Medical Malpractice Claim Causation Study

Posted on January 30, 2008 by Dr. David Edward Marcinko MBA MEd CMP™

Physician Errors Do Play a Role — A.I.M.

 By  Staff Writers

 According to a two-year old report in the Annals of Internal Medicine, physician errors are a factor in about 60% of medical malpractice claims that involved patients allegedly injured because of missed or delayed diagnoses. 

The B&WH Study 

For the study, researchers at Brigham and Women’s Hospital in Boston reviewed 307 claims from four large malpractice insurers that were closed between 1984 and 2004. 

181 of the claims involved diagnostic errors that allegedly injured patients; and ignored the outcomes of the claims.

Although most of the claims involved several factors, the major ones involved physician errors. 

The Results 

According to the study:

  • 100 claims involved failure to order appropriate diagnostic tests; 
  • 81 claims involved failure to establish a plan for appropriate follow-up care;  
  • 76 claims involved failure to obtain an adequate H&P or PE; 
  • 67 claims involved improper interpretation of diagnostic tests.  

 

Contributing Factors 

The main factors that contributed to the physician errors included failures in judgment (79%), memory problems (59%), lack of knowledge (48%), patient-related issues (46%) and patient handoffs from other physicians (20%).

Conclusion 

And so, how does this impact your thoughts on the topic; please comment? 

 More information: http://www.jbpub.com/catalog/9780763733421/

Filed under: Professional Liability | Tagged: | 1 Comment »

Cash Flow Terms and Budgeting Definitions

Posted on January 30, 2008 by Dr. David Edward Marcinko MBA MEd CMP™

A “Need to Know” Glossary for all Medical Professionals

Staff Writers 

Join Our Mailing List

Regardless of how much current income a physician may earn, financial resources and assets are only useful when they are converted to cash. Doctors who are in the accumulation phase of their careers can only amass new assets from free cash flow.

Free cash flow is the result of budgeting for excess cash flow and the prudent use of debt. And, debt can be either a friend or foe!  

If used properly, debt can increase a medical professional’s standard of living by allowing him or her to enjoy an asset or goal earlier than if he or she had to pay cash.  Or, it may be a catastrophe as seen in the recent housing market value-decline and security backed mortgage-bubble bust.   

Yet, debt management has become a serious issue in American society, especially for non-secured debt because of easy access to credit via credit cards. And, it is not unusual to hear the story of a medical professional with $100,000 of credit card debt; or more.  Although perhaps an extreme example, it is not unusual for doctor’s to have $15,000 to $25,000 of revolving credit card debt.  

Glossary of Terms 

Adjustable rate mortgage: A mortgage loan that has an interest rate that changes in response to market interest rates during the loan’s term. 

Cash reserve: The amount of assets that are quickly convertible into cash for the purpose of meeting un-foreseen expenditures or reductions in income. 

Closing costs: Expenses that accompany the buying, selling, or financing of real estate. 

Consumer Price Index: A statistic published by the Bureau of Labor Statistics for the purpose of reporting the average consumer inflation rate. 

Debt consolidation: A debt management strategy that involves borrowing money in a single loan to repay other debts. 

Deferred expenses: Expenditures that are planned to occur several years in the future, usually requiring large outlays of cash. Examples include paying for college expenses, buying a vacation home, and paying for a child’s wedding. 

Discount points: Payments made to a lender at the inception of a loan for the purpose of reducing the interest rate of a loan.

Federal Deposit Insurance Corporation: An agency of the United States government that insures deposits in federally and state-chartered banks. 

Federal Depository Insurance: A program of the Federal Deposit Insurance Corporation that insures depositors in federally and state-chartered banks. 

Fixed rate mortgage: A mortgage loan that has a constant interest rate for its whole term.

Home equity loan: A mortgage loan, usually in addition to the primary mortgage loan, which allows the borrower to convert a portion of real estate equity into cash. 

Loan origination fee: Payments made to a lender at the inception of a loan to pay for the lender’s underwriting services.

Money market deposit account: An account offered at a banking institution that has features similar to a money market mutual fund. Accounts under $100,000 are insured by the Federal Deposit Insurance Corporation. 

Money market mutual fund: A registered investment company that invests in securities that have short-term maturities (usually from several days to several weeks). 

Mortgage broker: An intermediary who charges a fee to facilitate acquisition of a loan to purchase real estate. 

Mortgage insurance: A coverage that is often required by lenders, and paid for by borrowers, for the purpose of insuring the lender against potential default by the borrower. 

National Credit Union Administration: An agency of the United States government that insures deposits in credit unions. 

National Credit Union Share Insurance Fund: A program of the National Credit Union Administration that insures shareholders of credit unions. 

Non-recurring expenses: Irregular household operating expenditures, the timing of which during a year may not be determined precisely, or expenditures that occur less frequently than monthly. Examples include car repairs, home repairs, and insurance premiums. 

Personal Inflation Index: A statistic that adjusts the Consumer Price Index to specific spending patterns of a household. 

Recurring expenses: Regular household operating expenditures that occur every month. 

Reverse mortgage: A loan secured by real estate that allows the borrower to convert equity into cash without having to make monthly payments during the term of the loan. The loan plus accrued interest is paid from the proceeds of the sale of the property.

Savings Association Insurance Fund: A program of the Federal Deposit Insurance Corporation that insures depositors in federally chartered savings institutions.

Securities Investor Protection Corporation: A membership corporation of securities firms that was authorized by the Securities Investor Protection Act of 1970. 

Total Annual Loan Cost: The total annual financing costs associated with a reverse mortgage.

For more information: www.HealthDictionarySeries.com 

Note: Feel free to send in your own related terms and definitions so that this section may be updated continually in modern Wiki-like fashion.

Product Details

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Filed under: Glossary Terms, Practice Management | Tagged: | 1 Comment »

“First Do No Harm” – A Medical Legal Imperative

Posted on January 30, 2008 by Dr. David Edward Marcinko MBA MEd CMP™

Primum Non Nocere

By Dr. Jay S. Grife; JD, MA

This Latin phrase is axiomatic in intent and is one of the earliest inoculations students of medicine receive.  It dovetails the Hippocratic Oath to provide both a moral and ethical foundation for physicians in furtherance of their mission to heal the sick. It asks little in objective terms but demands an immense measure of dedication and knowledge from those who practice their profession.  Yet, it is roughly estimated that one of every five practicing health care professionals will confront the enigmatic process of medical malpractice within a twelve-month span. Despite the fact that most health care practitioners will never see the inside of a courtroom, the sequelae of the event itself can scar the psyche forever after. And so, the quintessential risk-management question for all medical practitioners is: What can be done when the inevitable happens and what can you as a practicing doctor do to confront the process? 

-Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

INTRODUCTION

“Even among the sciences, [and in the managed care era], medicine still occupies a special position. Its practitioners come into direct and intimate contact with people in their daily lives; they are present at the critical transitional moments of existence. 

For many people, they are the only contact with a world that otherwise stands at a forbidding distance.  Often in pain, fearful of death, the sick have a special thirst for reassurance and vulnerability to belief.” 

Socialization of Medicine and the Litigation Prescriptive “Spark”  

When this trust is violated, whether rooted in factual substance or merely a conclusion lacking in reality, American jurisprudence offers several remedies with the core being civil litigation.

For example, I have witnessed a vast spectrum of reasons that prompts a patient to seek the counsel of an attorney.

Whether it be an untoward result of treatment or surgery, an outstanding invoice being mailed to a less than happy patient who decides that the doctor’s treatment did not measure up to expectations, a physician’s wife, employed as the office manager, charging a patient eighty-five dollars to complete a medical leave authorization form, or simply a perceived lack of concern on the part of the doctor or his personnel, patients can be motivated to seek redress outside the realm of the doctor’s office. 

Compound any of the above scenarios with well-meaning friends and family, and the proverbial initiating “spark” has been lit; and the prescription for litigation has been written.

Bilateral Communication is a Preventative Key 

Woven throughout any discussion of the topic, should be suggestions that might obviate the foregoing.

While it is not a panacea, nor a cure-all for medical negligence cases, many believe it to be the most effective methodology for resolving those differences that see the growth of a medical malpractice lawsuit; honest and bilateral communications. 

Not Trial Bound by Destiny 

In the United States, a trial is thought to be the most common manner in which disputes are resolved. Contrary to what we see on television, very few cases actually make it to trial with most be either dismissed or resolved through mediation or arbitration.

In fact, a few years ago the U.S. Department of Justice recently reported that only about three percent of all civil cases are resolved by a trial. The vast majority of civil lawsuits, and in particular medical malpractice cases, are settled or dismissed before any of the litigants see a courtroom. 

MORE: http://shrutinshetty.com/2016/10/27/primum-non-nocere/

Conclusion:

What has been your experience on this often contentious topic – settle or litigate – please comment? 

Reference: [1] Paul Starr: The Social Transformation of American Medicine, Basic Books, 1982, pgs. 4-5.

  Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

***

Filed under: Professional Liability | Tagged: , , | 2 Comments »