Live Blog: Managing Medicolegal Risk as a PA/NP – Whitney High, MD
In this live blog from the 12th Annual SDPA conference in Indianapolis, Dr. Whitney High lectured on “Managing Medicolegal Risk as a PA/NP.” Here are some of the highlights.
Medicolegal issues are hopefully something we don’t come across often if we are educated on preventative measures. In his lecture, Dr. Whitney High imparted his medical and legal knowledge to help PAs understand the risks or malpractice, how to prevent them and what to do in the case of a lawsuit.
For practitioners in the dermatological field, there are statistically fewer medical injuries. Neurosurgery is the specialty with the most. However, when things do go wrong for a dermatologist, the suits tend to be very high. A patient could receive up to $500k if a provider misses a skin cancer. So while malpractice suits do not come very often, they are pricey when they do.
On the legal side, Dr. High touched on the basics of malpractice. Malpractice is a civil (tort) law. This means that it is civil action with a monetary reward. The amount is based on the preponderance of the evidence. There are damage caps of varying amounts in different states. This is the most someone could win from a malpractice suit. Where criminal law uses “beyond a reasonable doubt,” to prove a case, civil law uses “more likely than not.” For the case to be considered the six elements of a prima facie case must all be satisfied. These elements are:
(2) Standard of Care,
(3) Breach of Duty
(4) Cause in Fact
(5) Proximate Cause
Different states have different “apology laws.” Check your states apology laws to educate yourself on what “can and will be used against you in a court of law.”
Here are some great ways to prevent and win malpractice suits:
Clear Chart Notes
Take notes often and with detail; Be clear who is calling the referral doc. in your notes; Put the patient’s own language in quotes in charts; document missed follow-ups by date; document informed refusal.
Double Check on Allergies
As you’re writing the prescription, ask for allergies one more time.
Be kind, attentive and humorous
Patients who enjoy their physicians are more likely to forgive.
Dr. High said that overall the two best instruments for safer medical care are follow-up calls and “tincture” of follow up.
Image: Brian Turner