I have been a physician for 26 years. I have been a fierce patient advocate throughout my entire career. It never occurred to me that physicians do not have the same rights of citizenship that the very patients I fight for do. I always thought I lived in a democracy. Medicine is not what it used to be. Articles relentlessly speak of physician burnout as though we are responsible for ...

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When a patient is dissatisfied with his or her care, he or she can consult an attorney, who will enlist a physician “expert” to determine if a doctor has deviated from the standard of care and whether that deviation caused a negative outcome. Over the past decade of reviewing cases involving medical malpractice, I have identified five categories of medical error, which has improved how I care for my patients. 1. ...

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The pandemic has raised pressing questions around preventive measures, vaccines, and safe treatment, but it has also obscured one key lingering uncertainty for medical professionals: Where are all the medical malpractice claims? A variety of factors create a cloud of uncertainty around when, if ever, we will see the claims we expected from the care provided just before the pandemic, much less claims deriving from care during the pandemic of both ...

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Every death related to anesthesia is a tragedy; even more so when a minor procedure such as a colonoscopy leads to a completely unexpected death. Everyone knows that open heart surgery carries a mortality risk, but few of us walk into the hospital for a colonoscopy thinking that death is a plausible outcome. We know so few facts at this point about what happened on January 21 at Beaumont Royal Oak ...

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As many of you know, burnout is an increasingly serious problem for physicians, affecting over 50 percent of clinicians in some studies conducted before our current COVID-19 pandemic.  In fact, in an interesting study, one of every four physicians is looking to do some non-clinical work, in part, to ease the stress of today’s clinical practice. In one survey just completed, more than 48 percent of physicians reported that since the ...

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In a few weeks, I will be retiring.  After 31 years and more than 100,000 patient visits, I will be hanging up my stethoscope.  Over the years, there have been tremendous highs but also horrible lows.  The latter includes having been victimized by a frivolous lawsuit where my patient suffered injuries attributed to a medicine prescribed by another doctor.  I was named in the suit, simply ...

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I recently represented a physician in a noteworthy peer review case at an academic medical center. The medical staff president initiated a complaint against a surgeon, who would later become my client. The complaint was that the surgeon inappropriately collected cash payment from an uninsured patient at the hospital's point of service instead of having his office invoice and collect payment from the patient. The medical staff felt this was ...

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If you are a doctor (or med student/health professional) and are human, you've probably made a medical mistake. You've probably not received emotional support for the mistake. Maybe you've never told anyone about a mistake that still haunts you today. The truth is that almost all physicians have admitted to medical mistakes sometime in their careers. Depending on the patient outcome, many doctors carry the distress of medical errors for months, ...

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"Telehealth has come into focus during the COVID-19 pandemic as physicians face an immediate need to reduce exposure by providing care—or at least triage—remotely when appropriate. Under usual circumstances, telemedicine is comparatively low risk. That said, telemedicine does bring specific risks to patient safety and physician/practice liability. Minimizing those risks calls for adapting daily practice routines around informed consent, documentation, and other ...

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Every doctor is an advocate, and every health care provider advocates. An advocate is someone who publicly supports something. Doctors advocate for avoiding smoking, losing weight, and taking medications. In those instances, doctors are advocating for better health. And that’s good. Do you know what’s better? Doctors advocating for themselves, for each other, and for their patients. And advocating is a skill that can be taught. I’ve taught it. For over ...

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Before COVID-19, the health care system was plagued by another epidemic: malpractice lawsuits.  Much is expected of doctors, and disappointments have consequences. Lawsuits are too often a consequence. Under normal conditions, there are 46,000 malpractice claims per year.  One-hundred percent begin with the allegation of medical negligence.  Seventy-three percent end deciding there is none. In these 33,800 cases are no indemnity payments, but there are $767 million in defense costs. Now ...

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In New York City, each evening at 7 p.m., the sound of people banging on pots and pans can be heard from apartment buildings within an earshot of hospitals all over the city. The cacophonous clanging is a salute to the beleaguered health care workers who are changing shifts on the asphalt down below. The ritual is meant to convey appreciation and thousands of idiosyncratic messages of hope. And that’s great. ...

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A radical change is emerging from within our health care system: Rather than deny or defend medical errors, some hospitals are acknowledging them upfront. This enlightened response has been gaining ground since 2001 when the University of Michigan Hospital introduced one of the first medical error disclosure programs: the Michigan Model. Hospitals that adopt the model also promise to explain why the error occurred, apologize, offer fair compensation, and learn from ...

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I recently started watching the HBO series Chernobyl, chronicling the events surrounding the 1986 disaster. For anyone who hasn’t seen it yet—I’d highly recommend this excellent production (It’s already deservedly won multiple awards). The great thing about TV like this, which documents real-life events (and I’d put another HBO series John Adams in the same category), is that they can really bring complex consequential events to the mass audience, in ...

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Ever since the publication of the infamous 2016 BMJ opinion piece claiming medical error should be considered the third leading cause of death in the U.S., the debate on the true incidence of deaths caused by medical error has been raging. Many, including me, felt the estimate of 251,000 deaths per year from medical error was grossly inflated. For example, the paper extrapolated the number of deaths from ...

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I am a middle-aged, full-time emergency physician, and part-time law student. Usually, I practice medicine during the day and attend law classes in the evening. Sometimes I have law classes in the afternoon or early evening then work in the emergency department all night. So, what’s harder: medical school or law school? Absolutely the most common question I am asked by physicians, attorneys, and students at all levels of training. The other most ...

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An excerpt from Technology and the Doctor-Patient Relationship. As disturbing as the structure of malpractice insurance is in America, a more significant problem is the defensive style of medical practice it induces. In a large-scale survey done by Jackson Healthcare in 2010, between 73-92% of physicians self-reported ordering unnecessary ...

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It’s hard to describe the feelings I had when I received my first letter of intent to sue. I think I went through the Kubler-Ross stages of grief — denial at first, of course. This denial didn’t last long since the letter was clearly addressed to me — first, middle, and last name. Anger was almost immediate … I was immediately upset at the deceased patient’s family who were bringing the ...

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I was struck by a post by Dr. Saurabh Jha about his views of the jury system — as some of his comments mirrored things I’ve said to juries in the past. Some things he got right, which go to the core our civil justice system. Some things, however, not so much. His perspective comes from growing up in India, which doesn’t exactly have the most efficient of justice systems. And ...

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The one thing doctors want to avoid like the plague is a lawsuit — a medical malpractice lawsuit. To be sued means the doctor loses precious time from work, endures emotional personal and family distress and is unable to fully invest oneself in providing the very best medical care possible. It is a dark cloud that hovers over the majority of physicians at least once in their lives. Some medical specialties, ...

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