Primary Care

Professional Education
Q&A - What Physicians Ask About Diagnosing and Treating Dementia
The Alzheimer's Project Series
This course focuses on the common concerns and questions expressed by physicians about dementia and cognitive impairment. This course covers making the initial observation of cognitive decline and beginning a conversation with older adult patients; overcoming common barriers to making a definitive diagnosis of dementia; and managing the ongoing clinical needs of patients experiencing dementia.
1.5 Credits

Jun 13, 2019
The Waning of the Physical Examination and Its Impact on Outcomes
Howard Marcus, MD, FACP
The physical exam should remain a central tool for evaluating and managing patients.
From The Doctor’s Advocate

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
Addressing and Managing Behavioral and Environmental Symptoms of Dementia
The Alzheimer's Project Series
The third course focuses on using the DICE (Describe, Investigate, Create Treatment Plan, and Evaluate) method to assess behavioral symptoms of dementia and to create effective treatment plans. The course also covers the careful use of medication during disease management, as well as common behavioral issues experienced by patients with dementia, including tools for management of these behaviors.
1.25 Credits

Professional Education
Addressing Patients and Families with End of Life Planning, Effective Communications, and Resources
The Alzheimer's Project Series
The fourth course covers important end of life planning topics and concepts, and tips for having these sensitive conversations with patients and family members. The course finishes with a focus on dementia community resources, effective communication strategies, and understanding when it is appropriate to make a referral to a specialist.
1.0 Credits

Professional Education
Use of Pharmacotherapy for Patients with Major Neurocognitive Disorder
The Alzheimer's Project Series
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 course focuses on the most frequently used prescription medications for Alzheimer's disease and dementias, the current research regarding its use, and guidelines for prescribing and discontinuing medication.
1.25 Credits

Professional Education
Pharmacological Management of Behavioral and Psychological Symptoms of Dementia
The Alzheimer's Project Series
This activity includes three video lectures and is the sixth in a series of courses that seek to educate clinicians on standardized screening, evaluation, and disease management of Alzheimer's and related dementias. This course focuses on the selection and appropriate usage of psychotropic prescription medications to manage the behavioral and psychological symptoms most frequently exhibited by patients with Alzheimer's and dementia diagnosis. This course activity includes three video lectures and covers the current research and guidelines for prescribing and for discontinuing use of these medications.
1.25 Credits

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 credit

Professional Education
Neurological Case Study: Management of the Surgical Patient
Claims Corner CME
This Claims Corner examines a neurosurgical case that alleges several failures to assess and treat a patient in a timely manner. It also highlights the importance of communicating with physicians and advanced practice providers involved with post-surgical care.
0.5 credits

May 13, 2019
Challenges of Cultural Diversity in Healthcare: Protect Your Patients and Yourself
Susan Shepard, MSN, RN, Senior Director, Patient Safety and Risk Management Education
Physicians often care for a multicultural society complicated by literacy issues. To address cultural diversity in healthcare, physicians must understand how each patient’s sociocultural background affects his or her health beliefs and behavior.

Apr 19, 2019
Rising Number of Measles Cases Creates Numerous Patient Safety Issues
Debbie Hill, RN, MBA, LHRM, CPHRM, Patient Safety Risk Manager
New cases of measles (rubeola) are once again making national headlines. Physicians should implement effective screening protocols, infection control techniques, and patient education to reduce liability risks and promote patient safety.

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.

Professional Education
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.
1.5 Credits

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.

Professional Education
Preventing Adverse Outcomes When Treating Children
The Doctor's Advocate
The Doctors Company studied claims filed on behalf of pediatric patients that closed over a 10-year period from 2008 through 2017. You are provided the most common types of claims and includes expert insights into the specific elements that led to patient injury, and risk mitigation strategies.
1.0 Credit

Professional Education
Pain Management and Appropriate Prescribing of Opioid Medication for Older Adults
This activity includes five video segments on effective pain management and appropriate prescribing of opioid medication for older adult patients. Presenters include a family practice physician, orthopedic surgeon, palliative care physician, and a pain management specialist provider.
1.5 Credits

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.

Dec 01, 2018
Employing Advanced Practice Providers: Balancing Benefits and Potential Malpractice Risks
Advanced practice providers (APPs), like physician assistants and nurse practitioners, perform both routine and complicated medical services for hospitals and medical practices across the country, improving patient access to healthcare. However, practices and hospitals that use APPs must also be aware of potential liability risks. Implementing effective risk management measures will help ensure that the benefits of using APPs are not at the expense of increased liability exposure.

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.

Video Oct 31, 2018
Threat of Global Epidemics: Surgeon General Speaks
There is a growing threat of global epidemics, including Ebola and Zika, and U.S. Surgeon General Vice Admiral Jerome M. Adams, MD, MPH, is working to address this threat and promote health through better community partnerships. He made his comments to attendees at The Doctors Company's 2018 Executive Advisory Board meeting.

Video Oct 31, 2018
Surgeon General's Priority: Partnering for Public Health
Community health and economic prosperity are connected, and healthcare professionals can partner with the business community to improve public health. This priority for public health was shared by U.S. Surgeon General Vice Admiral Jerome M. Adams, MD, MPH, with attendees at The Doctors Company's 2018 Executive Advisory Board meeting.

Video Oct 31, 2018
Fighting the Opioid Epidemic: Progress Report from Surgeon General
Programs for combatting the opioid epidemic, reducing overdose rates, and addressing other addiction epidemic issues (including heroin and fentanyl) are explored by U.S. Surgeon General Vice Admiral Jerome M. Adams, MD, MPH. His comments were made to attendees at The Doctors Company's 2018 Executive Advisory Board meeting.

Video Oct 31, 2018
Surgeon General's Strategies for the Opioid Epidemic
U.S. Surgeon General Vice Admiral Jerome M. Adams, MD, MPH, detailed some of the strategies, plans, and programs that can be effective in combating today's opioid epidemic when addressing attendees at The Doctors Company's 2018 Executive Advisory Board meeting. Topics include prescription drug monitoring programs, reasonable alternatives to opioids for acute and chronic pain management, medication-assisted treatment for those in recovery, and co-prescribing naloxone for those at risk of opioid overdose.

Video Oct 31, 2018
Surgeon General Addresses E-Cigarettes and Vaping
Vaping and e-cigarettes present a significant healthcare challenge for physicians today. U.S. Surgeon General Vice Admiral Jerome M. Adams, MD, MPH, addresses this issue and the fact that young people are susceptible to developmental delays and effects on the brain from vaping and e-cigarettes, which prime them for addiction up to age 26. His comments were made to attendees at The Doctors Company's 2018 Executive Advisory Board meeting.

Video Oct 31, 2018
Naloxone to Fight the Opioid Epidemic: Surgeon General's Perspective
Co-prescribing naloxone can help turn around opioid overdose rates and is an important first step in fighting the opioid epidemic, says U.S. Surgeon General Vice Admiral Jerome M. Adams, MD, MPH. His comments were made to attendees at The Doctors Company's 2018 Executive Advisory Board meeting.

Oct 30, 2018
U.S. Surgeon General Discusses Public Health Issues
United States Surgeon General Vice Admiral Jerome Adams, MD, MPH, discusses how vaping and e-cigarettes present a significant healthcare challenge for physicians, as well as how changes in healthcare payment models are increasing the focus on public health.

Oct 30, 2018
U.S. Surgeon General Discusses the Opioid Epidemic
United States Surgeon General Vice Admiral Jerome Adams, MD, MPH, discusses the opioid epidemic’s huge impact and strategies to combat it, including prescription drug monitoring programs, medication-assisted treatment for those in recovery, and co-prescribing naloxone for those who are at risk of opioid overdose.

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.

Sep 06, 2018
On Alert: What All Doctors Need to Know About Alzheimer’s Disease
Cynthia Morrison, RN, ARM, CPHRM, CPPS, Patient Safety Risk Manager, The Doctors Company
As the population ages, Alzheimer’s is becoming a more common cause of death. Early diagnosis of dementia, requiring the expertise of a neuropsychiatric physician who specializes in dementia, is essential to allow for maximum quality of life. Physicians of all specialties should become familiar with the early signs of this disease in order to refer patients with symptoms to a specialist for further testing.

Jul 27, 2018
Distracting Devices in Healthcare: Malpractice Implications
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.

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.

Jun 07, 2018
Team Synergy: A Critical Core Competency for Safe Care
Lisa McCorkle, MSN, MBA, Patient Safety Risk Manager, Department of Patient Safety and Risk Management
An account of one group’s efforts to create and sustain a team-oriented culture through teamwork training.
From The Doctor’s Advocate

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 Mar 26, 2018
Nurse Practitioners and the Changing Delivery of Primary Care
Increasingly, the growing need for primary care services will be met with nurse practitioners. The Doctors Company studied nurse practitioner medical malpractice claims over a six-year period and compared them to claims against primary care physicians (family medicine and internal medicine) to identify risk management issues that may be unique to nurse practitioners.

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.

Professional Education
The Alzheimer's Project
The goal of this series is to educate clinicians on standardized screening, evaluation, and management of Alzheimer’s disease and related dementias. The Doctors Company is pleased to support Champions for Health in training primary care physicians and other healthcare practitioners to diagnose and care for patients with Alzheimer’s or dementia.
Up to 9Credits

Video Jan 22, 2018
Internal Medicine: Innovations in Patient Safety
Howard Marcus, MD, an internal medicine physician in Austin, Texas, describes changes his practice made to improve patient safety based on the data and recommendations in The Doctors Company’s Internal Medicine Closed Claims Study. Thirty-nine percent of claims against internal medicine physicians are the result of a failure to diagnose. There are 8,000 possible diagnostic conditions, but the average primary care physician sees only about 400 per year—leaving a large number of diagnoses the physician sees only rarely.

Professional Education
Preventing Adverse Outcomes: Obstetrics
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. 
3.0 Credits

Oct 24, 2017
Give Your Patient Safety Culture a Check Up Using Assessment Survey
Robin Diamond, MSN, JD, RN, Senior Vice President of Patient Safety and Risk Management, The Doctors Company
Healthcare managers are making concerted efforts to cultivate a pervasive culture of patient safety. Creating a patient safety culture shifts the focus away from the blame game that punishes individuals for failures—which can increase liability over the long term—toward creating policies and procedures that cultivate an environment of openness and foster patient safety.

Professional Education
Diagnosing Breast and Cervical Cancers
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

Video Jul 24, 2017
The Opioid Epidemic: A Closed Claims Analysis
Opioids play an important role in pain management—both in the acute and chronic settings. Unfortunately, the dramatic increase in opioid use over the past few decades has resulted in an opioid-related epidemic of addiction and death. To take a deeper look at the epidemic, The Doctors Company reviewed 272 malpractice claims in which patient harm involved opioids.

Apr 17, 2017
Prescribing Opioids Safely: How to Have Difficult Patient Conversations
Roneet Lev, MD, Chief of Scripps Mercy Emergency Department, Chair of Prescription Drug Abuse Medical Task Force, and President of Independent Emergency Physicians Consortium
Drug overdose is the leading cause of accidental death in the U.S., and opioids account for over 60 percent of those deaths. Building a strong doctor-patient rapport can help facilitate tough conversations with patients about opioid prescriptions and reduce risks that could lead to malpractice suits.

Mar 16, 2017
San Diego Death Diaries
Roneet Lev, MD
Dr. Roneet Lev provides insights into the prescription opioid abuse epidemic.
From The Doctor’s Advocate

Mar 16, 2017
Analysis of Medication-Related Claims from The Doctors Company
David B. Troxel, MD, Medical Director, Board of Governors
Dr. David Troxel reviews 1,770 closed by The Doctors Company in which patient harm involved medication factors.
From The Doctor’s Advocate

Mar 01, 2017
Reduce Patient Safety Risks with Vaccinations
Debbie Hill, RN, MBA, CPHRM, and Lisa McCorkle, MSN, CPHRM, Patient Safety Risk Managers, The Doctors Company
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.

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.

Jan 25, 2017
Taking the Risks to Heart: Misdiagnosis of Heart Disease
Differences in the early symptoms and signs of an impending heart attack in women may make diagnosis more difficult compared to men.

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.

Oct 26, 2016
Optimize the EHR: Better Workflow Means Better Work-Life Balance
Chad Anguilm, Director of Professional Services, Medical Advantage Group. Medical Advantage Group is a wholly owned subsidiary of The Doctors Company.
There are tools that can streamline patient care and payment workflows in the electronic health record (EHR). By dedicating time and effort up front to optimize the EHR, physicians can get relief from administrative tasks, reduce duplicate entry of data, and save time by not having to search for records in multiple places.

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

Aug 26, 2015
Medical Malpractice and Preparticipation Sports Physicals
Michael C. Koester, MD, ATC, Slocum Center for Orthopedic and Sports Medicine.
Physicians should be aware of liability risks associated with preparticipation sports physicals.

Jul 08, 2015
Laboratory and Diagnostic Test Tracking in Ambulatory Practice
Dana Faber, RN, BS, Patient Safety Risk Manager.
Inadequate clinical laboratory and diagnostic test tracking is a top factor leading to patient injury.

Video Feb 23, 2015
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.

Dec 10, 2014
Editorial Comment on Maintenance of Certification
David B. Troxel, MD, Medical Director, Board of Governors
Dr. Troxel suggests ways to restructure the MoC examination process to adapt it to changes in the healthcare delivery system.
From The Doctor’s Advocate

Dec 02, 2014
Diagnostic Error in Medical Practice by Specialty
David B. Troxel, MD, Medical Director, Board of Governors
This closed claim review focuses on the variance between specialties in the incidence of diagnosis-related error.
From The Doctor’s Advocate

May 08, 2014
An Overview of Obesity-Related Malpractice Claims
Paul Nagle, ARM, CPHRM, Director, Physician Patient Safety
There has been an alarming increase in malpractice lawsuits that involve obese patients. Sensitive treatment of obese patients involves attending to their needs for comfort, safety, and respect.

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.

Nov 15, 2011
Diabetes Risk Management
Randy Linde, MD, a practicing endocrinologist in Palo Alto, California; updated by Howard Marcus, MD, FACP, Chair, Texas Alliance for Patient Access, and Chairman, The Doctors Company Texas Physician Advisory Board.
Diabetic patients pose unique risk management concerns for physicians.

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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