Through the monthly Risk Matters, online programs including specialty-specific programs, seminars, and individual communications with physicians, advanced practitioners, and practice executives, our Risk Education Department provides you with the most up-to-date, practical information to improve patient safet...
Medical care and treatment of children (“minors”) present unique challenges not typically found in the provision of medical services to adults. These challenges can often be a source of medical malpractice risk and, should a malpractice lawsuit be filed, juries tend to view injuries (especia...
We are often asked our position on allowing students or other non-employees to “shadow” physicians, providers, or staff in a medical practice or other clinical environment. Shadowing allows individuals to observe the day-to-day activities of a medical practice, giving them a realistic view o...
Informed consent is a fundamental ethical and legal requirement in healthcare, ensuring that patients have the autonomy to make decisions about their medical treatments and procedures. But who has the authority to provide such consent? With competent adults, this is rarely an issue. However, with ...
A recent article in the in the Tennessee Medical Association Legal News was entitled, “Featured Legal News: Medical Licensing boards seeking to “make an example” out of prescribing to self/family.”[1] The article identifies three physicians who had reported investigations or form...
Various applications utilizing some form[1] of artificial intelligence ("Al") have been in place in healthcare for decades. The utility and utilization of AI have increased dramatically as the technology continues to develop and improve. A 2019 Harvard Business Review study estimated that AI applications for ...
Medical malpractice lawsuits are extremely stressful, and a topic that is seldom discussed is Medical Malpractice Stress Syndrome (“MMSS”). MMSS involves having a traumatic reaction to a malpractice claim or lawsuit, impacting the provider’s emotional and possibly physical health. The ...
Remote healthcare technology continues to be an increasingly valuable tool, especially for delivering care to patients who have mobility or transportation challenges, or who live far away from their provider. According to a 2023 HHS report surveying over a million individuals, 22% of adults in the US re...
The potential benefits of wearable medical device technology in assisting with monitoring and managing general patient wellness, as well as chronic conditions, have been generally recognized for nearly a decade. As aptly stated earlier by one author, “Mobile health is at the swirling confluence of remot...
Obstetrics is a very rewarding field of medicine that celebrates the beginning of life and the joy of parenthood, but it’s also a field fraught with complex challenges and, at times, devastating outcomes. At its best, obstetrics exemplifies the compassion, expertise, and dedication of healthcare p...
The term “curbside consultation/opinion” is often used to describe an informal opinion or interpretation between colleagues that does not result in a “formal” consultation. Curbside consultations are transient in nature and typically occur in the hallway, break room, golf course,...
This is the last Risk Matters article for 2023. Normally, the end of the year is a time for reflection, but in the Risk department we are always looking toward the future to anticipate issues that may adversely affect our policyholders. According to Forbes magazine*, the Top 5 Healthcare Trends in...
Many physicians are finding ways to earn income in addition to their regular employment. These “side businesses” typically utilize a physician’s specialized skills, knowledge, and licensure to perform. Not all of them increase a physician’s risk of malpractice - for example...
As reported by many news outlets and industry experts, the healthcare profession is suffering a severe shortage of workers at every level. This crisis was only worsened by the COVID-19 pandemic and is projected to continue for the foreseeable future. As a result, healthcare institutions and medical prac...
With school starting back and fall sports practices commencing, many physicians and providers will be asked to perform a sports physical to provide medical clearance for student athletes to participate in sports activities. Most jurisdictions will find that even a single encounter for the limited purpos...
Are you aware of the role cognitive bias can play in medical decision making and diagnostic error? Cognitive bias affects behaviors and influences decisions. Bias may result in distortion of clinical reasoning and is an unintentional failure in perception and thought that often leads to human error. Many stud...
SVMIC is aware of a recent letter sent to all DEA-registered practitioners outlining a new law, referred to as the MATE Act, that requires a one-time, eight-hour training requirement for all such practitioners on the treatment and management of patients with opioid or other substance use disorders. Begin...
The expiration of the COVID-19 national public health emergency on May 11, 2023 brought a number of changes in healthcare. Among those changes was a significant shift in telehealth regulatory compliance risk. In March 2020, the US Department of Health and Human Services Office for Civil Rights (OCR) announced...
We are excited to announce the 2023 Risk Education live seminar “Challenging Relationships in Medicine”. The program will take an in-depth look at professional relationships in medicine. Attendees will examine distressed behaviors, conflict management, emotional intelligence, and effective c...
In general, physicians should not treat themselves, members of their own family, or people with whom they have an intimate relationship. There are specified limited exceptions such as in emergency settings, where there is no other qualified physician available, and for short-term, minor problems. ...
A few years ago, nationally recognized trial consultant, Dr. Jill Huntley Taylor, was a contributor to our live seminar program and wrote an article for our newsletter outlining juror expectations in a medical malpractice trial. To identify these expectations, she uses the acronym “MEDIC” wh...
Wrong-site, wrong-procedure, wrong-patient errors (WSPEs) continue to occur at an unreasonably high frequency as reflected in our reported claims. This is especially true for spinal surgeries. The causes can often be traced back to nonadherence to the Universal Protocol, erroneous site markings, a...
Most loyal readers of the Sentinel are familiar with the Risk Education department because of the monthly “Risk Matters” column. You may also know the department as the arm of your company that produces live seminars and develops many of our online courses. However, some of you may not...
Practices should be familiar with the general requirements of the HHS ONC Cures Act Final Rule, also known as the ONC Information Blocking Rule, which became effective in 2021. Among other aspects of compliance with the regulation, practices should have documented procedures that outline how both in-house and...
A topic which generates many questions from policyholders is the supervision of and delegation to advanced practice providers. The questions we are asked most frequently are: “What is the liability risk to the supervising/collaborating physician?” “What are the duties of the supervising/...
Providers are legally accountable for the accuracy of the information in their notes, and personal review of entries in a timely fashion provides the opportunity to make any needed corrections. All notes and medical record entries should be reviewed for accuracy and properly authenticated (signed) by the prov...
Missed diagnosis is a top claim received at SVMIC. The tracking of lab and diagnostic test results, as well as referred patients and missed or canceled appointments, is essential to avoid delays in diagnosis and/or treatment. A patient may fall through the cracks if an abnormal test result is misplaced ...
There are often many questions regarding the use of a chaperone such as who, when, why, what (if the patient refuses/is the chaperones role) and how often? This article will attempt to answer these questions by examining the recommendations of SVMIC and the AMA. In the current environment, it is important tha...
A frequently asked question when referrals are made is, “What is my duty as the referring physician to ensure that the patient keeps his/her appointment with the consultant?” Many physicians do a good job of tracking labs and diagnostic tests, but they do not think about tracking appointment...
It is common practice for physicians and providers to dispense free sample medications to patients. The benefits of dispensing sample medications are numerous: it allows patients to try new medications on a trial basis; saves patients money on expensive medications; reduces non-adherence to medicat...
“Everybody perceives stress in different ways… and there's not one blanket way of handling stress. But, the most important thing is to understand that you are stressed and recognize how it manifests in you. Some people clench their teeth, some tighten their shoulders, some have GI ups...
A wise attorney once told me, “The road to serenity is not paved with litigation.” How true that is. Unfortunately, litigation is a familiar experience for those of us who practice medicine -- most of us will find our serenity traumatized by a lawsuit during our career. The stress can be overwhelm...
Ever since the U.S. Food and Drug Administration (FDA) authorized the emergency use of specific formulation (10 mcg/0.2 ml) of the Pfizer-BioNTech coronavirus disease 2019 (COVID-19) vaccine for children ages 5 through 11 years, reports of mix-ups with the Pfizer-BioNTech COVID-19 vaccine formulation intended...
At SVMIC, we stress the importance of accurate and timely documentation and for good reason – in the event of a claim or lawsuit, the medical record will be the most important piece of physical evidence. But, just as important as what to include in the medical record is what not to include. Only ...
With the emphasis on COVID-19 vaccines and boosters, many patients may forget another respiratory virus that presents a significant health risk – influenza. It is important you educate your patients on the need to be protected from this potentially fatal virus, especially your patients who are 65 ...
Documenting telephone encounters should be treated with the same level of importance as documenting in-person visits. Telephone conversations, particularly those that occur after-hours, are a major area of liability risk. The advice given to a patient over the telephone often becomes crucial to his or her con...
EHR Duplication: Native Form vs. Printed Copy Physicians’ offices receive a large number of requests for copies of medical records from patients, their representatives, insurance carriers, attorneys, and other providers. Prior to the advent of electronic health records, someone in the offic...
Every EHR system has an audit trail. The timeline is no longer a guessing game. Gone are the days of using handwriting experts to try to determine when and by whom an entry was made in a patient’s chart. Forensic IT experts can now review the metadata contained within the EHR to determine everything tha...
Few medical errors are as indefensible as those involving patients who have undergone surgery on the wrong body part, undergone the incorrect procedure, or had a procedure performed that was intended for another patient. These “wrong-site, wrong-procedure, wrong-patient errors” (WSPEs) are termed ...
When an unsolicited test result is received regarding an established patient of the practice, it should be handled the same way as one that was personally ordered. Contact the patient, notify the ordering physician, and, if appropriate, arrange for needed follow-up care. Do not automatically assume normal res...
Last month, we discussed the importance of the informed consent discussion to prevent malpractice claims. As a follow-up, remember that it is the discussion that takes place between the provider and the patient (or patient’s legal representative) that constitutes the basis for the consent to be &l...
Informed consent is often the most important discussion that physicians will have with their patients, but unfortunately, it is sometimes viewed as merely obtaining a signature on a pre-printed form. While lack of informed consent is rarely the central issue in a malpractice lawsuit, it is almost always...
Governmental shelter-in-place orders and the need to avoid unnecessary physical contact driven by the coronavirus pandemic have caused many providers and patients to suddenly turn to the virtual world to provide and receive care. While this has generally been good for the healthcare system and patient s...
When practicing telemedicine, keep in mind that the medical services are being rendered at the patient’s location. Therefore, the provider must: be licensed in the state where the patient is located; be familiar with the standard of care in the patient’s location and comply with th...
An old Chinese proverb says that “the faintest ink is more powerful than the strongest memory.” Timely documentation is critical in order to ensure an accurate and complete record of the patient encounter. Office notes and dictated procedure notes should be completed, reviewed and signed within 2...
Physicians and other clinicians are well aware of the legal obligation to provide informed consent for treatment. A fundamental component of consent is providing the patient with sufficient information to make an informed decision about the risks, benefits, and alternatives of the proposed treatment. Clearly,...
Medical practices are often challenged with how to handle a missed appointment during which follow-up care or treatment was to be provided. It is important that the practice have a procedure to ensure that no-shows and cancellations are communicated to the treating provider and any actions taken are documente...
Each year, ECRI Institute – a nonprofit organization that researches approaches to improving patient care – identifies TOP 10 Patient Safety Concerns. This list identifies key areas to “support health care organizations in their efforts to proactively identify and respond to threats to ...
From time to time, physicians and other healthcare providers find themselves in receipt of diagnostic test results they did not order for their patient, or for individuals who are not even patients of the practice at all. Such results could be anything from laboratory or pathology reports to scree...
Like most busy physicians, you probably dread the monthly team meeting to take a closer look at office processes and systems. In a day filled with playing phone tag, wading through e-mails, dealing with unexpected patient situations, following up on tasks and documenting, where’s the time to squeez...
Increasing concerns about the quality of healthcare have arisen as a result of the public perception that cost-cutting measures have caused premature discharge and clinical mismanagement of patients. Changes in healthcare coverage have generated concerns that medical care has become a profit-motivated busines...
Have you or your staff been “drifting into unsafe habits?” Do you follow the template generated by your EHR without questioning its validity or applicability to the patient in front of you? Do you ignore alerts and other prompts? Do you ask only close-ended questions of patients such as, “Ar...
As healthcare evolves, so do patients’ expectations. Payers are changing reimbursement strategies to focus on value-based care, therefore patients' experiences and subsequent reviews of those experiences can affect the practice’s level of reimbursement. Understanding patients’ opinions and e...
Distractions and interruptions are a fact of life in today’s healthcare environment, but that doesn’t mean a practice should simply accept them and the threat they pose to patient safety. Identifying the sources and frequency of distractions and interruptions allows for implementation of strategie...
Electronic Health Records offer the potential for vast improvement in continuity of care, legibility and accurate recordkeeping. However, to most practitioners, that goal seems light years away. This is due to many factors out of the user’s control such as technology, design and integration issues. The ...
Last month, the CDC issued a letter to healthcare providers asking for help to ensure patients receive influenza vaccines by the end of October. The letter states “…To avoid missed opportunities for vaccination, providers should offer vaccination during routine health care visits and hospitalizat...
The adage about “people who live in glass houses” still holds true. Jousting usually occurs when another healthcare professional intentionally or unintentionally either verbally or in the medical record makes disparaging comments about other providers, nursing staff, equipment, EHR or administrat...
At SVMIC, we’re often asked if a practitioner can utilize the patient portal to notify patients of lab/test results that are normal and require no follow-up. The short answer is yes, you can use your patient portal to communicate lab/test results that are normal, require no immediate attention and are n...
Tempting as it may be, think twice before accessing medical records if you receive a notice of intent to sue or are served with a lawsuit. An electronic health record (EHR) system tracks activities and records the information in metadata—the “data about data”—o...
At the UT College of Medicine, rising third-year medical students usually begin their clinical rotations during the first week of May. In preparation, UT has historically educated these students in risk management, where they learn, among many other things, the importance of their patients’ knowin...
Do you have a procedure for handling a missed appointment during which follow-up care or treatment was to be provided? To avoid patient harm and a claim of missed or delayed diagnosis, it is important that practices have a procedure to ensure that no-shows and cancellations are communicated to the treating pr...
Spring has sprung, which means spring cleaning for many of us. It may also be a good time to retool your office tracking procedures, as diagnostic error accounts for one-third of SVMIC’s paid claims. Tracking system failures are a primary factor in diagnostic error. Maintaining a system within each offi...
One of the simplest tools for improving your communication with patients is intentional or "active" listening. When a new mother brings her baby to the office, listening to her description of the problem often provides that subtle clue a physical examination may not have revealed. Not all medical interactions...
According to the Food and Drug Administration (FDA), it regulates one trillion dollars’ worth of products each year or approximately 20 cents on every dollar spent in the U.S. When there is a serious problem with a product, the FDA would like to alert you immediately. The alerts contain actionable infor...
The term “culture” in your medical practice shouldn’t only mean a lab test to identify microorganisms. Even if you’re not aware of it, there is an environmental culture within your practice that affects productivity, staff performance and patient safety. Culture is a system of shared v...
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