Obstetrics and Gynecology

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.
3.0 Credits

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.
2.5 Credits

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.
3.0 Credits

Professional Education
Safe and Effective Opioid Prescribing - Florida Edition
Note: this course includes information specific to physicians licensed to practice in Florida. Content is approved by the Florida Board of Medicine.
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.
2.0 credits

Professional Education
HIPAA Fundamentals: 2019-2020 Edition
This program provides details on the HIPAA Privacy, Security, and Breach Notification Rules, such as the type of information that is protected, who must comply with the rules, and how patient information can be used and disclosed. This on-demand program includes many resources useful to staff training.
1.0 credits

Aug 27, 2019
Electronic Health Records Continue to Lead to Medical Malpractice Suits
Darrell Ranum, JD, Vice President of Patient Safety and Risk Management
We analyzed 216 medical malpractice claims that closed from 2010 to 2018 in which EHRs contributed to patient injury. The pace of these claims grew, from a low of seven cases in 2010 to an average of 22.5 cases per year in 2017 and 2018. As EHRs approach near-universal adoption, they may become a more prevalent source of patient safety risk.

Aug 13, 2019
Reduce Patient Safety Risks with Vaccinations
Debbie Hill, MBA, RN, Senior Patient Safety Risk Manager, and Lisa McCorkle, MSN, CPHRM, Senior Patient Safety Risk Manager
Whether seeing patients for back-to-school immunizations or preparing adult patients for travel abroad, this article can help doctors assess the vaccine administration protocol in their practice to reduce risks and enhance patient safety.

Jul 10, 2019
Delay in Treatment of Fetal Distress
Larry Veltman, MD, FACOG, CPHRM, DFASHRM, and Darrell Ranum, JD, CPHRM, Vice President, Department of Patient Safety and Risk Management
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
David B. Troxel, MD, Medical Consultant to The Doctors Company
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
The Doctor's Advocate
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.
0.75 Credits

Professional Education
Ob/Gyn: Telephone Communications
Claims Corner CME
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.
0.5 Credits

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
Darrell Ranum, JD, CPHRM, Vice President, Patient Safety and Risk Management
The Doctors Company analyzed 1,215 claims filed on behalf of pediatric patients that closed from 2008 through 2017. The study is based on the claims filed against physicians in 52 specialties and subspecialties and includes an overview of the most common types of claims, expert insights into the specific elements that led to patient injury, and risk mitigation strategies.

Feb 15, 2019
Is Your Patient a Victim of Human Trafficking?
Amy Wasdin, RN, MBA, Patient Safety Risk Manager II
A visit to a physician or dental practice may provide an opportunity to help a human trafficking victim.

Jan 15, 2019
Maternal Injury and Death Closed Claims Study
By Darrell Ranum, JD, CPHRM, Vice President, Department of Patient Safety
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.

Nov 16, 2018
Opioid Addiction in Pregnant Women and Moms: How to Make a Difference
Hannah Snyder, MD, and Christine Pecci, MD
Treating pregnant women and mothers with opioid addiction calls for a well-informed approach to patient safety.

Oct 26, 2018
Patient Safety Tips for Obstetrics and Gynecology
Pamela Willis, BSN, JD, Patient Safety Risk Manager II
In obstetrics and gynecology, doctors can reduce potential liability by following risk management strategies, such as adopting an "induction checklist."

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.

Jul 27, 2018
Distracting Devices in Healthcare: Malpractice Implications
Shelley Rizzo, MSN, CPHRM, Patient Safety Risk Manager II
Digital distraction in healthcare is emerging as a great 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.

Professional Education
Distracted Practice in the Perioperative Area
The invasion of personal electronic devices (PEDs) into certain healthcare environments can put patients at risk. The perioperative area is an environment where distraction from PEDs can lead to patient injury or death. This activity provides tools and information for individuals to become aware of risks, to assess how PEDs impact their environment, and to develop preventive measures to control PED usage.
1.25 Credits

Jun 26, 2018
Conflicting Guidelines on Mammograms Can Pose Risks
David B. Troxel, MD, Medical Director, The Doctors Company.
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.

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.

Apr 25, 2018
A Complication Involving Laparoscopic Lysis of Adhesions
David B. Troxel, MD, Medical Director, Board of Governors
A medical malpractice case about laparoscopic lysis of adhesions involved negligent performance of surgery and mismanagement of postoperative care.

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.

Professional Education
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. 
2.25 Credits

Professional Education
Obstetrics: Spotlight on Preventing Claims
The Doctor's Advocate CME
This activity highlights The Doctors Company's insights into preventing obstetrical claims by sharing the most likely risks encountered by obstetricians and preventive actions that have proven effective at mitigating these risks.
1.25 Credits

Professional Education
Breast and Cervical Cancer Diagnosis
This activity, designed for providers who are actively involved in delivering women’s healthcare, presents lessons gleaned from The Doctors Company malpractice claims related to diagnosing breast and cervical cancers. It includes data analysis by experts and discussion of established best practices.
1.5 Credits

Aug 28, 2017
Obstetrical Closed Claims: What Can We Learn?
Robin Diamond, JD, RN, Senior Vice President, Department of Patient Safety and Risk Management, and Susan Shepard, MSN, RN, Senior Director, Patient Safety and Risk Management Education
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.

Apr 10, 2017
Latex Precautions in Obstetrics and Gynecology
Rosanne Cain, BSN, LHRM, Patient Safety/Risk Manager II
Recognizing latex allergies is an important patient safety precaution.

Mar 31, 2017
Case Summary: A Delay in Diagnosing Breast Cancer
Donald Wood CRNA, CPHRM, Patient Safety Risk Manager II, Department of Patient Safety and Risk Management
There are numerous reasons patients might be non-adherent with diagnostic testing recommendations. Many people fear a cancer diagnosis, especially breast cancer.

Mar 01, 2017
Weekend Call Presents Unique Challenges with Surrogate Birth
Amy Wasdin, RN, CPHRM, Patient Safety Risk Manager, Department of Patient Safety and Risk Management.
Communication among healthcare providers, patients, and adoptive parents is critical.

Feb 18, 2017
Up for Review: Five Keys to Managing Online Criticism
Kevin Pho, MD, Founder and Editor, KevinMD.com
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.

Nov 30, 2016
Watch for the Signs: Screen All Patients for Suicidal Thoughts
Robin Diamond, MSN, JD, RN, Senior Vice President of Patient Safety and Risk Management, The Doctors Company
Patients with suicidal thoughts or ideation appear occasionally in physician encounters. Any patient, no matter what issue is being treated and in any setting, could be at risk for suicide. A consistent and formal screening process, plus a response plan, will protect both the patient and the physician.

May 12, 2016
Obesity: A Common Comorbidity in Malpractice Claims
David B. Troxel, MD, Medical Director, Board of Governors
From The Doctor’s Advocate

May 01, 2016
Effective Obstetrical Team Communication
Cynthia Morrison, RN, CPHRM, Senior Patient Safety/Risk Manager
Effective communication requires a team effort for the exchange of concise and relevant information.

Dec 08, 2015
New Early Warning Criteria Could Reduce Maternal Mortality
Susan Mann, MD, The Doctors Company OB Advisory Board Member
Guest author Dr. Susan Mann reports on a new initiative to address the significant increase in maternal deaths.
From The Doctor’s Advocate

Jul 13, 2015
Shoulder Dystocia Documentation: Implementing a Protocol in Your Facility
Pamela Willis BSN, JD, Patient Safety Risk Manager.
Shoulder dystocia claims have traditionally been among the most problematic to defend.

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.

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.

Dec 20, 2013
Interactive Guide to Patient Safety for Office Practices
This interactive guide is designed to help you uncover areas of potential malpractice exposure in your practice.

Feb 01, 2013
Interactive Guide for Obstetrical Practices
This interactive guide is designed to help you uncover areas of potential malpractice exposure in your obstetrical practice.

Dec 14, 2012
Interactive Guide for Hospitals: Clinical Departments: Obstetrics (OB) Units
This guide can help uncover areas of potential malpractice exposure in the obstetrics (OB) unit.

Mar 01, 2008
Getting Sued for Breast Cancer
This article, originally published in The Doctor’s Advocate in 2001, was written by Chairman and CEO Richard E. Anderson, MD, FACP.
Suits involving breast cancer are the most common cause of malpractice litigation in the United States. This article lists the most common issues that lead to claims.

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