critical.
Jun 18, 2020
Moderate or Conscious Sedation in the Office Setting
Prevent patient injury when providing moderate sedation in the office by incorporating these patient safety and practice improvement strategies.
Professional Education
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.
Apr 16, 2020
Shoulder Dystocia Documentation: Implementing a Protocol
Shoulder dystocia claims have traditionally been among the most problematic to defend.
Jan 01, 2020
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.
Professional Education
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.
Professional Education
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.
Professional Education
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.
Professional Education
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.
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.
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.
Jun 13, 2019
An Analysis of Malpractice Claims by Physician Gender
A gender-specific analysis of 5,897 claims from six medical specialties.
From
The Doctor’s Advocate
Professional Education
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.
Professional Education
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.
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
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.
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.
Nov 16, 2018
Opioid Addiction in Pregnant Women and Moms: How to Make a Difference
Treating pregnant women and mothers with opioid addiction calls for a well-informed approach to patient safety.
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 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 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.
Mar 26, 2018
Nurse Practitioner Closed Claims: Risk Mitigation Strategies
Strategies to help nurse practitioners and physicians prevent patient injuries.
From
The Doctor’s Advocate
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.
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.
From
The Doctor’s Advocate
May 03, 2017
Guide to Patient Safety and Reducing Liability in Obstetrics and Gynecology
This topic-based guide to reducing liability in obstetrics and gynecology is an essential reference for obstetricians, gynecologists, family practitioners, and advanced practice providers who are actively involved in delivering women’s healthcare.
Feb 18, 2017
Up for Review: Five Keys to Managing Online Criticism
No matter how professional and caring a doctor you may be, eventually you will face criticism on the web. Here are five keys to managing that criticism.