By Laura Fortner with contributions from FlexMedStaff
Life changes once you get served. Ten years ago, a Sheriff stood at my doorstep to notify me that I was being sued for medical malpractice. I contemplated how this could happen with my young children next to me. I had sacrificed most of my life to treat my patients, and now this. The stress of dealing with this malpractice claim and the fear of the unknown was mentally draining. I soon realized that I was not alone. To my surprise, I found out that most physicians go through a malpractice suit in their careers, and many suffer from the emotional toll of the process.
Anyone can be a victim of a malpractice suit. It can happen to you if you are the most skilled surgeon or an error-prone hospitalist. In medicine, we see many mistakes, complications, and bad outcomes. Surprisingly, not all these patients file malpractice claims when an adverse event occurs. So why and when do they sue?
Believe it or not, the ultimate reason for being sued for malpractice is usually not associated with an actual mistake. Complications occur often, yet not every complication results in a malpractice claim. In actuality, the data indicate that patients are more likely to file malpractice lawsuits if they feel like they were rushed or poorly treated. With this in mind, physicians must practice medicine in such a manner to avoid patients developing these feelings.
No publicly available data suggests that locums practitioners are more likely than other practitioners to be sued for malpractice. With that said, each practitioner must recognize that patients and families may view you differently as a locums practitioner. They may have a selective bias against locums practitioners. It would help if you did what you could to mitigate the possibility of malpractice claims as a locums practitioner.
As a locums practitioner, you must recognize that your first interaction with a patient and their family may dictate how they perceive you. Their desire to file a malpractice suit against you may depend on the first 5-15 minutes you spend with them. Understand how important those first few minutes can affect the possibility of you being sued. Therefore, be nice, don’t act rushed, answer their questions, draw pictures of the pathology, and be as thorough as possible to minimize your risk of a malpractice suit.
As a locums practitioner, you can take day-to-day actions to reduce the risk of a malpractice lawsuit. These are my tips for avoiding a malpractice lawsuit at your next locums assignment.
Ensure the appropriate attitude and optimize communication. It is essential to communicate in the best possible manner and have a good bedside manner with the patients. If the patient perceives that they are distracted, they are more likely to be disgruntled and sue. Maintaining eye contact with the patients, being compassionate, and spending more time with them is important. Other social cues such as acknowledging what the patient says, creating an emotional overlay to the patient’s situation, and being responsive to their concerns will help prevent malpractice claims. It is important not to stare at the computer the entire time during a visit. One may consider getting a scribe to help optimize the physician-patient interaction. It is also important not to show powerful emotions of frustration or anger and avoid conflict as much as possible. A professional demeanor with the patient goes a long way in ultimately preventing malpractice. If the patient becomes confrontational, it is more important to pause, think, and respond appropriately.
Think from the patient’s perspective. The patients want to be heard and feel they are seeing a doctor who cares for them. Building a solid relationship with the patient and thinking from their perspective can help prevent litigation. It is also important to avoid being defensive with the patients, even if you feel that you are being attacked.
Look Organized. It is important to ensure there are no cracks in the system, whether scheduling an appointment or handing out instructions. It is important to consider all aspects of your clinical operations, including how the front staff handles phone calls, how the nurse rooms the patients, how to send follow-up reminders, and how to obtain informed consent. At the hospital, ensure that all team members are aligned in treating a patient. Any confusion between the primary team, nurses, and consultants will look poorly upon you. If the patient perceives the process as unorganized or messy, it does not create a good look.
Self-care. Achieving a healthy work-life balance is essential as this will affect your demeanor with the patients. It is important to take care of yourself. Make sure you are appropriately dressed for the facility, have your hair organized, and smell good. For men, ensure that you have shaved or trimmed your beard.
Documentation is critical. Having clear, concise written documentation is always necessary. Clear documentation allows you to communicate with other providers and team members. It would help if you also considered using EMR templates to ensure the documentation is complete and thorough. In the eyes of the law, “If it is not documented, then it did not happen.” Remember that everything in the EMR is timed, so avoid long delays in completing your documentation. Last but not least, do not alter or change medical records, especially after you have been notified of a malpractice claim.
Whether you are a locums practitioner or not, there is a good chance you will be involved in a malpractice suit. Make sure to consider patients’ perceived thoughts of locums practitioners and use the above steps to help mitigate a malpractice suit. A malpractice suit may be unavoidable even if you are the most caring, competent physician. The emotional toll of any malpractice case can wear any individual down. Know that you are not alone! Other physicians like you have gone through the same or similar experiences.
Laura Fortner is Ob-Gyn physician and founder of The Med Mal Coach.
