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Building, Protecting & Transferring Wealth
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Don't Stop With "Just" Estate Planning
You probably already have a professionally prepared estate plan, as well as expert advice on your personal and business taxes and finances. However, the best estate and financial plan in the world can be rendered meaningless if you are not "asset protected." Just one large jury award for negligence can bankrupt a multi-million dollar estate. ABA's free, confidential analysis can show you if you are really "protected" or "exposed."
Med Mal Carriers Busted for Overstating Losses by Billions
How Medical Malpractice Insurance Companies Inflate Losses to Justify Sudden Surges in Rates and Tort Reform
Go to http://www.consumerwatchdog.org/patients/articles/?storyId=15672 to read this revealing report by the Foundation for Taxpayer and Consumer Rights. The "incurred losses" that medical malpractice insurance companies initially reported were, on average, 46% higher than the amount the insurers actually paid out. One study author said this shows that "incurred" losses can be manipulated to support insurers' need for higher premiums when their stock and bond investments go bad.
10 Ways to Guarantee a Lawsuit
Most patients who suffer an injury because of medical negligence do not end up suing their doctors. Those who do, however, are often motivated not by the negligence itself, but by nonclinical factors like a lousy bedside manner or poor communication. These are the kinds of mistakes that are well within your power to fix. Interviews with malpractice attorneys and risk management consultants resulted in the following things doctors do that are likely to get them sued.
1. Don't worry about keeping detailed records. The medical record is your best defense against a malpractice suit it's accurate. If it's not accurate, the plaintiff's attorney will smell blood, and use the error(s) to damage your credibility with jurors.
When recommending a certain treatment or medication, explain your reasoning to the patient, then document those reasons and the fact that you explained them. Even if your decision ultimately proves wrong, and the patient suffers an injury, those chart notes will help. In malpractice litigation, you do not have to be perfect, or even right. You just have to show that your actions were reasonable for a doctor in your specialty.
The medical record must be complete, unambiguous, and legible. If you say you told the patient to come back in three months for a follow-up visit, but did not note that instruction in the chart, the jury may not believe you ever said it. That is why defense attorneys warn their clients, "If it's not in the chart, it didn't happen."
2. Don't take the time to document informed consent discussions. Having the patient sign a consent form is advisable, but it is not an acceptable substitute for a detailed informed consent discussion. That discussion should be recorded in the chart. If the patient does not accept your treatment preference, document that also, including the reasons why you disagree with his choice.
The standard for informed consent used to be what the average doctor thought his patient should know. However, courts are increasingly basing their decisions on what a reasonable patient would want to know. That does not mean explaining every conceivable treatment option, but at least the reasonable ones.
3. "Fix" records quickly when something goes wrong. Altering records after a patient is injured is an easy way to lose a malpractice case. No matter how pure your intentions, any corrections you make to "help" your defense will be portrayed by the plaintiff's attorney and interpreted by the jury as an attempt to cover up what really happened. Such record tampering could also mean you will be paying for the cost of the defense yourself, since many policies specifically exclude coverage when a physician has altered his records.
It is okay to review your records to check for mistakes or omissions as long as you do it properly. Do not erase, white-out, or scribble over the mistaken entry. Instead, draw a single line through it, leaving it legible, and add your initials and the date. Then write the new note, explaining why the original one was incorrect, and initial and date that.
4. Trust the patient to follow through on referrals.While it is the patient's responsibility to comply with referrals to specialists, jurors may conclude that you should have followed up to make sure the patient actually did. Your office should have a strict protocol for keeping track of referrals:
Make sure the patient keeps the appointment; confirm receipt of the specialist's report; call his office if you don't receive it; make sure you see the report before filing it in the chart; and arrange a follow-up appointment if necessary. If a patient fails to keep a referral appointment, your staff should telephone her and follow up with a certified letter, and documented it in the chart.
5. Don't bother to track test results. Unreported test results are a frequent cause of delayed diagnosis claims. Labs and radiologists sometimes fail to send test results, or when they do, the report may slip through the cracks at your office. To avoid such errors, create a mechanism for tracking tests that you have ordered, making sure you actually receive the results from labs or radiologists, and that patients are promptly notified of the results after you have reviewed them.
If your office mails test results to patients, the message should include the nature of the test, the date it was performed, the test results, what they mean, and any required follow-up. If your staff reports test results by phone, make sure they follow up if they don't reach the patient on the first call. If test results are abnormal, you should report them to the patient yourself, especially if they suggest a serious condition. Only a physician can properly answer the questions the patient is likely to ask about the significance of the results, the long-range prognosis, and any required follow-up or referrals.
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