Dismissing a patient is challenging. Sometimes arranging a graceful exit is best for both you and your patient. This article discusses general tips.  Every case is different. When you do dismiss a patient, individualization is critical. Among other things, you must ensure continuity of care. If you are wondering when you can refuse to treat a patient, or terminate the doctor-patient relationship, schedule a free consultation with our Founder and CEO, Jeff Segal, MD, JD. Medical Justice has helped thousands of doctors address patient conflicts and a bevy of other medico-legal obstacles. We are ready to help.

With that said, onto the article.

Physicians dismiss patients for numerous reasons. The circumstances are never identical, nor are they always undesirable. Often the decision is mutual. As the patient’s care evolves, sometimes the physician responsible for his treatment must change. These “exchanges” are natural and sometimes necessary to drive a patient’s recovery. It’s worth noting patients can dismiss physicians, too.

Other times a patient is dismissed because he becomes a professional hazard. He doesn’t pay his bills. He abuses your staff. His presence creates distractions, which jeopardize the care of other patients.  

Reasons notwithstanding, when you need to dismiss a patient, the act is memorialized in a patient dismissal letter. These letters are chameleons. Their language must change to suit your patient’s circumstances. The art of writing the “bullet-proof” patient dismissal letter is one many a physician would love to master. Written correctly, these letters insulate you against potential charges of malpractice and patient abandonment.  

Let it be said – not all paper shields are useless. 

At Medical Justice, we’ve co-authored hundreds of patient dismissal letters with our clients. The objective of these letters is simple: Help our clients (and indirectly, their patients) formally end the doctor-patient relationship. This allows our clients to move on with their lives without living under the threat of a rogue abandonment charge or a meritless malpractice claim. Conversely, they free the patient to pursue care elsewhere.  

The purpose of this article is to teach doctors how to distinguish a competent patient dismissal letter from an incompetent one. Understanding the difference is important. If you get this wrong, the consequences will be steep. Patient abandonment can be career altering. Dismissal letters exist in part to foreclose such charges.

We’ll begin by defining the obstacle we are attempting to avoid. What is patient abandonment? Here’s our definition…

Patient abandonment occurs when a doctor cuts off the physician-patient relationship while the patient actively needs care and does so without adequate notice to allow the patient to reasonably obtain care elsewhere.

Keep in mind the decision to separate patient from doctor does not need to be mutual. It can be unilateral on your part, even if the patient objects. But medical care is a unique type of interaction because it can literally be a matter of life and death – so the dismissal letter must account for this fact. If the decision to separate is unilateral, your relationship with your patient may (or may not) be amicable. Which brings us to our next point… 

What if my patient is hostile? What if he’s suing me? Do I still have to treat him? 

Our answer is a hard but sympathetic: “Yes. Yes, you do.” You must remember: the doctor-patient relationship only ends when one entity discharges the other. Thus, the necessity of the patient dismissal letter. Unless the patient has previously provided you with a notice of termination of his own making, you have an affirmative duty to memorialize the termination of the relationship. 

Here’s a list of circumstances that, despite their frustrating nature, do not dissolve the patient-physician relationship…

+ If the patient has an outstanding bill, you must treat him.

+ If the patient is suing you, you must treat him. 

+ If he has not contacted the office for a long period of time, you must treat him.

+ If he behaves in a non-compliant manner, you must treat him.

+ If he leaves the hospital against medical advice (AMA), you must treat him. 

+ If the patient changes insurance coverage to an entity you do not accept, you must treat him.

+ If the patient’s managed care plan “deselects” you, you must treat him. 

Until you dismiss him (or until he dismisses you), you are married to him. That said – if your patient has an outstanding bill, intends to sue you, or regularly mistreats you or your staff, you should consider terminating your relationship with him ASAP. A companion piece that addresses these red flags – and several others – is available for download at the end of this article.  

Onto the heart of the piece: Distinguishing competent and incompetent dismissal letters. We’ll demonstrate by presenting templates we believe represent examples of competent patient dismissal letters. These “competent” examples will be followed by a list of characteristics that we associate with incompetent patient dismissal letters. We’ll conclude the piece by examining our templates and identifying how each avoids falling into the five traps described. 

The first item to address: Are you dismissing your patient? Or is your patient dismissing you?  

In the event your patient instigates the switch, he’s likely conversed with you about it. If you have received a signed letter (or an unambiguous message – email) from him affirming his decision to seek care elsewhere, rely on it.  

If you have received no documentation from the patient, don’t wait for him to act. Provide the patient with a dismissal letter. Memorialize your previous discussion. Medical Justice provides members of our organization with bullet-proof templates. If you are considering dismissing a difficult patient, schedule a free consultation with our Founder and CEO, Dr. Jeff Segal – a neurosurgeon and attorney.

This letter serves two purposes. It is a record of past events and demonstrates your willingness to cooperate with your patient. You are facilitating a smooth transition. You are not standing on the other side of the proverbial door, back braced, determined to repel the patient at all costs.  

If the roles are reversed and you are dismissing the patient, we can provide a suitable template.

The reason for termination is generally not stated. This is by design – we’ll explain why this matters shortly. The letter is careful to provide space for the physician to define the official date of termination. Do not make the date the patient receives the letter the starting line – transit is unpredictable. Instead, specify one week from the date of the letter and use that as the basis for any time calculations. 

Another point to address is the period of transitional coverage. Most states require physicians remain available to dispense emergency care for a “reasonable period of time.” This is typically 30 days. However, sometimes this “floor” is insufficient. If your patient lives in a rural area or is in the middle of a complex treatment, you must account for those details. Make sure you allot plenty of time to facilitate a complete transition. You can’t leave the patient stranded.

Dismissing a patient is challenging. Sometimes arranging a graceful exit is best for both you and your patient. This article discusses general tips.  Every case is different. When you do dismiss a patient, individualization is critical. Among other things, you must ensure continuity of care. If you are wondering when you can refuse to treat a patient, or terminate doctor-patient relationship, schedule a free consultation with our Founder and CEO, Jeff Segal, MD, JD. Medical Justice has helped thousands of doctors address patient conflicts and a bevy of other medico-legal obstacles. We are ready to help. For further reading, we suggest this article’s sibling piece: When Can You Refuse to Treat a Patient?

We’ll now take a step away from the templates and review five symptoms of a “bad” patient dismissal letter. You can probably guess a few of them by examining the qualities described above and turning those qualities upside down. 

A bad patient dismissal letter is excessively detailed.

When dismissing a patient, less is more. A patient dismissed under friendly skies usually does not require a verbose explanation. Presumably both parties understand why the relationship is ending. There are no surprises. 

When the patient is being dismissed for “bad behavior,” the physician may feel obligated to explain his decision – both to inform the patient and to cover his back. This can backfire. We typically advise against including the reason for termination. If the relationship has soured, the patient knows why the termination is taking place. Spelling it out for him will only make you appear hostile. And perceived hostility is kindling in the hands of unscrupulous malpractice attorneys. You can’t be certain who will see the letter after you send it. Sanitize your tone. Pertinent information only. 

A bad patient dismissal letter does not consider a patient’s environment. 

Your patient may be hell in human skin, but if he has no other treatment options available to him, you cannot carelessly dismiss him. Physicians practicing in remote communities need to be particularly careful. Consider this example: You are the only oncologist in a small community and your patient has received 1 of 3 planned treatments for chemotherapy. If you dismiss this patient, that dismissal letter could be a death sentence. If you must terminate your relationship with him, make sure the transfer of care is complete before attempting to move forward.  

A bad patient dismissal letter neglects to mention medical records. 

Your patient is always entitled to receive a copy of his medical records. Even if the patient has an outstanding bill, never hold medical records hostage. A competent patient dismissal letter informs the patient that he has access to these materials. A better patient dismissal letter uses simple instructions to tell the patient what he must do to retrieve them.  

A bad patient dismissal letter does not account for emergency care. 

After formally dismissing the patient, you must be available to provide him with urgent or emergent care for a reasonable period of time – or until that patient finds a new doctor, whichever comes first. As we stated previously, this period usually encompasses 30 days. If your patient’s circumstances require more time, you must account for it.  

A bad patient dismissal letter is poorly timed. 

Think twice before dismissing a patient immediately after concluding an operation. An unexpected or oddly timed dismissal may signal to the patient something is expected to go awry. Whether this is true is irrelevant – your patient’s perceptions will determine how he reacts. Many abandonment charges are fueled by feelings of fear. In the unlikely event something does go wrong, treating the complication will be easier if the patient has remained in your care. If circumstances require you dismiss the patient post-op, take the initiative. Find the patient another doctor to assume care and don’t distance yourself from him until the transfer is documented.  

In closing, the five traps we’ve identified are bound by a common thread: They all disregard an important aspect of the patient’s care or present information that could be leveraged against the physician in a malpractice case. Summarized, a competent patient dismissal letter… 

+ Includes only necessary information… 

+ Does not dismiss a patient in the middle of a treatment plan… 

+ Affirms that medical records will remain available…

+ Affirms the physician will remain available for a period to dispense emergency care and clearly states how long this period will last… 

+ Allows sufficient time to complete the transfer of care…

If this article conveys only a few essential truths, we hope this is one of them: dismissing a patient correctly is a delicate process. Most physicians would rather “stick it out” than dismiss potential hazards earlier than necessary. The labor required to end the patient-physician relationship is substantial.

When the doctor-patient relationship sours, it is sometimes best to terminate care and guide the patient towards a different doctor. The transfer of care is always tricky – do it wrong, and you may face an abandonment charge.

Did you know? Members of Medical Justice don’t need to worry about this scenario – our DISAPPEAR program ensures that if a doctor and a patient must part, the separation is complete, documented, and compliant.

There are times when it really is best to divorce yourself from your patient and move on. Every practice terminates a doctor-patient relationship at some point. This article discusses general tips. But each situation is different and details matter. A lot. No worries. Let our experts guide you through YOUR situation. Confidentially. No obligation. Ready when you are. Request a consultation below. And for further reading, we suggest this article’s sibling piece: When Can You Refuse to Treat a Patient?

Learn how Medical Justice can protect you from medico-legal mayhem… 

Jeffrey Segal, MD, JD

Chief Executive Officer and Founder

Dr. Jeffrey Segal, Chief Executive Officer and Founder of Medical Justice, is a board-certified neurosurgeon. Dr. Segal is a Fellow of the American College of Surgeons; the American College of Legal Medicine; and the American Association of Neurological Surgeons. He is also a member of the North American Spine Society. In the process of conceiving, funding, developing, and growing Medical Justice, Dr. Segal has established himself as one of the country’s leading authorities on medical malpractice issues, counterclaims, and internet-based assaults on reputation.

Dr. Segal was a practicing neurosurgeon for approximately ten years, during which time he also played an active role as a participant on various state-sanctioned medical review panels designed to decrease the incidence of meritless medical malpractice cases.

Dr. Segal holds a M.D. from Baylor College of Medicine, where he also completed a neurosurgical residency. Dr. Segal served as a Spinal Surgery Fellow at The University of South Florida Medical School. He is a member of Phi Beta Kappa as well as the AOA Medical Honor Society. Dr. Segal received his B.A. from the University of Texas and graduated with a J.D. from Concord Law School with highest honors.

In 2000, he co-founded and served as CEO of DarPharma, Inc, a biotechnology company in Chapel Hill, NC, focused on the discovery and development of first-of-class pharmaceuticals for neuropsychiatric disorders.

Dr. Segal is also a partner at Byrd Adatto, a national business and health care law firm. With over 50 combined years of experience in serving doctors, dentists, and other providers, Byrd Adatto has a national pedigree to address most legal issues that arise in the business and practice of medicine.

Medical Justice Founder and CEO, Jeffrey Segal, MD, JD, Medical Justice General Counsel, Michael Sacopulos, JD, and many guests discuss modern medico-legal threats to physicians. Opening and closing music written and produced by Grammy award winning artists: Lili Haydn and Itai Disraeli (performed by The Service Cats).

The information presented on this site is for general educational purposes only. It is not specific medical or legal advice. Nothing on this site should be construed as establishing a doctor-patient or attorney-client relationship.

EP 94: Surgeon Unmasks the Unmaskable Defamatory Reviewer – How She Did It (Part 2)

Dr. Susan Schroeder is an extremely talented dermatological surgeon. She’s been in practice for over two decades. She’s treated thousands of patients. In the mid-2000s, she noticed an abnormally large number of negative reviews. She suspected foul play and spearheaded an investigation. Over the course of several years, she slowly unmasked the malicious entities responsible for the damaging reviews. Her success bucks the trend. Doctors who attempt to use the law to uncover these defamatory entities often lose, and lose big. How did she do it, and what were the final outcomes? Our two-part podcast has the details…

EP 93: Surgeon Unmasks the Unmaskable Defamatory Reviewer – How She Did It (Part 1)

Dr. Susan Schroeder is an extremely talented dermatological surgeon. She’s been in practice for over two decades. She’s treated thousands of patients. In the mid-2000s, she noticed an abnormally large number of negative reviews. She suspected foul play and spearheaded an investigation. Over the course of several years, she slowly unmasked the malicious entities responsible for the damaging reviews. Her success bucks the trend. Doctors who attempt to use the law to uncover these defamatory entities often lose, and lose big. How did she do it, and what were the final outcomes? Our two-part podcast has the details…

EP 92: Raving Patients and Reputation Marketing with Dr. Len Tau (Part 2)

Chosen as one of the top leaders in dental consulting by Dentistry Today, Len Tau, DMD, has dedicated his professional life to improving dentistry for patients and other dentists. After purchasing his practice, the Pennsylvania Center for Dental Excellence in Philadelphia in 2007, Len practiced full-time while consulting with other dental practices, training thousands of dentists about reputation marketing, leading the dental division of BirdEye, a reputation marketing platform, and hosting the popular Raving Patients podcast. He recently authored the book Raving Patients and 100+ Tips to 100 5-Star Reviews in 100 Days released in March 2022.
Len lectures nationally and internationally on using internet marketing, social media, and reputation marketing to make dental offices more visible and credible as well as how to increase their case acceptance. Dr. Tau and Dr. Segal discuss reputation marketing best practices specific to dentists – but the take-home points resonate with all healthcare professionals. Join us.

EP 91: Raving Patients and Reputation Marketing with Dr. Len Tau (Part 1)

Chosen as one of the top leaders in dental consulting by Dentistry Today, Len Tau, DMD, has dedicated his professional life to improving dentistry for patients and other dentists. After purchasing his practice, the Pennsylvania Center for Dental Excellence in Philadelphia in 2007, Len practiced full-time while consulting with other dental practices, training thousands of dentists about reputation marketing, leading the dental division of BirdEye, a reputation marketing platform, and hosting the popular Raving Patients podcast. He recently authored the book Raving Patients and 100+ Tips to 100 5-Star Reviews in 100 Days released in March 2022.
Len lectures nationally and internationally on using internet marketing, social media, and reputation marketing to make dental offices more visible and credible as well as how to increase their case acceptance. Dr. Tau and Dr. Segal discuss reputation marketing best practices specific to dentists – but the take-home points resonate with all healthcare professionals. Join us.

EP 90: Prescribing Testosterone and Other Controlled Substances Without Getting Blown Up (Part 2 of 2)

There are medical reasons for prescribing testosterone, and there are ways doctors can prescribe it to patients in need while mitigating risk. How?
Enter Mr. Rick Collins, JD. Mr. Collins is an esteemed legal authority in the field of many controlled substances – including testosterone. Dr. Jeff Segal and Mr. Collins discuss at length how to safely prescribe testosterone, the implications of marketing the substance, and how to occupy the interstice of what a patient wants and what the law allows.

EP 89: Prescribing Testosterone and Other Controlled Substances Without Getting Blown Up (Part 1 of 2)

There are medical reasons for prescribing testosterone, and there are ways doctors can prescribe it to patients in need while mitigating risk. How?
Enter Mr. Rick Collins, JD. Mr. Collins is an esteemed legal authority in the field of many controlled substances – including testosterone. Dr. Jeff Segal and Mr. Collins discuss at length how to safely prescribe testosterone, the implications of marketing the substance, and how to occupy the interstice of what a patient wants and what the law allows.

EP 88: Surviving Board Issues from Hell (Part 2 of 2)

Medical board issues top the list of threats doctors fear the most, and for good reason. Not many of us know what to do or who to contact when the Board comes knocking – but best practices do exist. And it’s important doctors take these issues seriously, even if the threats themselves come from a meritless source. Doctors need expert guidance no matter what. Enter James McClendon, JD. Mr. McClendon is a Partner at Husch Blackwell and an expert at addressing Board issues of all kinds. He helps doctors survive high-stakes conflicts and come out on top. Medical Justice and Mr. McClendon speak at length about what doctors can do to increase their odds in the event a confrontation with the Board is inevitable. Our podcast has the details…

EP 87: Surviving Board Issues from Hell (Part 1 of 2)

Medical board issues top the list of threats doctors fear the most, and for good reason. Not many of us know what to do or who to contact when the Board comes knocking – but best practices do exist. And it’s important doctors take these issues seriously, even if the threats themselves come from a meritless source. Doctors need expert guidance no matter what. Enter James McClendon, JD. Mr. McClendon is a Partner at Husch Blackwell and an expert at addressing Board issues of all kinds. He helps doctors survive high-stakes conflicts and come out on top. Medical Justice and Mr. McClendon speak at length about what doctors can do to increase their odds in the event a confrontation with the Board is inevitable. Our podcast has the details…

EP 86: The Ideal Screening Tool for Body Dysmorphic Disorder: Ounce of Prevention Worth Pounds of Cure (Part 2 of 2)

It’s not uncommon for clients to call us with a patient conflict and tell us the following: “I performed a perfect procedure, and the patient is still livid. What did I do wrong?” The problem may not have been the procedure – it’s possible the patient was not a good fit for the procedure in the first place. Here’s what we mean: A patient suffering from a condition like body dysmorphic disorder will likely never be satisfied. Patients suffering from these conditions generally need a referral to a provider who specializes in treating such individuals. How do you broach the subject? How can you screen prospective patients for these challenges BEFORE you assume ownership of their care? Leslie Fletcher, NP-BC, is a highly respected aesthetic nurse injector who has worked since 2001 with world-renowned, celebrity dermatologists and plastic surgeons. Leslie has trained over 6,000 providers and is a master at addressing and resolving patient conflicts specific to the medispa space. Medical Justice and Leslie Fletcher, NP-BC, discuss in detail how surgeons can screen prospective patients for these conditions before treatment starts – increasing the likelihood the patient is a good fit for your practice and minimizing the risk of patient conflict. Our podcast has the details…

EP 85: The Ideal Screening Tool for Body Dysmorphic Disorder: Ounce of Prevention Worth Pounds of Cure (Part 1 of 2)

It’s not uncommon for clients to call us with a patient conflict and tell us the following: “I performed a perfect procedure, and the patient is still livid. What did I do wrong?” The problem may not have been the procedure – it’s possible the patient was not a good fit for the procedure in the first place. Here’s what we mean: A patient suffering from a condition like body dysmorphic disorder will likely never be satisfied. Patients suffering from these conditions generally need a referral to a provider who specializes in treating such individuals. How do you broach the subject? How can you screen prospective patients for these challenges BEFORE you assume ownership of their care? Leslie Fletcher, NP-BC, is a highly respected aesthetic nurse injector who has worked since 2001 with world-renowned, celebrity dermatologists and plastic surgeons. Leslie has trained over 6,000 providers and is a master at addressing and resolving patient conflicts specific to the medispa space. Medical Justice and Leslie Fletcher, NP-BC, discuss in detail how surgeons can screen prospective patients for these conditions before treatment starts – increasing the likelihood the patient is a good fit for your practice and minimizing the risk of patient conflict. Our podcast has the details…

EP 84: Doctors, Data Theft, and Cyber Liability Protection (Part 2 of 2)

Ten years ago, no one talked about cyber liability insurance. That’s changed. So has the world. The laundry list of cyber security threats that COULD disrupt a doctor’s practice is growing. Doctors need an expert who can help them prioritize the risks specific to their practice and act accordingly – BEFORE it’s too late. Enter Teddy Gillen. Teddy and Dr. Segal discuss how doctors can survive cyber-attacks like ransomware, data theft, and more. Our podcast has the details…

EP 83: Doctors, Data Theft, and Cyber Liability Protection (Part 1 of 2)

Ten years ago, no one talked about cyber liability insurance. That’s changed. So has the world. The laundry list of cyber security threats that COULD disrupt a doctor’s practice is growing. Doctors need an expert who can help them prioritize the risks specific to their practice and act accordingly – BEFORE it’s too late. Enter Teddy Gillen. Teddy and Dr. Segal discuss how doctors can survive cyber-attacks like ransomware, data theft, and more. Our podcast has the details…

EP 82: Charting the Healthcare Professional’s Path to Wealth (Part 2)

Healthcare professionals possess high-earning potential. That’s not news. But their path to wealth is different. That’s why it’s critical they consult with experts. Ideally, seasoned pros with a visceral understanding of both medicine and finance. Medical Justice Founder and CEO, Dr. Jeff Segal, and Mr. Jefferey Taxman, the principal of Physicians Financial Services, discuss blueprints for achieving wealth in a special two-part podcast. This is a whirlwind tour. Dr. Segal and Mr. Taxman outline the paths to wealth that will help you thrive – and how to avoid the pitfalls that create havoc. Your wealth (and the financial security of those who count on you) is invaluable. Our collaborative podcast dispenses pearls of wisdom that pay dividends.

EP 81: The Radonda Vaught Verdict from a Nurse’s Perspective (Part 2 of 2)

RaDonda Vaught worked as a nurse at the Vanderbilt University Medical Center between 2015 and January 2018. If you follow medical news outlets, you are likely familiar with Vaught’s case. She mistakenly injected a patient with a paralytic agent, killing her. Healthcare professionals are concerned her case could set a precedent for criminalizing medical errors. Will it? Tina Vinsant is a registered nurse with a BSN from Lincoln Memorial University in East Tennessee. Tina has been a nurse for six years. She worked for four and a half years in a Progressive Care Unit at the region’s only level one trauma center. She worked as a team leader in this PCU as a certified Progressive Critical Care Nurse for over a year. She has since moved to the Cardiovascular Intensive Care Unit and is now a certified Critical Care Registered Nurse. Tina also operates her own podcast, Good Nurse, Bad Nurse. Medical Justice speaks with Tina at length about Vaught’s case, outcomes, and sentencing. The Vaught case will impact ALL healthcare professionals. During these events, a nurse’s perspective is invaluable. Our podcast has the details…

EP 80: Charting the Healthcare Professional’s Path to Wealth (Part 1)

Healthcare professionals possess high-earning potential. That’s not news. But their path to wealth is different. That’s why it’s critical they consult with experts. Ideally, seasoned pros with a visceral understanding of both medicine and finance. Medical Justice Founder and CEO, Dr. Jeff Segal, and Mr. Jefferey Taxman, the principal of Physicians Financial Services, discuss blueprints for achieving wealth in a special two-part podcast. This is a whirlwind tour. Dr. Segal and Mr. Taxman outline the paths to wealth that will help you thrive – and how to avoid the pitfalls that create havoc. Your wealth (and the financial security of those who count on you) is invaluable. Our collaborative podcast dispenses pearls of wisdom that pay dividends.

EP 79: The Radonda Vaught Verdict from a Nurse’s Perspective (Part 1 of 2)

RaDonda Vaught worked as a nurse at the Vanderbilt University Medical Center between 2015 and January 2018. If you follow medical news outlets, you are likely familiar with Vaught’s case. She mistakenly injected a patient with a paralytic agent, killing her. Healthcare professionals are concerned her case could set a precedent for criminalizing medical errors. Will it? Tina Vinsant is a registered nurse with a BSN from Lincoln Memorial University in East Tennessee. Tina has been a nurse for six years. She worked for four and a half years in a Progressive Care Unit at the region’s only level one trauma center. She worked as a team leader in this PCU as a certified Progressive Critical Care Nurse for over a year. She has since moved to the Cardiovascular Intensive Care Unit and is now a certified Critical Care Registered Nurse. Tina also operates her own podcast, Good Nurse, Bad Nurse. Medical Justice speaks with Tina at length about Vaught’s case, outcomes, and sentencing. The Vaught case will impact ALL healthcare professionals. During these events, a nurse’s perspective is invaluable. Our podcast has the details…

EP 78: Delayed Melanoma Diagnosis Dooms Patient – Or Does It? The Wonky World of Loss of Chance.

The patient/plaintiff was a 78-year-old man. Doctors identified and removed what they believed was a basal cell carcinoma on his arm. Turns out, it was melanoma. When the patient was eventually diagnosed with melanoma, the disease was advanced. The plaintiff’s attorney argued that the initial misdiagnosis damaged his client’s chances of survival. But did it? There’s a legal theory called “loss of chance.” The idea is that when a patient has a horrible prognosis, doctors aren’t always liable for a bad outcome. But details matter. Here’s what doctors need to know…

EP 77: Bad News, Wrong Man. Patient‘s Prostate Removed by Mistake.

Eric Spang underwent a routine prostate examination in late-2020. His blood test revealed elevated levels of a prostate-specific antigen (PSA). This sometimes indicates the presence of prostate cancer. He underwent a biopsy to confirm. When his biopsy came back apparently positive, Mr. Spang and his wife discussed his options and his doctor. After seeking a second opinion, surgeons removed Mr. Spang’s prostate, believing the procedure would save his life. It wasn’t until the procedure concluded that the surgeons realized the mistake. Mr. Spang did not have prostate cancer…

EP 76: Pandemic Violence, Produce Sabotage, Physician Infighting in Idaho. The COVID Half-Hour.

The pandemic has spawned numberless medico-legal challenges. We bring three of the most interesting to your attention. A Texas man staunchly opposed to vaccination threatens a Maryland doctor with violence. Another man in his 40s falsely claims he paid a friend suffering from COVID to visit a local grocery store and lick produce. An Idaho medical association wages war against one of its own leaders when he publicly advocates prescribing Ivermectin to treat COVID. Only in the midst of a pandemic do these events make even a little sense.

EP 75: Fertility Specialist Impregnates Multiple Patients with His Own Sperm and Examines His Own Daughter – 30 Years Later…

The defendant practiced as a fertility specialist in the 1980s. Several of his patients were told they would receive sperm samples donated by medical students. The lawsuit alleges he skirted this detail, substituting his own sperm. He impregnated multiple women.

Flash forward to the late 2010s – a young woman in her 30s is examined by the defendant. This woman is the man’s biological daughter. When this woman investigated her own genetic heritage, she learned the truth…

EP 73: Doctor Sexually Assaults Veteran Patient.

The plaintiff is an Iraq war veteran. The doctor was treating injuries he suffered during combat. The doctor is accused of inappropriately touching the patient’s genitalia during treatment – and then withholding the patient’s prescription unless he allowed the doctor to inappropriately touch him.

The result: A bench trial. The patient received a $1.5 million settlement. It’s important we discuss how we can protect ourselves, our colleagues, and our patients from this kind of horrific behavior.

EP 72: Surgeon Vs. Surgeon: Noncompete Violation. Borrowed Prescription Ledger. Messy Lawsuit.

We return to the state of Florida, and its surgeon vs. surgeon. The defendant signed a non-compete contract with his former employer. He allegedly departed the practice and set up shop next door – violating his non-compete agreement.

It gets juicier – the departing surgeon allegedly told patients he still worked for his former employer. He may have also used a prescription ledger from his previous employer. This case is messy. Our podcast has the details…

EP 71: 5 Year-Old Patient. Misdiagnosis. Catastrophic Stroke.

A five-year-old child presented at the ER with difficult symptoms. The child was seen by a physician’s assistant – not an MD. The physician’s assistant tested the child for strep throat, based on the child’s symptoms. The test returned positive. The child was prescribed medication and sent home. A few hours later, the child suffered a massive stroke. The child is now bound to a wheelchair and requires a life-care plan. How did this happen? And what can we learn?

EP 70: Pharmacy Refuses to Fill (Then Confiscates) Valid Opioid Prescription. Lawsuit Ensues.

The patient, who became the plaintiff, suffered from a defective hip replacement. He needed medication to manage his pain. He tried to fill his prescription at a local pharmacy. The pharmacist believed the man was pill-seeking and turned him away.

The patient called his doctor, who told the pharmacist the prescription was legitimate. The pharmacist still refused to fill the order. Worse, they confiscated the man’s prescription. Cue opioid withdrawal. What happened?

EP 69: Fewer Malpractice Claims, Safer Medicine, Happier Doctors. We Share Vanderbilt‘s Secret Sauce. (Part 2 of 2)

Why do certain doctors attract a disproportionate amount of malpractice claims? It’s complicated, but the answers are out there. And with the right data and support, high-risk doctors can identify what puts them at risk and course-correct before there’s a crisis.

Dr. Gerald B. Hickson is the Founding Director of the Center for Patient and Professional Advocacy (CPPA) at Vanderbilt University Medical Center. Dr. Hickson and the CPPA have worked tirelessly to support high-risk physicians. Dr. Hickson and his colleagues at Vanderbilt created the CPPA to make medicine kinder, safe, and more reliable for doctors and patients. Preeminent education and research are powerful crisis deterrents.

We spoke to Dr. Hickson at length.

Listeners can learn more about the CPPA by visiting the links below.

Website: https://www.vumc.org/patient-professional-advocacy/vumc-cppa-home

Twitter: VUMC_CPPA

EP 68: Fewer Malpractice Claims, Safer Medicine, Happier Doctors. We Share Vanderbilt‘s Secret Sauce. (Part 1 of 2)

Why do certain doctors attract a disproportionate amount of malpractice claims? It’s complicated, but the answers are out there. And with the right data and support, high-risk doctors can identify what puts them at risk and course-correct before there’s a crisis.

Dr. Gerald B. Hickson is the Founding Director of the Center for Patient and Professional Advocacy (CPPA) at Vanderbilt University Medical Center. Dr. Hickson and the CPPA have worked tirelessly to support high-risk physicians. Dr. Hickson and his colleagues at Vanderbilt created the CPPA to make medicine kinder, safe, and more reliable for doctors and patients. Preeminent education and research are powerful crisis deterrents.

We spoke to Dr. Hickson at length. Listeners can learn more about the CPPA by visiting the links below.

Website: https://www.vumc.org/patient-professional-advocacy/vumc-cppa-home

Twitter: VUMC_CPPA

EP 67: How a 21st Century Answering Service Immunizes Practices from a Surprisingly Common Source of Litigation. The After-Hours “He-Said She-Said.”

We cannot count the number of times a doctor has called us and said: “If I only had a recording of my conversation with the patient, my case would have been dropped instantly.” During a medico-legal crisis, solid evidence can save a doctor from a disruptive, expensive, drag-out knock-down lawsuit.

We spoke at length with Dr. Michael Nusbaum, co-founder of MedXCom. MedXCom provides doctors with a simple, reliable, HIPAA-compliant way of storing and retrieving conversations with their patients for 23 years. The technology makes patient-to-doctor communication easier, more secure, and lower-risk. MedXCom is more than just an automated answering service – if you are sued, its technology can save you.

Our podcast has the details. Here’s what doctors need to know…

EP 66: The Legal Scourge Taking a Bite Out of Doctors: Websites Triggering ADA Lawsuits (Part 2 of 2)

There is a scourge taking a bite out of West Coast physicians. What kind of scourge? A legal scourge. Doctors of all specialties (but especially those in cash-pay specialties) have been targeted by frivolous lawsuits specific to website accessibility and the American’s with Disabilities Act (ADA). Thankfully, remedies exist. We spoke with Mr. Nick Pujji, of the Dentons Law Firm, at length about this topic. We discuss how doctors can reduce the risk they’ll be sued for frivolous ADA challenges – and what do to in the event they are sued. Mr. Pujji’s wisdom is invaluable – every doctor NEEDS to protect their practice BEFORE they sued. Our podcast has the details. 

EP 65: The Legal Scourge Taking a Bite Out of Doctors: Websites Triggering ADA Lawsuits (Part 1 of 2)

There is a scourge taking a bite out of West Coast physicians. What kind of scourge? A legal scourge. Doctors of all specialties (but especially those in cash-pay specialties) have been targeted by frivolous lawsuits specific to website accessibility and the American’s with Disabilities Act (ADA). Thankfully, remedies exist. We spoke with Mr. Nick Pujji, of the Dentons Law Firm, at length about this topic. We discuss how doctors can reduce the risk they’ll be sued for frivolous ADA challenges – and what do to in the event they are sued. Mr. Pujji’s wisdom is invaluable – every doctor NEEDS to protect their practice BEFORE they sued. Our podcast has the details. 

EP 64: Pregnant Patient + False HIV Diagnosis + Inept Delivery = Trainwreck (Part 3)

In January 2017, a husband and wife applied for life insurance. The wife was pregnant. Part of the application process required them to complete a blood test. The blood test indicated the wife was HIV positive. When this news was delivered to the patient in front of her husband, the patient vomited. When she demanded an explanation, the practice insinuated her husband was participating in an extra-marital affair.

The lab result was ultimately deemed a false positive. The husband and wife sued, the practice, alleging the practice’s negligence inflicted undue emotional distress. The lawsuit also stated that even if the woman WAS HIV positive, this information should not have been casually revealed in the presence of her husband. A defense verdict was delivered – meaning the doctor/practice prevailed. What can we learn? Our podcast has the details.

EP 63: ”Hey, Doc – Those Are MY Pictures on YOUR Website.” What Now? Copyright Infringement Defense 101. (Part 2 of 2)

Doctors sometimes receive this warning: “Prepare to be sued for copyright infringement.” They dismiss these warnings, assuming they are scams. Some of these notices are scams. But many others signal real litigious intent. Minor infringement can add up to an expensive and disruptive payment. It is critical doctors understand how to qualify and de-escalate claims of copyright infringement. We spoke with copyright and intellectual property attorney Steve Vondran at length. He understands these domains viscerally.

EP 62: Pregnant Patient + False HIV Diagnosis + Inept Delivery = Trainwreck (Part 2)

In January 2017, a husband and wife applied for life insurance. The wife was pregnant. Part of the application process required them to complete a blood test. The blood test indicated the wife was HIV positive. When this news was delivered to the patient in front of her husband, the patient vomited. When she demanded an explanation, the practice insinuated her husband was participating in an extra-marital affair.

The lab result was ultimately deemed a false positive. The husband and wife sued, the practice, alleging the practice’s negligence inflicted undue emotional distress. The lawsuit also stated that even if the woman WAS HIV positive, this information should not have been casually revealed in the presence of her husband. A defense verdict was delivered – meaning the doctor/practice prevailed. What can we learn? Our podcast has the details.

EP 61: ”Hey, Doc – Those Are MY Pictures on YOUR Website.” What Now? Copyright Infringement Defense 101. (Part 1 of 2)

Doctors sometimes receive this warning: “Prepare to be sued for copyright infringement.” They dismiss these warnings, assuming they are scams. Some of these notices are scams. But many others signal real litigious intent. Minor infringement can add up to an expensive and disruptive payment. It is critical doctors understand how to qualify and de-escalate claims of copyright infringement. We spoke with copyright and intellectual property attorney Steve Vondran at length. He understands these domains viscerally.

EP 60: Pregnant Patient + False HIV Diagnosis + Inept Delivery = Trainwreck (Part 1)

In January 2017, a husband and wife applied for life insurance. The wife was pregnant. Part of the application process required them to complete a blood test. The blood test indicated the wife was HIV positive. When this news was delivered to the patient in front of her husband, the patient vomited. When she demanded an explanation, the practice insinuated her husband was participating in an extra-marital affair.

The lab result was ultimately deemed a false positive. The husband and wife sued, the practice, alleging the practice’s negligence inflicted undue emotional distress. The lawsuit also stated that even if the woman WAS HIV positive, this information should not have been casually revealed in the presence of her husband. A defense verdict was delivered – meaning the doctor/practice prevailed. What can we learn? Our podcast has the details.

EP 59: Hypertensive Patient Receives Facelift, Bleeds Post-Op, Sues Surgeon After 18 Day Hospital Stint. Surgeon Prevails. (Part 2 of 2)

A patient approached a plastic surgeon, seeking a facelift. The surgeon evaluated the patient and scheduled the procedure. The patient was on medication for high blood pressure, and the surgeon understood this. After the procedure was finished, the patient began to bleed and was rushed to the hospital. After an 18 day stint in the hospital, the patient sued her surgeon, alleging he failed to anticipate her various post-op complications. The surgeon prevailed (defense verdict), but there are still lessons to be learned.

Our podcast has the details.

EP 58: An ER Doctor Was Sued. She Survived and is Thriving. Hear Her Story. (Part 2)

Dr. Gita Pensa is an experienced ER physician. In 2007, Dr. Pensa was sued. Dr. Pensa eventually prevailed and is thriving – but it wasn’t easy. She went to court in 2011. A defense verdict was delivered – and then overturned in 2015. She prevailed again in 2019, 12 years after the saga began. Dr. Pensa is passionate about teaching other doctors how to survive legal turmoil. In addition to her work as an educator and an ER physician, Dr. Pensa operates her own podcast, Doctors and Litigation: The L Word. Her mission? Teach doctors how to survive malpractice litigation and thrive in the aftermath. We spoke to Dr. Pensa at length. Her insights are invaluable.

EP 57: Patient Shot in the Back, Advised to Have Surgery, Refuses, then Sues. (Part 1 of 2)

A German tourist was enjoying a drink at a bar located in the southern United States. After a brief argument with another patron, he was shot in the back. Due to the extent of his injuries, surgery was advised. The patient initially refused and demanded to be transferred to a different hospital. He was transferred and the receiving doctor performed 9 surgeries. The patient recovered and sued the first hospital that received him, alleging a delay in treatment worsened his injuries. An interesting way of expressing gratitude.

Our podcast has the details…

EP 56: An ER Doctor Was Sued. She Survived and is Thriving. Hear Her Story. (Part 1)

Dr. Gita Pensa is an experienced ER physician. In 2007, Dr. Pensa was sued. Dr. Pensa eventually prevailed and is thriving – but it wasn’t easy. She went to court in 2011. A defense verdict was delivered – and then overturned in 2015. She prevailed again in 2019, 12 years after the saga began. Dr. Pensa is passionate about teaching other doctors how to survive legal turmoil. In addition to her work as an educator and an ER physician, Dr. Pensa operates her own podcast, Doctors and Litigation: The L Word. Her mission? Teach doctors how to survive malpractice litigation and thrive in the aftermath. We spoke to Dr. Pensa at length. Her insights are invaluable.

EP 55: It’s All in the Delivery: Breaking Bad News to Patients – How To Do It (Part 2)

No one likes delivering bad news. But delivering bad news is a reality most doctors must navigate every day. Doctors who learn to do it well can carry patients through the most difficult days of their lives. Doctors who do it poorly wreak havoc. Dr. Anthony Orsini, an experienced neonatologist and creator of The Orsini Way, has mastered the art of delivering bad news. We spoke to Dr. Orsini at length. His insights are invaluable. Dr. Orsini hosts his own podcast, Difficult Conversations: Lessons I Learned as an ICU Physician, on his website, The Orsini Way. Contact Dr. Orsini via his website, The Orsini Way, or via email at drorsini@theorsiniway.com.

EP 54: It’s All in the Delivery: Breaking Bad News to Patients – How To Do It (Part 1)

No one likes delivering bad news. But delivering bad news is a reality most doctors must navigate every day. Doctors who learn to do it well can carry patients through the most difficult days of their lives. Doctors who do it poorly wreak havoc. Dr. Anthony Orsini, an experienced neonatologist and creator of The Orsini Way, has mastered the art of delivering bad news. We spoke to Dr. Orsini at length. His insights are invaluable. Dr. Orsini hosts his own podcast, Difficult Conversations: Lessons I Learned as an ICU Physician, on his website, The Orsini Way. Contact Dr. Orsini via his website, The Orsini Way, or via email at drorsini@theorsiniway.com.

EP 53: Anonymous Major League Pitcher versus Anonymous Surgeon. $5 Million Settlement. Surgeon on Phone in OR.

The plaintiff underwent spine surgery to relieve chronic back pain. In the days following the procedure, the plaintiff’s wound began leaking spinal fluid. Investigation revealed a stray shard of bone was the culprit.

The twist: The plaintiff alleged the surgeon was distracted during the procedure, texting his colleagues and booking future cases while operating. But is there more to this story? Our podcast has the details.

EP 52: Padding Test Results. $3 Million Verdict. What Was He Thinking?

A nine-year-old child was referred to a neurologist. The neurologist diagnosed the child with epilepsy and prescribed medication. When the child’s condition failed to improve, the mother investigated. She eventually filed a lawsuit, alleging the doctor INTENTIONALLY MISDIAGNOSED her child (and many others) so that he could collect substantial kickbacks from his hospital. We have the details. Here’s what doctors need to know.

EP 51: Lawsuit Tsunami: Understanding the ADA So YOU Don’t Get Sued (Part 2)

Website accessibility lawsuits against medical clinics large and small are exploding. According to one 2020 study, as many as 98% of clinics may be vulnerable to financial loss. It is critical doctors understand the Americans with Disabilities Act. Bill Goren, JD, is THE ADA expert. We spoke with Bill directly – his insights are invaluable. Here’s what doctors need to know…

EP 50: Lawsuit Tsunami: Understanding the ADA So YOU Don’t Get Sued (Part 1)

Website accessibility lawsuits against medical clinics large and small are exploding. According to one 2020 study, as many as 98% of clinics may be vulnerable to financial loss. It is critical doctors understand the Americans with Disabilities Act. Bill Goren, JD, is THE ADA expert. We spoke with Bill directly – his insights are invaluable. Here’s what doctors need to know…

EP 49: Hospital Blasted with $80K Penalty for Dragging Its Heels in Releasing Records (Part 2)

Most practices dispense medical records on auto-pilot. A patient requests them, the practice delivers. It’s the law. Most practices do so in a timely manner – but the penalty for dragging your feet was minor. That’s changed. In 2019, two entities were blasted with an $80,000 penalty for failing to release these records quickly. Factoring in the cost of attorneys, that number easily inflated to six figures. Here’s how YOU can avoid getting blasted…

EP 48: Hospital Blasted with $80K Penalty for Dragging Its Heels in Releasing Records (Part 1)

Most practices dispense medical records on auto-pilot. A patient requests them, the practice delivers. It’s the law. Most practices do so in a timely manner – but the penalty for dragging your feet was minor. That’s changed. In 2019, two entities were blasted with an $80,000 penalty for failing to release these records quickly. Factoring in the cost of attorneys, that number easily inflated to six figures. Here’s how YOU can avoid getting blasted…

EP 47: The New Business Intelligence Platform Changing The Way Aesthetic Practices Do Business

Terri Ross is a world-renowned aesthetic consultant. She understands the business side of medicine viscerally – she’s lived in that world for 15+ years. And as an aesthetic consultant, her financial health is tied directly to the financial health of her clients, so she’s got only one option: See that her clients excel.

Terri and her team at APX examine the overall health of a practice, identify where practices are making money, where they are losing money, and what changes practices must prioritize to grow.

The path to growth is rarely obvious – which is why Terri’s skill set is invaluable. On this episode of our podcast, Terri translates her years of experience into actionable insights every aesthetic practice must-hear.

EP 46: $30 Million Judgment. Patient Deceased. Surgeon Unable to Be in Two Places at Once. (Part 2)

The defendant surgeon was on-call. A patient with a gunshot wound to the liver was rushed to the hospital. The defendant was in the middle of an elective hernia procedure and could not treat the wounded patient. When the surgeon finished his first elective case, he began another scheduled elective procedure. When contacted by the hospital staff, the surgeon suggested they find someone else to perform the surgery. The injured patient died. The payout? $30 million. How did this happen? Is there more to this story?

EP 45: $30 Million Judgment. Patient Deceased. Surgeon Unable to Be in Two Places at Once. (Part 1)

The defendant surgeon was on-call. A patient with a gunshot wound to the liver was rushed to the hospital. The defendant was in the middle of an elective hernia procedure and could not treat the wounded patient. When the surgeon finished his first elective case, he began another scheduled elective procedure. When contacted by the hospital staff, the surgeon suggested they find someone else to perform the surgery. The injured patient died. The payout? $30 million. How did this happen? Is there more to this story? Here’s what doctors need to know…

This episode explores Part I of this case. Part II will be released soon.

 EP 44: A Doctor’s Trip to Cyber-Hell and Back: Surviving Ransomware and Data Breaches (Part 2)

Ransomware is a virtual pandemic. Doctors train their staff to filter suspicious messages and encrypt devices loaded with sensitive information. Despite these precautions, breaches are inevitable. Some cost doctors hundreds of dollars per patient. And breaches almost always impact large volumes of patients. With that in mind, overnight bankruptcy is not an exaggeration. Cyber liability coverage provides a cash cushion, and there are other best practices doctors MUST follow.

EP 43: How Powerhouse Law Firm ByrdAdatto Protects Doctors with NO Hourly Billing (Part 2)

Michael Byrd and Brad Adatto are partners at the ByrdAdatto law firm. ByrdAdatto is a legal powerhouse in the healthcare niche. Michael and Brad understand doctors viscerally. Not only because of their training and client-base but because they are children of physicians. 

Today, we discuss what doctors need to know to protect themselves from expected and unexpected medico-legal mayhem – and why smart doctors with good intentions end up in prison.

Every doctor is exposed to different medico-legal risks. The law as it pertains to medicine is rarely black and white. ByrdAdatto guides doctors through the black, the white, and the grey with expert counsel.

And the best part? They do all this with NO hourly billing. Michael Byrd and Brad Adatto host their own podcast – the Legal 123s with ByrdAdatto. Listen and subscribe on your favorite podcast platforms like Apple Podcasts, Spotify, Google, and YouTube.

EP 42: How Powerhouse Law Firm ByrdAdatto Protects Doctors with NO Hourly Billing (Part 1)

Michael Byrd and Brad Adatto are partners at the ByrdAdatto law firm. ByrdAdatto is a legal powerhouse in the healthcare niche. Michael and Brad understand doctors viscerally. Not only because of their training and client-base but because they are children of physicians. 

Today, we discuss what doctors need to know to protect themselves from expected and unexpected medico-legal mayhem – and why smart doctors with good intentions end up in prison.

Every doctor is exposed to different medico-legal risks. The law as it pertains to medicine is rarely black and white. ByrdAdatto guides doctors through the black, the white, and the grey with expert counsel.

And the best part? They do all this with NO hourly billing. Michael Byrd and Brad Adatto host their own podcast – the Legal 123s with ByrdAdatto. Listen and subscribe on your favorite podcast platforms like Apple Podcasts, Spotify, Google, and YouTube.

EP 41: A Doctor’s Trip to Cyber-Hell and Back: Surviving Ransomware and Data Breaches (Part 1)

Ransomware is a virtual pandemic. Doctors train their staff to filter suspicious messages and encrypt devices loaded with sensitive information. Despite these precautions, breaches are inevitable. Some cost doctors hundreds of dollars per patient. And breaches almost always impact large volumes of patients. With that in mind, overnight bankruptcy is not an exaggeration. Cyber liability coverage provides a cash cushion, and there are other best practices doctors MUST follow.

EP 40: Former FBI Hostage Negotiator Teaches Prevention and Treatment of Clinical Violence in YOUR Medical Practice (Part 2)

Don Robinson is a retired FBI crisis negotiator. He knows conflict. The medical practice is no stranger to conflict (or violence), which is why every doctor MUST heed Don’s wisdom. He’s translated his experiences in counterterrorism, organized crime, and narcotics investigation into an invaluable, trainable skillset for doctors. His goal? Train doctors and their staff in the art of crisis management. Reducing clinical violence by even a modest percentage could save hospitals millions, reduce burnout, and save lives. Violence against healthcare works is an epidemic. Don’s skillset is the cure. Listen to the first part of our conversation now.

Visit Don’s website to download his white paper on preventing clinical violence in your medical practice. 

Contact Don Robinson:

Website: https://clinicalsecurity.org/

Phone: 1-888-705-1007

Email: info@clinicalsecurity.org

EP 39: Former FBI Hostage Negotiator Teaches Prevention and Treatment of Clinical Violence in YOUR Medical Practice (Part 1)

Don Robinson is a retired FBI crisis negotiator. He knows conflict. The medical practice is no stranger to conflict (or violence), which is why every doctor MUST heed Don’s wisdom. He’s translated his experiences in counterterrorism, organized crime, and narcotics investigation into an invaluable, trainable skillset for doctors. His goal? Train doctors and their staff in the art of crisis management. Reducing clinical violence by even a modest percentage could save hospitals millions, reduce burnout, and save lives. Violence against healthcare works is an epidemic. Don’s skillset is the cure. Listen to the first part of our conversation now.

Visit Don’s website to download his white paper on preventing clinical violence in your medical practice. 

Contact Don Robinson:

Website: https://clinicalsecurity.org/

Phone: 1-888-705-1007

Email: info@clinicalsecurity.org

EP 38: Doctor Indicted in Money Laundering Scheme Involving Non-Approved Drugs

Dr. Rahim Shafa and his office manager, Nina Shafa operated the Novel Psychopharmacology Clinic. They are both 62. And they were both indicted in an international money laundering scheme involving non-approved drugs. They have been accused of purchasing these substances from a vendor outside of the US, taking strategic measures to disguise the substances once they made it stateside. The indictment suggests they had been at it for at least 10 years. What possessed the couple to take such a risk so late into their careers? And what can doctors learn?

Guest Episode: Preventing Lawsuits, Dealing with Curbside Consults, and Avoiding Other Legal Land Mines – Dr. Jeff Segal

Dr. Segal is a board-certified neurosurgeon who is also a practicing lawyer! On this episode of the Scope of Practice podcast, Dr. Segal chats with Dr. Brent Lacey. Listen to more episodes of the Scope of Practice Podcast on Dr. Lacey’s website. 

Medical Justice is a physician-based organization focused on keeping doctors from being sued for frivolous reasons. Dr. Segal also founded eMerit to help doctors protect and preserve their reputations – particularly online.

Dr. Segal has established himself as one of the country’s leading authorities on medical malpractice and online reputation.

EP 37: Prescribing the Most Regulated Drug in America: Human Growth Hormone and the Law

Human growth hormone is considered the most regulated drug in the United States. Authorized uses are extremely limited – which is why it is critical doctors of all specialties understand when the drug can be prescribed and when it cannot. Doctors specializing in age medicine must pay especially close attention. The legal consequences of getting this wrong are severe. Bodybuilder and internationally recognized “steroid lawyer” Rick Collins, JD, is our guide on this whirlwind tour of this controversial substance. Don’t miss it. 

EP 36: Steroid Lawyer Reveals What Doctors NEED to Know About Prescribing Performance Enhancing Substances

Rick Collins is a bodybuilder. Rick is also an internationally recognized legal authority in the fields of testosterone, anabolic steroids, and other performance-enhancing substances. He is the original “steroid lawyer.”

Doctors prescribe all types of medications, including performance-enhancing medications – assuming they are medically indicated. Performance enhancing is more than excelling at a sport – it’s about feeling better, looking better, recovering faster, feeling youthful, etc. Doctors who prescribe these medications NEED to understand what the law allows and does not allow. Get this wrong, and you’ll burn. Rick Collins is your “fire-fighter.”  Here’s what doctors need to know…

EP 35: Doctor Murders Doctor: The Bloody History of Medical Licensing in the US (Part II)

These men were like father and son – until an organized effort to regulate the practice of medicine drove one doctor to murder the other. Most of us can’t imagine a world where the practice of medicine in the US is unregulated. But until the late 1800s, that was the American reality. Professor James Mohr, the author of the fascinating book, Licensed to Practice: The Supreme Court Defines the American Medical Profession, takes us on a wild two-part ride through the past no doctor should miss.

EP 34: The Surgeon Who Appeared in Traffic Court by Zoom During Surgery. Hear the Real Story. From Him.

Dr. Scott Green is a talented plastic surgeon trapped in a 21st-century media storm. Dr. Green received a traffic ticket. Because of COVID restrictions, he appeared in traffic court via Zoom after successfully completing the salient portion of his patient’s surgery. His fellow was closing. A faulty Zoom connection created a false narrative that Dr. Green was careless and cavalier. This judgment is both false and unfair.

How do we know? We spoke to Dr. Green ourselves. Every doctor needs to hear his side of the story. Why? What happened to him could happen to any of us. Listen to his story…

EP 33: Doctor Murders Doctor: The Bloody History of Medical Licensing in the US (Part I)

These men were like father and son – until an organized effort to regulate the practice of medicine drove one doctor to murder the other. Most of us can’t imagine a world where the practice of medicine in the US is unregulated. But until the late 1800s, that was the American reality. Professor James Mohr, the author of the fascinating book, Licensed to Practice: The Supreme Court Defines the American Medical Profession, takes us on a wild two-part ride through the past no doctor should miss. Our podcast has the details…

Guest Episode: How to Keep Lawyers from Circling Your Aesthetic Practice with Teri Ross

EP 32: Med Spas: Cash Cows, or Multi-Million Dollar Landmines? (Part II)

We resume our roller-coaster discussion with Alex Thiersch, JD, Founder and CEO of the American Medical Spa Association. Here’s the reality: Many highly skilled and well-intentioned doctors working in or operating medical spas are slammed for medico-legal oversights. We identity the legal challenges that are closing doors and reveal what actions doctors can take today to neutralize the worst outcomes. 

If you work in, currently operate, or are considering opening a med spa, this podcast is a must-listen… 

EP 31: Med Spas: Cash Cows, or Multi-Million Dollar Landmines? (Part I)

What do you do when you see a massive, multi-billion-dollar industry developing right before your eyes – only to find out it is largely operating illegally? If you are Alex Thiersch, JD, Founder and CEO of the American Medical Spa Association, you jump into that space and start working out the regulatory pathways required to make that multi-billion-dollar industry operate safely, profitably, and legally.

Many doctors working in or operating med spas are getting thrashed due to legal oversights. Here’s what doctors need to know to protect their practices…

Episode 30: Las Vegas Couple Makes Killing Billing the Dead for Bullsh** Medicaid Expenses

Dead men tell no tales – so they can’t report you to the federal authorities for money laundering and Medicaid fraud. Before ultimately getting caught, this couple used their ill-gotten gains to finance a penthouse condo, a sports car, a cellar packed with fine wine, and a private jet.  How the hell did they pull this off? How did they get caught? And what lessons can doctors learn from this kind of criminal activity? Our podcast has the details. Don’t miss it.

Episode 29: When Hannibal Lecter is Your Patient.

A violent criminal was pursued by police. Backed into a corner, the criminal killed the advancing canine unit and jumped from a building. He was severely injured in the fall and treated at a local hospital. There, the criminal became a patient. He was monitored by a female guard. He was left unrestrained and attempted to escape, stabbing the guard with a shank. The result? Lots of blood. And a negligence case. Really.

Why was this patient not restrained? How much liability falls on the shoulders of the hospital? The patient (criminal)? The guard? This case is a fascinating, violent mess.

Episode 28: Armed Conflicts in the Practice, Violent Threats, and Suicide Prevention – Former FBI Agent and Police Sergeant Teach Doctors How to Prevent the Worst. (Part 2)

We continue our two-part discussion with Kathy Leodler (former FBI) and Paul Leodler (former police sergeant) of the Rampart Group.

Concealed weapons in the medical practice – where to begin? Is it possible to balance the protection firearms provide with the risks they create? And how should doctors react when a patient (or employee) with a history of extreme behavior (and a sizeable gun collection) threatens violence – or suicide? Most patient interactions are conflict free. But not all of them. Some can be deadly. And if it is predictable, it’s often preventable.

Before we get into the show, here’s a quick message from Resolve – a physician contract review company.

At Resolve, they believe that knowledge is power for physicians. And that power gives you control over your financial future.

Resolve believes that by mining, analyzing and synthesizing data, they can provide you with the information and insight that empowers you to diagnose the health of your career, fully understand your worth and maximize your full potential.

As a company founded by a doctor, for doctors, Resolve’s focus is on the wellbeing of those whose purpose in life is to care for the wellbeing of others.

To have this incredible company review your employment contract, find them at www.doctorpodcastnetwork.com/resolve.

__________________________________

Episode 27: Violent Patient or Employee? Active Shooter? Former FBI Agent and Police Sergeant Teach Doctors How to Prevent the Worst. (Part 1)

Kathy and Paul Leodler run the Rampart Group, a security consulting and investigations company. Kathy Leodler is a former FBI agent who retired after a distinguished 23-year career. Paul Leodler served in local law enforcement for 16 years and has over 40 years security and investigative experience.

They have assisted many doctors. They’ve seen it all. Angry patients. Family members who are exploding – metaphorically. Employees who want the practice to know who’s the “real boss.” They understand security at the highest level – including security nuisances to crises specific to medical practices. Most patient interactions are conflict free – but not all. Some can be deadly. Preparation is key. Here’s what doctors must know…

This episode of the Medical Liability Minute is sponsored by John McCarthy, co-founder of Physician Tax Advisors, and his team of CPAs have a combined total of over 60 years of experience helping physicians save money. Doctors have full plates already – and taxes just add stress.

Get the help you need and save money while you’re at it with Physician Tax Advisors.  

This firm is physician-family owned and works exclusively with physicians to lower their tax bills. By specializing in physician finances, John and his team have helped many physicians with high student debt decide if they need to file their taxes jointly with their spouse or separately. 

We ran the numbers and know that working with John just makes sense. Check them out at www.doctorpodcastnetwork.com/CPA. 

+ Request a complimentary, confidential medico-legal consultation

+ Members: Receive a free month of protection when your colleague joins Medical Justice.

+ Help us make future episodes even better. Review our podcast on iTunes.

+ Questions about membership? Call our admin, Wendy Cates: 336-358-5587

Episode 26: Patient Blinded and Doctor Blind-sided by Referral Gone Bad. Who’s to Blame?

An ophthalmologist determined his patient required the attention of a niche specialist. Fortunately, such a qualified specialist practiced next door (literally). Flash forward: The patient was rendered partially blind. And the cherry on top? The specialist next door did not take the patient’s insurance. A suit resulted.

Questions abound: How much research is the doctor obligated to perform prior to referring a patient? How can doctors reduce risk to themselves (and their patients) when making a referral? And what are the chances this could happen to you?

This episode of the Medical Liability Minute is sponsored by Physician Wealth Services.  Physician Wealth Services is a fee-only financial planning firm devoted to the financial well-being of physicians. Ryan Inman, founder of PWS and creator and host of the Financial Residency Podcast, developed a sense of responsibility to help physicians with their financial goals after witnessing how vulnerable his wife was to poor financial advice during her residency. To work with Ryan so that you can feel more in control of your money, contact him and his team at www.doctorpodcastnetwork.com/physicianwealth

+ Request a complimentary, confidential medico-legal consultation

+ Members: Receive a free month of protection when your colleague joins Medical Justice.

+ Help us make future episodes even better. Review our podcast on iTunes.

+ Questions about membership? Call our admin, Wendy Cates: 336-358-5587

Episode 24: Surgeon Slammed by NFL Star. When Celebrity Patients Sue Doctors. 

An orthopedic surgeon operated on an NFL star athlete. When the athlete experienced a bad outcome, he blamed the surgeon for prematurely ending his career. When a patient’s lost earning potential can be measured in the tens of millions, how can doctors protect themselves from catastrophic settlements?

Most doctors would jump at the chance to operate on someone famous. But star-power can cut.

Here’s what doctors must keep in mind when caring for celebrity patients…

+ Request a complimentary, confidential medico-legal consultation

+ Members: Receive a free month of protection when your colleague joins Medical Justice.

+ Help us make future episodes even better. Review our podcast on iTunes.

+ Questions about membership? Call our admin, Wendy Cates: 336-358-5587

Guest Episode 3: I’m a Doctor: What Will a Medical Liability Mitigation Advisor Do For Me?

Huh? What’s that? Malpractice is a large and expensive part of what doctors have to face in today’s medical landscape. By establishing this relationship ahead of time with an advisor, you can head off a lot of problems before they become really big problems.

Our colleagues at the Paradocs podcast discuss how Medical Justice works offensively against the parties bringing lawsuits against member doctors.

Guest Episode 2: Lessons from a Neurosurgeon-Attorney-CEO

Dave Mandell, partner at OJM Group and host of the Wealth Management for the Modern Physician podcast, discusses, business, medicine, and wealth management with Medical Justice Founder and CEO, Jeff Segal, MD, JD. Listen and subscribe to future episode of the Wealth Management for the Modern Physician podcast here: https://www.ojmgroup.com/wealth-planning-for-the-modern-physician-podcast/

Guest Episode 1: Have You Heard of HIPAA’s Angrier Cousin, TCPA?

Here’s what doctors must know: Texting a patient (without proper written authorization) can result in a $500 penalty. Per text. With no caps. Doctors who text patients without written permission risk ruin. Legislation known as the TCPA (Telephone Consumer Protection Act) dictates stiff penalties specific to texting and privacy violations. 

The good news: The enclosed podcast, produced by our colleagues at the Insight Marketing Group (and featuring Medical Justice Founder and CEO, Jeff Segal, MD, JD) will teach you how to protect yourself from the worst outcome. Need help addressing TCPA compliance? Schedule a free consultation with Medical Justice Founder and CEO, Jeff Segal, MD, JD.

Episode 23: A Storm is Brewing in the Med-Mal World. 

Click here to read the podcast transcript…

A storm is brewing in the med mal world – and one of the best professionals to educate us on the gathering clouds is Teddy Gillen. Who is he? Teddy is a principal at EPIC Insurance Brokers & Consultants. He’s been in the med-mal space his entire career. He has a gift for turning medical malpractice insurance, a subject most perceive as dry and dreary, into a whirlwind narrative that is fascinating and informative. Doctors frequently call us after a crisis has hit. If you spend even a modest amount of time with us today, you’ll walk away with wisdom that will help guard you against the worst med-mal outcomes.

+ Request a complimentary, confidential medico-legal consultation

+ Members: Receive a free month of protection when your colleague joins Medical Justice.

+ Help us make future episodes even better. Review our podcast on iTunes.

+ Questions about membership? Call our admin, Wendy Cates: 336-358-5587

Episode 22: America’s Leading Voice on COVID Speaks from the Frontlines. 

Click here to read the podcast transcript…

Dr. Roger Seheult is arguably America’s leading voice on COVID-19.  He is a pulmonary and critical care doctor treating COVID-19 patients on a daily basis. His website, MedCram, has released over 100 videos on COVID-19. His YouTube channel has over 800,000 subscribers. MedCram’s content has been cited regularly as one of the most credible and accurate sources of COVID information available.

We spoke with Dr. Seheult about his experiences caring for patients on the frontline. And we discuss it all – victories, setbacks, emerging vaccine candidates, and potential treatment options.

+ Request a complimentary, confidential medico-legal consultation.

+ Members: Receive a free month of protection when your colleague joins Medical Justice.

+ Help us make future episodes even better. Review our podcast on iTunes.

+ Questions about membership? Call our admin, Wendy Cates: 336-358-5587

Episode 21: E.R. Doc Sued After Dousing Patient’s Laceration with Pesticide. Who’s to Blame? 

Click here to read the podcast transcript…

A patient was rushed to the E.R. after a lawnmower lacerated his forearm. Sitting on the counter was a product called CaviCide. What’s CaviCide? An industrial strength pesticide. Absolutely not for human use. Which, of course, is precisely why the attending physician and his nurse sprayed it repeatedly into the patient’s gaping wound.

How did this happen? Why was an industrial strength pesticide present in the treatment room? And why did the jury deliver a defense verdict? It’s a complicated case.

+ Request a complimentary, confidential medico-legal consultation.

+ Members: Receive a free month of protection when your colleague joins Medical Justice.

+ Help us make future episodes even better. Review our podcast on iTunes.

+ Questions about membership? Call our admin, Wendy Cates: 336-358-5587

Episode 20: Missiles in the OR. Patient’s Eyeball Pierced by Flying Needle. Who’s to Blame?

Click here to read the podcast transcript…

A 30-gauge needle pierced a patient’s eyeball during an elective procedure. The patient was advised all was well and sent home. She returned a short time later with rapidly deteriorating vision. She was ultimately rendered blind. Was the surgeon at fault? Or was his scrub tech to blame? It’s a complex case.

+ Request a complimentary, confidential medico-legal consultation.

+ Members: Receive a free month of protection when your colleague joins Medical Justice.

+ Help us make future episodes even better. Review our podcast on iTunes.

+ Questions about membership? Call our admin, Wendy Cates: 336-358-5587

Episode 19: Every State Determines Brain Death Differently. Really.

Click here to read the podcast transcript…

What does it mean to be dead? You’d think the answer to that question is binary. You are, or you are not dead. But the fact is every state in the US determines death differently. And the subtle differences can have major consequences for doctors and their patients.

On this episode of the Medical Liability Minute, we discuss brain death with Thaddeus Pope, JD, PhD. Professor Pope is one of the world’s leading experts on medical law and clinical ethics. We are privileged to have Professor Pope as our guest on this episode of the Medical Liability Minute.

+ Request a complimentary, confidential medico-legal consultation.

+ Members: Receive a free month of protection when your colleague joins Medical Justice.

+ Help us make future episodes even better. Review our podcast on iTunes.

+ Questions about membership? Call our admin, Wendy Cates: 336-358-5587

Episode 18: Asset Protection and Wealth Creation for Doctors – Protect Your Nest Egg from COVID-19 with Medical Justice and the OJM Group

Click here to read the podcast transcript and learn how you can get several of the OJM Group’s publications for free…

The COVID-19 pandemic has turned our world on its head – both in terms of our health and our finances. On this episode of the Medical Liability Minute podcast, Medical Justice Founder and CEO, Jeff Segal, MD, JD, discusses asset protection strategies for doctors with David Mandell, JD, MBA. The objective? Help doctors protect their nest eggs during these turbulent times.

David Mandell is a partner at the OJM Group, a multi-disciplinary wealth management firm. What distinguishes them? Their focus on physicians. The OJM Group has worked with over 1500 physician clients in 48 states. David Mandell is an author and renowned authority in the fields of asset protection and general wealth management. We are privileged to have him as our guest on this episode of our podcast.

+ Request a complimentary, confidential medico-legal consultation.

+ Members: Receive a free month of protection when your colleague joins Medical Justice.

+ Help us make future episodes even better. Review our podcast on iTunes.

+ Questions about membership? Call our admin, Wendy Cates: 336-358-5587

Episode 17: Family Practitioner Treats Patient for Depression While Sleeping With His Wife on the Side

It is not uncommon for patients to develop romantic feelings for their caregivers. Managing these emotions is critical. When these emotions are mismanaged, bad outcomes often result.

A family practice doctor was treating a husband and his wife for an assortment of challenges. To make a long story short – the patient’s wife (who was also the doctor’s patient) fell in love with him.

Did this development resolve healthfully? If it did, we wouldn’t be discussing it. What can we learn?

+ Request a complimentary, confidential medico-legal consultation.

+ Members: Receive a free month of protection when your colleague joins Medical Justice.

+ Help us make future episodes even better. Review our podcast on iTunes.

+ Questions about membership? Call our admin, Wendy Cates: 336-358-5587

Episode 16: A Prescription for Humanity in Medicine

Neurosurgeons (and surgeons in general) have a reputation for being cold. Deserved or not, the stereotype has stuck. Dr. Joseph Stern argues embracing humanity in medicine is the key to combating burnout and improving patient outcomes. He speaks from his own experiences and makes compelling arguments.

We are privileged to have him as our guest on this episode of the Medical Liability Minute…

+ Request a complimentary, confidential medico-legal consultation.

+ Members: Receive a free month of protection when your colleague joins Medical Justice.

+ Help us make future episodes even better. Review our podcast on iTunes.

+ Questions about membership? Call our admin, Wendy Cates: 336-358-5587

Episode 15: Combating Sexual Harassment in Healthcare: Protecting Your Employees, Your Patients, and Yourselves

It is critical doctors take steps to protect their staff, their patients, and themselves from sexual harassment. These cases often rear their heads without warning. Many doctors have the power to do more than they realize. Those caught unaware pay a high price. 

On this episode of the Medical Liability Minute, Medical Justice Founder and CEO, Jeff Segal, MD, JD, and Medical Justice General Counsel, Mike Sacopulos, JD, discuss key measures doctors can take to protect their employees, their patients, and themselves from sexual harassment.

They do this by dissecting a real sexual harassment case from Tennessee…

+ Request a complimentary, confidential medico-legal consultation.

+ Members: Receive a free month of protection when your colleague joins Medical Justice.

+ Help us make future episodes even better. Review our podcast on iTunes.

+ Questions about membership? Call our admin, Wendy Cates: 336-358-5587

Episode 14: How to Have Your Day in Court and Keep Your Nest Egg | Top Med-Mal Defense Measures with Super Lawyer Chris Schulte, JD

Let’s pretend you’re on trial for malpractice. The jury delivers a runaway verdict – a 5 million dollar judgement. You have a 1 million dollar malpractice policy. You could be on the hook for the 4 million dollar difference – but because you and the plaintiff agreed to invoke a certain kind of agreement, your nest egg is untouched. And you get to keep your house.

What is this agreement? And what other key strategies can doctors invoke to protect their interests before, during, and after a trial?

Listen to this episode of the Medical Liability Minute to find out…

+ Request a complimentary, confidential medico-legal consultation.

+ Members: Receive a free month of protection when your colleague joins Medical Justice.

+ Help us make future episodes even better. Review our podcast on iTunes.

+ Questions about membership? Call our admin, Wendy Cates: 336-358-5587

Episode 13: What Doctors Get Wrong About Med-Mal Litigation | A Deep Dive with Florida Super Lawyer Chris Schulte, JD

On this episode of the Medical Liability Minute, Medical Justice Founder and CEO, Jeff Segal, MD, JD, and Florida Super Lawyer, Chris Schulte, JD, discuss what most doctors get wrong about medical malpractice litigation – and what they can do to increase the chances they’ll get their case dismissed or prevail in court.

Chris Schulte, JD, is a seasoned medical malpractice defense attorney from Tampa, Florida.

We are privileged to have him as our guest on this episode of the Medical Liability Minute…

+ Request a complimentary, confidential medico-legal consultation.

+ Members: Receive a free month of protection when your colleague joins Medical Justice.

+ Help us make future episodes even better. Review our podcast on iTunes.

+ Questions about membership? Call our admin, Wendy Cates: 336-358-5587

Episode 12: A Doctor’s Greatest Nightmare. Indictment. Prison. Then the Road to Redemption.

Dr. Roy Shelburne was, by all accounts, living the dream. He was leading a successful dental practice. He was providing high-quality care to patients who otherwise would’ve gone without. And he was serving a community of friends and family.

In 2003, the FBI kicked down his door. Over the next few years, his every word was scrutinized. A few years later, he was indicted and found guilty of healthcare fraud, racketeering, money laundering, etc.

Now he teaches others how to avoid fatal mistakes. We are privileged to have him as our guest on this episode of the Medical Liability Minute…

+ Request a complimentary, confidential medico-legal consultation.

+ Members: Receive a free month of protection when your colleague joins Medical Justice.

+ Help us make future episodes even better. Review our podcast on iTunes.

+ Questions about membership? Call our admin, Wendy Cates: 336-358-5587

Episode 11: Making Primary Care Cool Again with Dr. Josh Umbehr and Atlas MD