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.
Clinical Presentations Cause Delays: Failure to Diagnose Myocardial Infarction
In reviewing closed malpractice claims, The Doctors Company identified missed or delayed diagnosis of myocardial infarction (MI) in the ambulatory internal medicine setting as a reoccurring problem. This course highlights the importance of recognizing the varying clinical
presentations of MI and contributing factors associated with failure to diagnose and treat. Assumptions, lack of a thorough history and physical, communication failures, and failure to recognizing atypical signs and symptoms are highlighted in this case study.
Delayed Diagnosis of Stroke
In reviewing closed malpractice claims, The Doctors Company identified diagnostic failure as a reoccurring problem and one of the top three leading allegations that result in malpractice claims. This failure often leads to a delay in treatment and causes significant harm to patients. The following highlights the importance of recognizing the signs and symptoms of a stroke.
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.
Oct 18, 2021
Using Artificial Intelligence to Improve Radiology Workflow
Although artificial intelligence has the potential to enhance workflow improvements in radiology, its applications may also have downstream consequences that are not yet fully realized.
Alzheimer's – 4 Addressing Patients' and Families' Needs through the Disease Stages of Dementia
This activity includes seven video lectures and is the fourth in a series of four courses that seek to educate clinicians on standardized screening, evaluation, and disease management of Alzheimer’s disease and related dementias. This fourth course covers life planning through disease stages, assessing and assisting caregivers, improving communications, utilizing community resources, and end of life decision-making. These sensitive conversations with patients. The course finishes with a focus on dementia resources, effective communication strategies, and understanding when it is time to make a referral to a specialist.
Alzheimer's – 2 Evaluation and Diagnosis of Alzheimer’s Disease and Related Dementias
This activity includes eight video lectures and is the second in a series of four courses that seek to educate clinicians on standardized screening, evaluation, and disease management of Alzheimer’s disease and related dementias. This second course introduces the Alzheimer’s project evaluation algorithm and evaluation instruments and focuses on differential diagnoses. Finally, the course discusses how to prepare and engage in a sensitive dementia diagnosis disclosure with patients and caregivers.
Alzheimer's – 3 Addressing and Managing Behavioral and Environmental Symptoms of Dementia
This activity includes eight video lectures and is the third in a series of four courses that seek to educate clinicians on standardized screening, evaluation, and disease management of Alzheimer’s disease and related dementias. This third course focuses on using the DICE method to assess behavioral symptoms of dementia and create and evaluation treatment plans. This course also covers the careful use of medication during disease management as wells as common behavioral issues with dementia patients including tools for management of these behaviors.
Alzheimer's – 1 Screening for Dementia Among Adults with Cognitive Decline
This activity includes eight video lectures and is the first in a series of four courses that seek to educate clinicians on standardized screening, evaluation, and disease management of Alzheimer’s disease and related dementias. This first course focuses on introducing the Alzheimer’s Project and highlighting the increasingly important role of primary care providers in dementia care. This course also introduces the Alzheimer’s Project cognitive impairment screening algorithm and screening instruments and covers addressing reversible conditions that may present similar symptoms to cognitive impairment.
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.
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.
Aducanumab for Treatment of Alzheimer's Disease – Controversy and Appropriate Communications
Panel discussion among neurologists and geriatric psychiatrists to clarify controversial issues surrounding the FDA’s recent approval of Aducanumab for treatment of Alzheimer's disease, and appropriate messaging to patients and family members. Following their presentations, the panel experts will conduct a question-and-answer session.
Patient Safety in Spine Surgery
Spine surgery requires a series of best practice patient safety
interventions to reduce the frequency and severity of patient harm while
giving the care team the resources to mitigate such harm. Evidence-based clinical methods, pathways, and tools coupled with an evolving culture of patient safety through effective communication, teams, and teamwork has shown to reduce patient harm exponentially. Patient and clinical team experiences are enhanced while ensuring a learning culture is built that approaches surgery from both a technical and nontechnical approach alike.
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.
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.
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.
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.
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.
Diagnostic Radiology: Analysis of Closed Malpractice Claims
Studying diagnostic 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 in these, risk mitigation strategies can be developed and implemented reducing adverse patient outcomes and increasing patient safety.
Feb 03, 2021
The Importance of Clinical Health Information at the Point of Radiology Order
Having ready access to patients’ clinical information helps radiologists eliminate assumptions and apply their skills and expertise in rendering accurate interpretive reports.
Diagnostic Radiology: A Failure to Diagnose
In reviewing closed malpractice claims, The Doctors Company identified delayed diagnosis of a malignancy as a reoccurring problem. The following highlights the importance of recognizing a spinal abnormality and recommending further follow up of a lesion seen on imaging. Contributing factors include misinterpretation of radiologic studies, narrow diagnostic focus, lack of communication and failure to establish a differential diagnosis.
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.
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.
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.
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.
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.
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.
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 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.
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.
Feb 25, 2020
Artificial Intelligence's Promise for Radiology: Reducing Risks
Bradley N. Delman, MD, MS, discusses the findings in a recent study of malpractice claims against radiologists, how artificial intelligence (AI) may help reduce the risk of patient injury, and—despite the benefits—the concerns he has with AI.
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.
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.
Interventional Radiology: Communications and Assessments
Ensuring patient safety for any procedure requires communication between the diagnosing physician and the proceduralist. This includes ensuring all physicians are aware of pre-procedural testing that the proceduralist would need to adequately care for the patient and manage complications.
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.
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.
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.