Patients, Communication, and Malpractice

Malpractice cases involving physicians can occasionally revolve around objections to an unexpected outcome rather than any actual injury or substandard care. 

The Doctors Company, a physician owned insurance provider, analyzed claims filed against orthopedists that resolved between 2007 and 2014.  They found that the top patient claims involved claims of improper management after surgery (16%), followed by diagnosis issues – delays or misdiagnoses (13%).

Upon further analysis, physicians at The Doctors Company found that in nearly 33% of the medical malpractice cases they surveyed, patients did not comply with the treatment plans which were provided by their physicians.  In addition, patient decisions contributed to additional complications in nearly 29% of the cases.

In a significant portion of the cases, patients did not follow instructions, did not go to follow-up appointments, or did not comply with restrictions on activities.  In a slight majority of those cases, documentation by physicians precluded patients’ claims that surgeries were not performed correctly or that they received inadequate care.

Insufficient communication between physicians, patients, and patients’ families was also found to be a factor in patient non-compliance in 12% of claims.  Insufficient communication can include lack of a common language, a poor interpersonal connection between the physician and patient, issues concerning informed consent about the risks of surgical procedures or medications.

Even if adequate care is provided, healthcare professionals must understand that a medical malpractice claim can happen if inadequate communication affects a patient’s expectations, post-surgery actions, or understanding of risks.  Physicians must make effective communication a priority in their practice.

Contact us for more information regarding medical malpractice risks.

Patients Search the Internet For Health Info, But Is It Ethical For Physicians to Google Patients?

Patients regularly surf the internet for health care information, doctor reviews, and treatment choices, generally starting with Google. Nonetheless, is it ethical for physicians to Google their patients? Doctors and bioethicists are weighing if this sort of search is proper.

Jessica Pierce, bioethicist, says that doctors shouldn't Google their patients. An Internet search isn't an ethical method to gather information about a patient and a physician isn't likely to find anything clinically applicable, she writes in Psychology Today.

Others contend that Internet searches by physicians regarding a patient might be satisfactory in very limited circumstances.  Examples of possible satisfactory utilization of Internet searches include scenarios where the doctor has a duty to warn of possible injury, to see if a patient's story is credible, to see if another professional's advice raises questions about a patient's story, and if there are suspicions of abuse or concern about suicide risk.

One example the authors noted was an instance where the doctor discovered that a cancer patient misrepresented her family's cancer history and was increasing funds, maybe fraudulently, to attend a cancer convention.

A bioethicist at The Hastings Center, a bioethics institute, argues that these notions of what represents an appropriate search are too far reaching. She says that doctor intent is what matters most. Why is the physician moved to do this? Is it going to help the patient or is it just out of personal curiosity?

The American Medical Association has new guidelines involving physician use of social media, nevertheless, those guidelines do not adequately cover this issue of a physician's Internet research on patients. The AMA admits this is an unresolved issue within the organization. The AMA's chair on the Council of Judicial and Ethical Affairs, Patrick McCormick, wrote in a blog post that physicians have a fundamental obligation to honor a patient's privacy and that professionalism and physician ethos extend to social networking.

Standards and guidelines involving a physician's use of the Web and social media are complex and still in development. To learn more,contact us.