An Ounce of Prevention
First in Patient Safety: Reducing Risk and Improving Patient Care for 50 Years
Summary
Our Patient Safety and Risk Management Department partners with clinicians and healthcare organizations to improve system processes and help keep patients safe.
When we say, “First in patient safety,” it’s not just a slogan—it’s an accurate description of the history of The Doctors Company.
In 1999, The Doctors Company established the medical professional liability insurance industry’s first-ever Patient Safety Department, focusing not only on reducing the risk of litigation but also on preventing patient harm and improving patient care. Risk management has been at the core of our services since our founding in 1976, but inspired by the work of physician and researcher Lucian Leape, MD, in the 1990s, we brought the principles of patient safety to medical malpractice insurance.
Dr. Leape believed the best way to reduce medical errors was not to punish individual clinicians, but to build systems where everyone on the healthcare team works together to make mistakes less likely. This revolutionary new focus directly aligns with our mission to advance, protect, and reward the practice of good medicine.
Founder and Medical Director Mark Gorney, MD, holding The Doctors Company’s “Risk Management Sourcebook” in 1990.
Partnering With Doctors for Safer Patient Care
The transition to a Patient Safety and Risk Management Department not only allowed us to grow the services and resources we offer to our members but to also partner with them and their practice staff in deeper ways.
“We played a key role in educating our member doctors and their staff on patient safety and its importance,” says Carol Murray, RHIA, CPHRM, Senior Patient Safety Risk Manager, who has been with the company for 27 years. “When we’d speak to doctors in their practices, we’d tell them, ‘If you keep your patients safe, you’re keeping yourself and your practice safe. It all blends together.’ They could speak about that with their patients, explaining that the systems in place are there for the patients’ protection and to help the practice take the best care of patients possible.”
“Before the evolution to the patient safety movement, healthcare conversations seemed to be hiding behind risk management,” says Julie Brightwell, BSN, JD, RN, CPHRM, Director, Patient Safety, who has been with the company for 19 years. “There was previously a lot of silence around adverse events, and evolving our focus toward patient safety allowed us to increase transparency among clinicians, hospitals, and patients. We are a safe space for physicians to discuss difficult issues so we can help them find ways to improve future care. Things can’t get better without being open about them.”
“Before I came to The Doctors Company, I was a malpractice claims investigator and provided risk management consulting services to hospitals and physicians,” says Kathleen Stillwell, MHSA, MPA, RN, CPHRM, Senior Patient Safety Risk Manager, who has been with the company for 19 years. “I would find when speaking with solo practice doctors that they didn’t have access to these types of services from their insurer or anyone else. Back then it was risk management—‘Someone messed up’—and not the patient safety focus of improving systems to prevent adverse events. So when I had the opportunity to join The Doctors Company, I was struck by the vision of leadership to make patient safety such a big focus and service for members of all practice sizes.”
We are truly partners with our members. Members can call their dedicated patient safety risk manager or the 24/7 on-call hotline to get immediate support for urgent issues, like a patient complication or potential adverse event.
Answering a member call in 1983.
“When they call, we want them to have the human touch right away,” says Dana Faber, MS PSL, RN, Senior Patient Safety Risk Manager, who has been with the company for 17 years. “Often when a member calls, they are in a stressful situation, and we provide both advice for next steps and support for them emotionally. We have many touch points with them as their patient safety risk manager to get to know them and their practice, and that builds the relationship so that they feel comfortable coming to us when things are challenging.”
Growing Our Services: From Packets to an Industry-Leading Resource Library
Today, the Patient Safety and Risk Management Department has nationwide patient safety risk managers to support members wherever and however they practice, with online resources and on-site practice visits. This personalized approach allows us to craft individual risk reduction plans to meet each practice’s unique needs.
“In the beginning, we were just answering calls and putting together resource packets for our members—it wasn’t yet the large, coordinated department it is now,” Ms. Stillwell says. “Then we’d go to a practice and ask, ‘What can I do to help you?’ and turns out they had many things they wanted us to help with. Now we have a large suite of services and resources to offer them.”
In 1995, The Doctors Company was accredited by the Accreditation Council for Continuing Medical Education to offer continuing medical education (CME) credits for healthcare professionals. In 2023, we debuted a new and improved CME platform, CloudCME, for our library of on-demand courses.
“Looking back at the growth of the department, we started with no CME platform, then we earned accreditation to offer CME credits, and now we have an industry-leading CME program,” Ms. Faber says. “Our risk assessments evolved from paper to digital. And then we brought on board coders to code the claims in our database, which allows us to analyze our claims data and produce closed claims studies that provide specialty-specific guidance based on lessons from real-world claims.”
These expert tools grew more sophisticated as we moved from general risk management programs to a specialty-specific patient safety focus—ensuring we have actionable resources for all our members regardless of specialty. Our INSIGHT Services use a data-driven, collaborative approach with member practices to improve safety and patient care. We regularly lead education courses with our medical society partners, and we publish in top publications like JAMA and Medscape to help extend the reach of our expertise.
This patient safety focus also goes beyond clinicians: Our Risk Management Fundamentals for the Practice Manager program helps practice managers play a critical role in supporting physicians to provide the highest quality patient care.
Specialty-specific advisory boards, like our most recent Advanced Practice Clinician Advisory Board, have helped us stay up to date on the latest developments in each specialty so we can provide resources to meet the most pressing needs of each practice environment.
Our Anesthesiology Advisory Board meets in 1996, as featured in The Doctor’s Advocate.
Most of these resources are open to all, not just members, as part of our mission to advance the practice of good medicine across the country.
“I’m so thankful to work for a company that prioritizes sharing our patient safety resources widely—because the ultimate goal is to keep as many patients safe and prevent as many adverse events as possible,” says Debra Kane Hill, MBA, RN, Senior Patient Safety Risk Manager, who has been with the company for 15 years.
Innovative Resources That Are Always Evolving
Our vast library of articles and videos cover both day-to-day safety practices and trending healthcare topics, such as guidance for doctors during the early days of EHRs. Perhaps the most time-sensitive and important work for our department was our efforts to assist the healthcare heroes of the COVID-19 pandemic. Responding to this once-in-a-lifetime crisis meant “building the airplane while it was flying” for many of our members.
“We wrote the first article giving guidance on the novel coronavirus on January 28, 2020, and we’ve done over 40 updates of the article since then,” Ms. Hill says. “Our leadership sent us all PPE kits so that we could stay safe if we needed to do in-person site visits. It was a very intense time and I’m proud of how much we were able to support healthcare professionals nationwide.”
Within a few days of the declaration of the Federal Public Health Emergency, we prepared a full online COVID-19 resource center—updated nearly daily—to offer much-needed guidance to our members on issues such as implementing telehealth care, infection control protocols, and closing and then reopening practices safely. After the initial emergency period, we continued to offer resources that adjusted alongside the changing environment, including guidance for handling missed care during the pandemic, caring for long COVID patients, and addressing high levels of burnout in the healthcare system. Our nearly 50 COVID-19 articles were viewed more than 500,000 times throughout the pandemic.
“For our members, we are part of the team, helping them navigate challenging situations,” says Lisa McCorkle, MSN, CPHRM, Senior Patient Safety Risk Manager, who has been with the company for 16 years. “A lot of us come from clinical backgrounds—I am a nurse, for instance—so we have a first-hand understanding of both the practice environment and the emotional and mental challenges clinicians face. This allows us to empathize and understand how to help them through thorny issues. At the end of every member call, I say to them, ‘Thank you for your service,’ because it really is an honor for us to serve the people on the front lines of patient care.”
A Future Focus
Our Patient Safety and Risk Management Department has always been defined by our innovative, future-thinking work. As healthcare has consolidated, we have adjusted our resources and services to meet the needs of practices of all sizes.
“When I work with larger accounts, I’m proud to represent Patient Safety and Risk Management for The Doctors Company on a wider scale, partnering with prestigious organizations that have committed to improving patient care,” Ms. McCorkle says. “It requires a different approach than a smaller practice, where the staff is running fast with fewer resources. They may not have time for a full risk survey, but I can point them to our online resources and be just a phone call away if they have an issue. We can scale our services to meet members with what they need.”
The history of Patient Safety and Risk Management at The Doctors Company is a story of evolving alongside the evolution of healthcare, from the movement to patient safety, to building tools to address the digitization of medicine, to adding support for advanced practice clinicians in their expanding roles.
Keeping patients safe is a collective effort, and we’re proud to have been a part of that effort for half a century.
Patient Safety and Risk Management in
The Doctor’s Advocate Over the Years
Risk management has been a key focus in The Doctor’s Advocate from the beginning, with ongoing columns from experts and essay contests to ensure we hear directly from clinicians on the challenges they face—this is the Medical Director column from the first-ever issue in 1993.
Our content has always been informed by data and case examples that highlight real-world issues in clinical practice, like this article from a 1995 issue.
The Doctor’s Advocate provides guidance for urgent issues in clinical practice, like this article with strategies to protect against Y2K in 1999.
Practical daily guidelines for safety featured in 2005.
Our Chairman and CEO, Richard E. Anderson, MD, FACP, shared his personal insights on the patient safety movement in this 2007 issue of The Doctor’s Advocate.
Our personalized patient safety site surveys give us unparalleled insight into trends across the country, as featured in this 2011 article.
In 2012, we conducted the largest physician survey to date on the outlook of healthcare in America and featured it in a special issue of The Doctor’s Advocate.
Our closed claims studies give data-informed insights on top risks across specialties and practice technologies, like the implementation of EHRs—as featured in this column from our Medical Director in 2013—and this study of malpractice claims involving children in 2019.
Special issues of The Doctor’s Advocate in 2020 featured our timely guidance to assist healthcare professionals during the pandemic.
The Doctor’s Advocate is published by The Doctors Company to advise and inform its members about loss prevention and insurance issues.
The guidelines suggested in this newsletter are not rules, do not constitute legal advice, and do not ensure a successful outcome. They attempt to define principles of practice for providing appropriate care. The principles are not inclusive of all proper methods of care nor exclusive of other methods reasonably directed at obtaining the same results.
The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider considering the circumstances of the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.
The Doctor’s Advocate is published quarterly by Corporate Communications, The Doctors Company. Letters and articles, to be edited and published at the editor’s discretion, are welcome. The views expressed are those of the letter writer and do not necessarily reflect the opinion or official policy of The Doctors Company. Please sign your letters, and address them to the editor.
