How to avoid a medical malpractice claim

摘要

MONEY MATTERSPatients, frustrated with high deductibles and copays, out-of-pocket costs and lack of medical coverage, are showing this frustration by raising their expectations when seeking ophthalmic care. When a physician does not meet these high expectations, patients want their fees reduced, either through refunds, waived fees or for the practice to pay for additional care. If these upset patients do not have their complaints resolved, their dissatisfaction could lead to an allegation of negligent care, a type of malpractice claim.Here are two common scenarios. The first patient, Mr. Jones, underwent cataract surgery and selected a premium lens implant. Unsatisfied with his postop vision, he demanded his money back. The second patient, Ms. Smith, underwent a bilateral upper and lower blepharoplasty. Postoperatively, she experienced dry eyes and one eye appeared smaller to her than the other eye. The surgeon told the patient that he would address her dry eye condition first, followed by her concerns with the size of her eye. The patient, dissatisfied with the care, never returned. Instead, she went to another ophthalmologist who treated her. The patient later asked the first ophthalmologist for her money back, claiming she had to see a second surgeon in order to receive the treatment she wanted.In such cases, without any admission of negligence, physicians may wish to extend a gesture of goodwill, including: refunding or waiving fees or paying for additional care. Contact your medical malpractice carrier to discuss the matter and ensure proper reporting of the incident. With their guidance, greater than 50% of incidents can be resolved without a formal claim.Some advice on preventing these requests for money:Establish a strong physician-patient relationship.Manage a patient’s expectations of the surgical outcome, thereby eliminating the first step toward filing a claim.Ensure the patient understands that all surgeries are serious; do not describe a procedure as “routine” or “quick and easy.”Explain the differences between a complication and an adverse event. While complications are known potential problems that arise from surgery, adverse events are unexpected problems or outcomes related to the surgical event — and the latter is a potential negligent event.