Annals of EM Malpractice Editorial

Mark Graber Mark.Graber at IMPROVEDIAGNOSIS.ORG
Thu Feb 15 18:48:50 UTC 2018


Thanks for posting this article Keel and welcome to our discussions.

I’ll take issue with the implication in the editorial and the Venkat article<http://dx.doi.org/10.1016/j.annemergmed.2017.06.023> that there is nothing that can be done to prevent malpractice suits in the ED.  I have no argument with the findings that no practice characteristics have been identified to date, but would argue that the interventions we believe could improve diagnosis have not been evaluated in the ED setting so far.  These include: Better patient engagement, better teamwork, better follow-up, and more use of clinical decision-support.

We will have trouble eliminating the ‘crapshoot’ element, but to the extent that we could improve the diagnostic process, there’s hope that at least some fraction of claims could be avoided.

   Mark

Mark L Graber MD FACP
President, SIDM
Senior Fellow, RTI International
Professor Emeritus, Stony Brook University
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From: Keel Coleman <keelcoleman at GMAIL.COM>
Reply-To: Listserv ImproveDx <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>, Keel Coleman <keelcoleman at GMAIL.COM>
Date: Thursday, February 15, 2018 at 8:43 AM
To: Listserv ImproveDx <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
Subject: [IMPROVEDX] Annals of EM Malpractice Editorial

Long time reader, first time poster.
Attached find an editorial from Annals of Emergency Medicine regarding a study of malpractice claims.

The editorial reviews the current literature looking for three things:
1. Are their practice patterns or decisions by EM providers that are associated with increased likelihood of being named in a suit?
 Answer: No. None that we can find.

2. Are there identifiers for EM providers that are associate with likelihood of being named in a suit?
Answer: Yes. Time in practice (number of years), and number of pts seen.

3. What other avenues might we study to further understand patterns of malpractice litigation?
Answer: Look at your local patient-plaintiff attorney relationships.

Given these answers, what can be done to first protect patients from the wages of defensive medicine, and deranged decision making driven by the fear of of litigation?

Second, what can be done to support physicians who will certainly find themselves in the crosshairs of litigation despite doing 'the right thing' every day?

Third, as the study of indemnity claims moves to focus on local variability of malpractice environments, how do we maintain objectivity and best practices when a care space becomes adversarial by virtue of its location?

Thank you.
Keel Coleman DO, MBA, FACEP




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