Patient handoffs increases the risk of medical errors.

It’s a phenomenon during residency, as doctors are mandated to leave the hospital after a defined number of hours.  But it’s also prevalent outside of an academic setting, as more institutions use hospitalists for their inpatients.

This increases malpractice risk.

Perhaps the biggest problem with hospitalists is the transition during discharge, when the patient is handed back to the primary care physician’s care.

Various questions inevitably arise: “Did the primary doctor make sure that the hospitalist knows of the patient’s allergies? Did the hospitalist speak to the primary when the patient was admitted and discharged? Did the hospitalist convey the need for a follow-up computed tomographic scan in 3 months? Was there a delay in faxing the discharge summary? Does the patient know who he’s supposed to contact if complications arise?”

And what if disaster strikes, and the patient suffers because of a communication lapse?

It’s a fertile ground for malpractice:

If something goes wrong, both the hospitalist and primary doctor will be sued. The duty to provide adequate follow-up is shared … It’s a poor defense in a malpractice case to argue, “I assumed the hospital (or the primary) was handling that,” when the injury could have been prevented if the 2 sides had communicated better. Jurors are rarely forgiving when physicians point fingers of blame at each other.

Doctors are becoming more specialized and that further fragments care. It’s imperative that patients not fall through the cracks, and communication between doctors be a top priority.

Failing to do so risks injuring patients and brings the specter of malpractice closer to everyone involved.