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Physicians can be first-line deterrents to suits filed by unhappy patients

Key iconKey Points

  • It is partly the responsibility of physicians to reverse the trend of rising malpractice payments
  • Many underlying issues in malpractice claims are based on unmet patient expectations
  • Physicians should strive to spend adequate amount of time with each patient, explaining aspects of procedure in great detail, expert says

Medical malpractice claims have become an all-too-common trend in medicine today. But physicians can take some thoughtful, proactive steps to help stem the rising frequency of malpractice suits.


Dr. Whiteside
In medicine as a whole — and particularly in plastic and cosmetic surgery — there is a global rise not only in the frequency of malpractice claims, but also in their severity in terms of the amounts paid to patients. The causes of the rise in malpractice payments vary, and it is partly the responsibility of the physician to reverse this trend, one risk management expert says.

"In the last two to three quarters, we are seeing a little bit of an uptick across the board in the number of malpractice claims filed. I believe that a lot of what goes on in the area of litigation is reflected by the socioeconomic undercurrents of the time," says Hayes V. Whiteside, M.D., senior vice president of risk management and chief medical officer at ProAssurance Company. "If you are seeing an increase in litigation, and particularly successful litigation, you will see a rise in frequency of it." Dr. Whiteside spoke on the topic of malpractice at Vegas Cosmetic Surgery 2011 in June.

According to Dr. Whiteside, some companies may be more settlement-oriented, which may only propagate the vicious cycle of litigation in the medical arena. In order to help reverse the increasing number — as well as the severity — of malpractice cases currently seen in medicine, physicians should try to work proactively to help avoid such claims in the first place, Dr. Whiteside says.

ANALYSIS, ANTICIPATION ProAssurance collects information from the Physician Insurers Association of America (PIAA), which pools data from most of the medical malpractice companies in the United States and Canada. One of the central tasks Dr. Whiteside and his staff perform involves looking at the claims and the underwriting issues and assessing where and how these issues arise — and how they can be remedied.

"Being intimately involved with the claims, I see a lot of these on an individual basis. After a careful assessment of the facts involved in a given case, we then formulate and suggest strategies aimed at preventing these claims from ever being made," Dr. Whiteside says.

"It is in part an anticipation of potential claims but also keeping a sharp eye for current trends of malpractice claims, and accordingly, we will try to adjust our loss-prevention strategies for physicians," he says.

ISSUES WITH EXTENDERS In very busy plastic and cosmetic surgery practices, it is not uncommon for physicians to delegate certain tasks and authority to their licensed providers (such as nurse practitioners). Suture removal, bandage change or follow-up consultation may be delegated to capable office staff, but often, patients feel sidelined after the actual procedure, particularly when cosmetic results may be viewed as less than optimal.

"Patients may feel that their physician did not spend enough time with them before, during or after the procedure, and in the eyes of the patient, the suboptimal results achieved as viewed by the patient are possibly a direct result of a lack of (or less) care by the physician. This assumed lack of care on behalf of the physician may lead to a malpractice claim," Dr. Whiteside says.

As every patient and their specific needs vary, Dr. Whiteside suggests that surgeons treat every patient individually, catering to each patient's specific needs. Perioperative care and the numerous aspects and tasks involved with that care can then be delegated to office staff accordingly — again, depending on the particular patient's needs or requests.


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