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Medical Justice Blog

Dental Practice Fined $10k for Improperly Responding to Online Reviews

Elite Dental Associates, a Dallas dental practice, just wrote a check for $10,000 to the Office of Civil Rights (OCR) for Dept. Health and Human Services. The reason. A HIPAA violation. What “egregious” act did the practice commit? Responding to negative reviews on Yelp…

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Do Health Insurance Carriers Have to Pay for Injuries Caused by DUIs?

In the news. Patrick Conway, the president and CEO of Blue Cross Blue Shield of North Carolina was arrested and faces charges of driving while impaired and reckless driving after an alleged alcohol-related automobile accident in summer, 2019. In additional, because two minor children were in the car with him, he also faces charges of misdemeanor child abuse. My point is not to pile on – but use the example to analyze what happens to the average Joe with a fender bender, a DUI, and an injury. And a giant hospital bill.  

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“Doctor, I Need You to See This Patient”

When a nurse beckons, and says she’s worried, you should listen. A recent paper supports this assertion. The title is self-explanatory: The fifth vital sign? Nurse worry predicts inpatient deterioration within 24 hours. The article concluded that nurses’ pattern recognition and sense of worry provides important information for detecting acute physiologic deterioration. How did our Nostradamuses do for 3,000+ patients?

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Cyber-stalker Criminally Indicted for Defaming Physician 

In Texas, there’s a law which makes it a felony to use the name or persona of another person to create a web page or post on a social networking site if the action is taken to harm, threaten, defraud or intimidate the other person. A patient in Austin had a beef with his ophthalmologist. This patient supposedly posted over 100 reviews from 20 different aliases. The origin of the dispute lies in a $45 check. What was his beef? And how did the ophthalmologist overcome him? 

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A Doctor Attempts to Murder an Attorney

Everyone knows we have an opioid crisis. Now we have an opioid treating doctor with his own crisis. Dr. Daniel Schwartz is a pain management physician in Ohio. He was charged with conspiracy, attempt to possess, and attempt to distribute a controlled substance. The conspiracy charge is not a typical physician indictment. Particularly since his attorney described Dr. Schwartz as a “wonderful, gentle guy.” What happened?

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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. It is our privilege to have him as our guest on today’s episode of the Medical Liability Minute. 

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What Do You Want to Get from this Visit?

“What do you hope to get from this visit?” This was the introductory question a physician asked me when I first met him. I prioritized my goals and started a brief narrative. And away we went to the races. The more I thought about this simple question, the more brilliant I thought it. First, it sets a tone that my priorities are important, and a successful visit will be my determination, not the doctor’s. So, find out what matters the most to me.

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Getting Sued Even When You Never Saw the Patient

Medical bulletin boards and blogging sites caught fire about a recently decided case in Minnesota, Warren v. DinterThis glaring headline noted that the essential law underpinning a medical negligence claim – that a doctor-patient relationship must exist for a plaintiff to prevail – was overturned. Doctors are understandably very concerned over this. The implications for medical practice if that were true would be devastating – any doctor could actually be liable to any patient for, well, anything…

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A Severely Mentally Ill Patient Sues You. Now What? 

A Medical Justice member was served with a summons of a case filed in federal court and signed by the clerk of the court. The patient filed pro se – so no lawyer was involved. The surgeon has a limited window of time to respond. Absent a timely response, this patient could receive a default judgment in her favor. This patient appears to exhibit some of the hallmarks of schizophrenia. The summons reads like word salad. There’s no template for events like this – so, here’s what happened…

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The Man Who Told Yelp to Buzz Off. He Succeeded Beyond His Wildest Imagination.

Heard of Botto Bistro? It’s a pizzeria in the Bay Area. Chef Davide Cerrentini, who emigrated to the US in the 90s, opened the restaurant’s doors in 2009. Cerrentini is famous for asking happy diners to give him a one star Yelp review. That’s right. One star. But here’s the thing – he is enormously successful…

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

Dr. Josh Umbehr is a leader in the DPC (Direct Primary Care) movement. Briefly defined – it is prepaid primary care. And it is revolutionizing primary care across the country. This week, the Medical Justice Blog features a new episode of our podcast – the Medical Liability Minute. On this episode of the Medical Liability Minute, Dr. Umbehr and Dr. Segal discuss multiple topics: the DPC movement’s history, its impact on patient outcomes, and what doctors can do to participate….

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Patient Feedback: A Goldmine for Your Practice – in 4 Steps

Patient feedback presents doctors with a chance to look at themselves from the public’s perspective. While this perspective is not always accurate, you shouldn’t discard it. You risk throwing away information that could be used to refine your quality of care (outcomes, safety, and patient experience). This piece will teach you how to make the most of that feedback in four steps…

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A Century of Brutal Call Schedules. The Libby Zion Case. And Cocaine. 3 Converging Stories.

Dr. William Halsted is known as the Father of Modern Surgery. There’s a reason for this – objectively speaking, he was a supremely talented surgeon. The techniques he invented saved lives. But his work-life balance was nonexistent. The man did not sleep. And that lack of sleep shaped the behavior patterns of physicians-in-training for decades…

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Physicians and Gallows Humor. Is It Unprofessional?

Gallows humor is defined as grim and ironic humor in a desperate and hopeless situation. Physicians frequently use gallows humor. They do it to blow off steam. To head off compassion fatigue. Is it unprofessional?

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Defeating Internet Defamation: How Doctors Crush Lies Online

Platforms like Google, Healthgrades, Vitals, and Yelp present the public with information. Information about their health, information about their potential physicians, and information about their local healthcare systems. These platforms exist to educate the public. Overall, they succeed. Unfortunately, their popularity has increased the frequency physicians and dentists are defamed online. Fortunately, solutions exist…

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When Can You Refuse to Treat a Patient?

As you have likely heard, the relationship between a doctor and a patient is a contract. The patient consents to be treated and the doctor consents to treat.  In that purely legal sense, the doctor would therefore have an unfettered right to refuse their role. Of course, that is not actually so. There are critical limitations on when a doctor may refuse to care for a patient…

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New Patient Comes in For Dental Exam. Surprise. He’s 450 Pounds. Is Americans with Disabilities Act Triggered?

We received a call from a dentist in the Midwest. A week earlier someone called for an appointment. He wanted a run of the mill check-up. First available appointment was Friday at 4PM. Just before closing. In the waiting room, the patient appeared morbidly obese… 

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FDA and Drugs Used in Executing the Death Penalty

For years, the FDA took the position that it did not have authority to regulate drugs used for executions – or in the alternative – it had discretion to avoid review. If the intended use is death, it’s hard to argue that a drug is safe and effective for death. Of course, you can make the argument, but saying something is safe for death doesn’t jive with our traditional notions of safety – namely the mitigation or avoidance of harm or death…

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5 More Golden Rules Physicians Should Follow When Responding to Patient Reviews

In February, we published two articles related to patient reviews. One piece was published online. The second was made available for download. Both remain available, and we encourage our readers to study them. Considering the overwhelmingly positive reception both pieces received, we decided to return to the topic and discuss five more golden rules physicians should follow when responding to online reviews. Read the full article to learn how you could win one free HIPAA compliant response to a patient review of your choice…

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Man Bites Dog

If a dog bites a man, that is not newsworthy. When a man bites a dog, it makes news. A patient sues a doctor. Not newsworthy. Doctor sues a patient. That’s a headline. Dr. Leonard Hochstein, star of the reality TV series “The Real Housewives of Miami” is suing two patients, Nicole George and Kristen LaPointe. The two wrote negative online reviews about the practice. As one might expect, an emotionally-charged reaction followed…

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A Good Deed Ends in Arrest

Casey Smitherman is superintendent of a small school district in the Midwest. The town, Elwood, Indiana, has 8,500 people and struggles with serious poverty. Many of its students do not have adequate resources. Ms. Smitherman took a specific student to a medical facility and checked him in for evaluation using her son’s name…

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A Serial Malpracticer

I had never heard of the phrase “serial malpracticer.” It seems to apply to Dr. Spyros Panos, an orthopaedic surgeon who surrendered his medical license six years ago. An arbitrator awarded $140 million to resolve 255 medical malpractice lawsuits in New York. Dr. Panos refused consent to settle. What is shocking is how long it took for this practitioner to be ousted…

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5 Golden Rules for Responding to Negative Patient Reviews | Featuring 4 Real Life Examples

Negative patient reviews are a fact of life. You can’t avoid them, and you shouldn’t ignore them. Instead, deal with them by leveraging the techniques you’ve honed as a physician – diagnose the problem, synthesize a cure, and administer treatment. Today, we are sharing the essentials ingredients with the public – addressing reviews from anonymous patients slamming doctors online.

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Perfecting the Patient Dismissal Letter – How to Avoid Patient Abandonment and Other Medicolegal Complications When Terminating the Doctor-Patient Relationship

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. The purpose of this article is to teach the public how to distinguish a competent patient dismissal letter from an incompetent one.

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How Doctors Are Using (And Abusing) Facebook to Market Their Practices

Facebook has been with us for fifteen years. In three years, it will old enough to vote. What an invigorating thought. In those fifteen years, Facebook has distinguished itself as one of the most powerful advertising platforms on the planet. It has also made a name for itself as a regulatory compliance hazard.

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Press Ganey Scores and Unicorns

A unicorn is a mythical creature. It does not exist. Which brings me to Press Ganey scores. For those of you entirely immune to the numeric patient satisfaction benchmarks, Press Ganey is eponymous with HCAHPS scores mandated by CMS. HCAHPS was initially rolled out to allow comparisons between institutions providing inpatient care. The usefulness of these scores is subject to debate…

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Why Do Doctors Take Med-Mal Lawsuits So Personally?

Here’s a question that perplexes many plaintiff’s attorneys. I hear it all the time. Why do doctors take medical malpractice so personally?

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47 Tips to Keep You Away from My ER

Recently, we published a piece by Dr. Rada Jones on the 68 Laws of the ER. She returns now for prescient and timely advice to patients on how to stay out of the ER. The best way to do her post justice is to present it as is without editorial or comment. Enjoy!

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Doc, How Long Do I Have to Live?

When a patient has a difficult diagnosis, they want answers. They want to know how to structure the time they have left. It’s also a question that determines whether a patient qualifies for government funding for hospice. A case is currently marinating in the 11th US Circuit Court of Appeals which addresses civil and potential criminal liability based on the medical judgment of whether a patient will last beyond 6 months…

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Board of Medicine Gives Reprieve Enabling Sexual Predator to Practice for 18 Years. Justice Finally Served.

Dr. Johnnie Barto pleaded guilty in December 2018 to sexually abusing two family members. He also pleaded no contest to sexually assaulting 31 children, most of them patients. Dr. Barto is 71 years old. He appeared before the Pennsylvania Board of Medicine in 2000 on administrative charges he molested two young girls in the 1990s. And yet – the charges were dismissed. How did this happen? And what finally brought him to justice?

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Federal Government Considering Plunge into Regulating Stool

C. difficile is a thorny problem for hospitalized patients because physicians have generously prescribed progressively stronger broad spectrum antibiotics, killing off good bacteria, making it easier for the bad bacteria to proliferate.

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Before and After Photos. Do You Own Them? Or Not?

Many aesthetic surgeons and dentists use before and after photos on their web site to market their practices. They are demonstrating to the public at large what they can reasonably expect if they select their practice. Presumably, the patients depicted have given you permission to showcase them. But do you own the photos? The answer is more complex than many practitioners realize…

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Medspa Slammed with Class Action Lawsuit for Violating TCPA

Ever heard of TCPA? Most people haven’t. It stands for Telephone Consumer Protection Act. And it’s the second most frequent federal lawsuit after employment law claims. And now a medspa is on the receiving end…

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Nursing Home Sues Law Firm Over Ads

A friend and colleague, Doug Wojcieszak, recently posted an article on his blog, Sorry Works, about responding to criticism in health care.  Actually, it was more than just criticism. A law firm ran ads soliciting plaintiffs against a nursing home. The nursing home sued the law firm. The story and Doug’s response are worth reading.

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Who’s Your Daddy?

I may not be clairvoyant. But I know one family that will receive a gigantic check soon. A 29-year-old woman had been in a persistent vegetative state for about ten years. She was involved in a near drowning incident. Unbeknownst to the staff at Hacienda Healthcare, a long-term care facility, the patient was pregnant. She started to moan and gave birth on December 29th.

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Can NC Physicians Legally Prescribe Meds to Suffering Terminally Ill Patients to Precipitate a Peaceful Death?

One role of the physician is to relieve suffering. Adult patients, who are mentally competent and terminally ill, sometimes implore their physicians to help them achieve a more peaceful death to alleviate either actual or impending suffering. Broadly, what risk might a physician face engaged in such prescribing?

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68 Laws of the ER

Every now and then you read a piece about life in the medical trenches that fully hits the mark. Dr. Rada Jones is an Emergency Physician who did precisely that. She penned the 68 Laws of the ER. The best way for me to do it justice is to present it as is without editorial or comment. Enjoy!

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Fire Her and Yank Her License

Is practicing medicine a right or a privilege? Most physicians treat it as a privilege. They appreciate being given the responsibility of earning a patient’s trust and caring for them.  The vast majority of physicians conform to established norms. It doesn’t mean we are all saints. And not all patients are loveable or even likeable. Which brings me to the case of Cleveland Clinic resident, Lara Kollab. She engaged in anti-semitic invective on Twitter.

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Is Facebook Engaged in the Practice of Medicine?

Facebook is watching us. And if it senses one of its users is contemplating suicide, it will flag his posts and attempt to intervene. Mason Marks, MD, JD, recently posted an article that asks the following question. Should this practice be regulated?

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The Most Frivolous Lawsuit Contest Redux: Part II

Medical Justice takes aim squarely at deterring frivolous litigation. And we provide remedies for those unjustly sucked into such lawsuits. Ten years ago, we ran a contest for the Most Frivolous Lawsuit. The “winning” defendant received a free year of membership in Medical / Dental Justice. Recently, we decided to hold that contest again. We highlighted two of our winners last week; the other two follow – read on…

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The Most Frivolous Lawsuit Contest Redux: Part I

Medical Justice takes aim squarely at deterring frivolous litigation. And we provide remedies for those unjustly sucked into such lawsuits. Ten years ago, we ran a contest for the Most Frivolous Lawsuit. The “winning” defendant received a free year of membership in Medical / Dental Justice. Recently, we decided to hold that contest again. Today, we’re ready to announce two of our “winners” from our most recent contest…

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Need Spine Surgery? If You Work for Walmart, Talk to Your Travel Agent.

Most patients want to receive care close to where they live. Patients also want the option to travel to centers of excellence, if necessary. Walmart has flipped that model on its head for its employees. Effective January 2019, Walmart will mandate its employees travel to high-profile healthcare systems for spinal procedures…

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Training Medical Students to Perform Rectal and Pelvic Exams

When I was training, paid models served as teachers when we learned how to do a pelvic exam. They had done this before. They provided feedback. They knew what they were getting into. Fast forward to today –  an article in the journal Bioethics noted that educational pelvic exams are often performed on anesthetized women. What are the ethical (and legal) implications of  performing pelvic exams on anesthetized patients?

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Hell Hath No Fury Like Office of Civil Rights Scorned

A three doctor Allergy and Immunology practice in Connecticut just wrote the Department of Health and Human Services Office of Civil Rights a check for $125,000. Three Boston hospitals, Mass General, Brigham and Women’s and Boston Medical Center wrote a check for $1M. What was the common thread? They all disclosed a patient’s protected health information without the patient’s authorization.

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The Art of Being in “Two Places” at the Same Time

To the layman, a “concurrent” surgery and an “overlapping” surgery sound interchangeable. He says to-may-toe, she says to-mah-toe. But surgeons need to understand the difference. And most do. So for those of us who do know the difference, here’s a question – which type of surgery presents the patient (and doctor) with the least risk?

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“Grief as My Guide. How My Sister Made Me a Better Doctor.”

Dr. Joseph Stern, a neurosurgeon, wrote a moving piece published in the NY Times, about how his sister’s recent fight with cancer impacted him. The process of sitting by her bedside, sharing moments and comforting her, and his grief over her death made him a better doctor.

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O-Rings and Phone Numbers

Many practices use trackable phone numbers to measure the success of their marketing campaigns. If multiple campaigns are running consecutively, a practice may have many different phone numbers directing patients to the practice. These disposable phone numbers are essential when collecting success metrics. But – they are disposable. So, what happens when a patient in need calls a discontinued number and can’t get care?

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Demystifying EMTALA: Issues that Pop Up When You Are On-Call

ER physicians usually know EMTALA’s requirements and limitations very well. But physicians whose only interaction with the Emergency Department is an occasional call often do not, and so are at risk for inadvertently violating the law. These violations are costly – personal fines can go as high as $50,000. Let’s review some common questions that a doctor on-call may have about their obligations under EMTALA…

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The Difference Between Skydiving and the Practice of Medicine

Skydiving is dangerous. Most skydivers land safely. But, not all. And if your chute does not timely open (and properly), death or injury are likely. How is it skydiving facilities are rarely sued? And, if they are sued, the facility usually prevails. What about the practice of medicine? Can patients “assume the risk” for a treatment or procedure? Can the standard of care rise to “gross negligence” if the patient does assume the risk?

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Do You Want Your Kid to Be a Doctor?

I hear two stories from doctors. Some believe medicine is still a noble calling. A career in medicine delivers significant professional satisfaction. It pays well. And it comes with significant social stature. Others believe medicine hit its peak years ago and today is a formula for frustration and professional burnout. What do you think?

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A Report Card on Report Cards. Risks of Publicly Reported Surgical Outcomes

Skeptical Scalpel publishes an excellent blog. He recently tackled the topic of whether the public even understands how to interpret surgical complication rates and surgeon report cards. He graciously gave us permission to distribute his post. Read on…

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A Contingency Plan for Taking a Case on Contingency

Plaintiff’s attorneys frequently argue there is no way a seasoned attorney would take a meritless med mal case. They note that taking such cases to trail is expensive. They take such cases on contingency…

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Can You Patent a Medical Procedure? Well, Yes  and No

In the mid-1990s, Dr. Samuel Pallin patented a type of stitch-less cataract surgery procedure. He attempted to license the patient to other ophthalmologists. One such surgeon was Dr. Jack Singer… 

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Jail Time for the Wrong Pronoun

Most physicians defer to patients’ wishes as to how they want to be called. It’s a sign of deferential respect. There’s a brewing brouhaha in California related to Senate Bill 219 which was signed into law. Among other things, it could criminalize the act of deliberately referring to a patient by the wrong pronoun…

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Medical School for Free

NYU Medical School recently announced it will waive tuition for all medical students, now and going forward. One reason NYU made this commitment was because many medical students are saddled with crushing debt when they graduate. Not surprisingly, many people have opinions on whether NYU’s policy is the best way to help medical students…

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Why Doctors Don’t Like to Retire

An April 5, 2017 Time Magazine article broke down retirement rates by professions. They charted the percentage of workers still working after age 65. It seems that this is an accurate yardstick to measure the issue.  Although not near the top, physicians and surgeons were still in the top third at 8 percent. So why then do so many physicians resist retirement?  There are multiple reasons to consider…

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Crap, It’s Always Something…

We recently heard from a surgeon in Ohio. He was performing an office-based procedure. An employee was looking for the doctor. She quickly opened the door to the room where the surgeon was working. The surgeon was not expecting the intrusion.

His hand moved…

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FDA Warns Companies Against Marketing Benefits of Vaginal Rejuvenation

Medical practices often add new techniques and procedures to increase revenue. I’m not suggesting the only reason is revenue. Presumably it’s to serve the patient and make a living BY serving the patient. And, I’m not opposed to physicians expanding what they do from treating disease to promoting health.

But, I must admit, I did a double take when I saw the full court press on promoting vaginal rejuvenation at several recent meetings…

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Man Bites Dog. Doctor Sues Attorney and Wins $8M in Jury Verdict for Malicious Prosecution.

An account of this doctor’s odyssey reads like the Book of Job. There’s an ex-spouse involved. Bankruptcy proceedings. Complaints filed with the Board of Medicine. Documents both incriminating and vindicating. And the best part? The plaintiff wasn’t even sure why the doctor was being sued. So, how did this doctor win his “happy” ending?

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Physicians Interrupt Patients After 11 Seconds

A recent article evaluated 112 recorded clinical encounters. The rationale was testing of “shared decision-making tools.” I was confused by the findings and conclusions. The headline adopted by the media was that physicians interrupt patients quickly. It was not intended as praise.

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Some Attorneys Behave Like Jerks

Most of the time, when an attorney requests a copy of medical records for something like a personal injury case, auto accident, worker’s comp, they are professional, courteous, and offer to pay you the reasonable cost of copying the record. But sometimes they’re just a pain.

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Not All Threats Patients Make Are Equal

Patients may be unhappy with their doctor for a variety of reasons. Dialogue solves most of them. But, sometimes this angst escalates. It culminates in a threat. All threats are not equal in the eyes of the law.

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Is It Really Unprofessional to Write Prescriptions Outside the Office?

A famous US Supreme Court Justice Potter Stewart once opined on obscenity: “I know if when I see it.” The Maryland Board of Medicine weighed in on whether it was unprofessional to write a prescription for a patient at a restaurant / bar. Excerpts from the legal case tell the tale.

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Lions, Tigers, and Bears. Oh My. Therapy Animals in the Operating Room

First, let’s discuss the difference between a service animal and a therapy animal. According to the U.S. Department of Justice, service animals are…

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The Pros and Cons of Allowing Family into the Trauma Bay

Many years ago, the presence of family members during cardiopulmonary resuscitation was verboten. The reigning principles were two-fold. Family members would get in the way of allowing the team to save the loved one. And they would be emotionally scarred forever. Makes sense on paper. But is this really true?

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Looking for Deep Pockets

Ebola is making a comeback in Africa. Fortunately, the World Health Organization is on top of it. Further, vaccines are being distributed. Hopefully these vaccines will prove safe and efficacious. Which brings me to Coming Attractions Bride and Formal in Ohio…

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Ambulance Chasers on Mobile Phones

There are billboards of personal injury attorneys not too far from hospitals. But, you’d never see an ad for a personal injury attorney in the ER. Unless you own a phone…

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Arbitration for Med Mal – One Sentence You Must Include in Your Agreements

Imagine you received a request for records from a medical malpractice attorney. Not a good start to your day. But, the clock is ticking. The statute of limitations is about to run. If the clock runs out, you’re home free.  You are now one month BEYOND the statute of limitations. Then, you get a notice demanding arbitration…

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Using Alexa in the Operating Room

A client recently asked our thoughts on using Alexa in the operating room. Presumably, the tasks Alexa would be charged with doing would be basic. Turn the lights on. Turn the lights off. Make a call. And so on. Still, the OR demands a certain level of privacy. Do Alexa’s security risks outweigh her small conveniences?

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Pesky Little Details in Brain Death Determination

We have previously written about medico-legal challenges related to brain death determination. The American Academy of Neurology updated its guidelines in 2010 to create more uniform determination. Let’s review…

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The Curious Case of Cassandra

Not too long ago, the Connecticut Supreme Court ruled on a case that dealt with a mature minor; someone not quite 18, but close, and whether they are entitled to make their own medical decisions. If a child has been emancipated by the courts, they do not need parental consent for medical treatment. Let’s see this played out in the real world…

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British Hairdresser Sentenced to Life in Prison for Infecting Men with HIV

Daryll Rowe is a 27 year old hairdresser from Brighton. In court it was revealed he deliberately tried to infect at least 10 men with HIV. For that, he was handed a life sentence, and will have to serve a minimum of 12 years for the “determined, hateful campaign of sly violence.”

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Stuck by a Needle. Your Patient Refuses Consent for HIV Testing. Now What?

We recently blogged about a healthcare worker who was on the receiving end of a needlestick injury. The source patient agreed to be tested for HIV and hepatitis B and C. While the initial HIV test was positive, repeat testing was negative. Great news. But what would have happened if the patient refused testing?

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Spousal Consent for Vasectomy

I recently came across an informed consent form for a vasectomy. (Not mine. I was doing research.) The consent form included the expected items; risks, options, benefits, and so on. There was a signature line for the patient. There was a signature line for a witness. Just below was a paragraph of additional text and a signature line for the spouse…

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Is Death in the Eye of the Beholder?

It’s been said the only thing certain in life is death and taxes. Tax rates vary by state. And, what may come as a surprise to many doctors, the definition of death (or how someone is declared dead) is not uniform across all 50 states. A little background…

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Circumcision Wars

The topic of circumcision often stirs up spirited debate. More than other “body modification” procedures such as, say, cosmetic rhinoplasty in minors or piercing ears. Regardless, it might be hard to steady one’s hands to do a proper cutting if there were protestors outside the door…

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Beware of the Trojan Horse

The number of medico-legal landmines associated with running a practice is huge. Our cup runneth over. And most physicians are at least aware of these debacles. What most practices are blissfully unaware of: brouhahas caused by employees…

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Informed Consent and Facial Fillers: Risk versus Reward 

It’s easy to forget that cosmetic procedures are medical procedures; with risks and potential complications – some irreversible. Abide best practices. Inform your patients of the risks, keep your operating environment organized, and set the right expectations…

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Prescribing Over the Phone

Prescribing medication over the phone is convenient. But like most convenient things in medicine, tele-prescriptions can become legal headaches.

Here’s what you need to know before prescribing over the phone…

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Should You Have a Pre-Nup?

A harsh reality: the divorce rate for first marriages in the United States is almost 50 percent. When at least one spouse is a physician, the divorce rate for first marriages can be as high as 70 percent. That is why many physicians use pre-nuptial agreements. Not only to manage assets in a divorce, but to navigate other complicated marital issues.

So – should you have a pre-nup?

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Patients to Be Dinged by Insurance If ER Visit Not Emergent

Anthem rolled out a new policy holding patients directly responsible for the ER bill if it is later deemed non-emergent. And who will decide whether the visit was emergent or not? You guessed right…

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Iowa Board of Medicine Makes Love an Actionable Offense

Perhaps the headline should read “Iowa Board of Medicine Makes Making Love an Actionable Offense.” Boards of Medicine generally take action if a physician inappropriately propositions a patient for sex. Some boundary issues are obvious…

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Dodging a Bullet. The Occupational Hazards of Healthcare.

If you practice in an operating room, sooner or later you will get stuck with a needle. We all try to follow best practices. But, when you have sharp tools, on occasion, the unfortunate does happen. Last year, a scrub tech was pricked by a needle that had been exposed to a patient’s blood. The patient agreed to be tested for the usual. Her results  – HIV positive. Now what?

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Should a Doctor Change His Name? Witness Protection Lite.

Doctors occasionally change their name. They get married. They get divorced. Some keep their name. Some change their name. It happens all the time. But, that is a deliberate choice. Are there times doctors might want to change their name – against their will?

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Plaintiff Receives Nine Figure Personal Injury Settlement. Oh My.

In Illinois, a jury awarded a plaintiff $148 million. The state’s previous record was a $47 million medical malpractice settlement in 2017. The defendant, the Chicago Department of Aviation, was able to negotiate the verdict down to $115M. Whew. The plaintiff accepted to avoid the risk of an appeal. Now, about the case…

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Informed Consent? Sure. We’ve Got All the Time in the World…

The Supreme Court of Pennsylvania recently ruled a physician must obtain informed consent himself – he cannot delegate this task to a qualified assistant. If this ruling goes national, how will it change the operations of your practice?

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Professional Negligence Versus Ordinary Negligence in a Medical Office

Your medical office is a place of healing. It is also a place of business. This means that you are not just under a duty to diagnose and treat your patients properly but are also to provide safe environment for all who enter. No doctor wants to be charged with neglecting his patient. That’s why it is essential doctors understand the legal definition of negligence in all its forms…

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A Tale of Woe. A Bad Asset Protection Plan.

Doctors are at risk for being sued. Asset protection plans help mitigate the risk. Here’s an example of one asset protection plan, done on the cheap, that failed…

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Large Insurance Carrier Outs Patients With HIV

By now, doctors have been trained to think about the ramifications of patient privacy before taking action. We make sure that first name and last initial are on the operating room scheduling board. On hospital room doors – same thing. We ask for authorization before posting a patient’s picture on social media. It has not been easy adapting to this new world. That’s why I’m scratching my head on this…

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Surgeon Laser Etches His Initials into Liver in Transplant Patients

Let’s start at the end. You kind of know how this ends. Dr. Simon Bramhall, a liver transplant surgeon in the UK, pleaded guilty to two counts of assault by beating. He pleaded not guilty to the more serious charge of assault occasioning actual bodily harm. Prosecutors accepted his plea and he is scheduled for sentencing on January 12th

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Law Pushing for Cameras in the Operating Room

“Julie’s Law” is a Wisconsin bill named in honor of Julie Ayer. The patient had breast augmentation surgery in 2003. Sadly, the patient flatlined during the procedure. CPR was initiated, but too late.  Advocates suggest the addition of cameras will increase transparency. Opponents argue inserting cameras into the OR will turn an already high-pressure environment into a toxic one…

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Not Mastering the Art of Being in Two Places at One Time

A recent report in the New England Journal of Medicine highlighted a case of a patient who presented to the Emergency Department, unconscious, with a Do Not Resuscitate tattoo sprawled across his chest. The staff decided initially to not honor the DNR tattoo. The words Do Not Resuscitate were inked. With a replica of his signature. This was a serious tattoo…

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Doctors Flummoxed by DNR Tattoo

Dr. Reinaldo de los Heros was practicing as a psychiatrist in Maine. On August 31, Dr. de los Heros was evaluating a female patient – presumably in his office. During this evaluation, a male prison inmate called the woman…

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Necessary Action or Elder Abuse?

Dr. Konopka graduated from medical school in Poland in 1960. She moved to the U.S. soon thereafter and she has been a licensed physician in the .S. since 1968. She is currently 84. She will serve any patient who can pay her $50 in cash…

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The Migration from Third Party Insurance to Accepting Risk

My goal in writing this is to disseminate the strategies some are using to avoid paying stratospheric sums for plain vanilla health insurance on the individual market because they believe they have limited options.

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Who Bears Risk for Medical Decisions About Pacemakers at Risk of Being Hacked?

Thirty years ago, no one would have thought of this scenario. Hacking into a pacemaker to cause harm…

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Divorce is Politics By Other Means

Carl von Clausewitz was a Prussian general and military theorist who famously said: “War is a mere continuation of politics by other means,”. I leave the full parsing of its meaning to other military strategists. But, the quote serves as a useful segue to discuss how divorced parents sometimes use the medico-legal playing field to continue their battles.

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Cease and Desist

If you’re a surgeon, I have little doubt you have done a stellar job in selecting your patients. You’ve never made a mistake. Never overruled your staff when they detected “red flags.” Never talked yourself into accepting a patient for the operating room when you’ve had nagging doubts whether the patient had realistic expectations. If this characterizes your history over decades, you have a follow-up career in writing fiction.   

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Delivering Bad News – or Delayed Good News – to Patients

When a person is sick, they are stressed and anxious. No surprise. And it’s human nature to fill in the blanks with bad news. That’s why ambiguous information can be magnified into a worst case scenario…

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WTF is MACRA?

I sat in on a lecture about prospering with MACRA. I wanted to learn more. In the auditorium I saw a few physicians. While I believe the program is well-intentioned (who would be against quality or value; it’s like Mom and Apple Pie – everyone is for it), I’m skeptical the programs will deliver value or quality….

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Legal Issues in Physician Advertising

Many doctors advertise a lot. Some a little. A few not at all. Be careful of the creative marketeer you just hired. He may be an expert in persuading patients to see you. But, he is probably not an expert in regulations that bind physicians…

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Physicians Who Perform Surgery On Themselves

I know many surgeons who received a laceration of their torso or leg. They went into their office, pulled out some Lidocaine, and went to work. Sutures placed. Bandage on top. Back to the picnic. Now for the curious case of Leonid Rogozov. Don’t read further yet. Props to any trivia buffs who can identify his claim to fame…

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Why Are So Many Neurosurgeons in – or Potentially Headed to – Jail?

It’s been an active year for neurosurgeons and the criminal justice system. One doctor was sentenced to life in prison or knowingly and recklessly injuring patients. Two were killed. Two more were paralyzed…

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Lawyers Have Their Own “HIPAA” Issues – The Story of a Prostitute

Do not conclude I am equating an attorney to a prostitute. I’m not. Jerene Dildene started working as an escort when a divorce and cutback in work hours (teaching Spanish in area pubic school) created financial hardship. Initially she searched Craigslist for part time work. She became a bikini model. On one modeling job, the client apparently asked her if she would exchange sex for money…

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Being a Doctor and Playing Poker – The Overlap

Dr. Kelly McMasters, a surgical oncologist, graciously allowed us to republish the commencement address he delivered to the University of Louisville School of Medicine Class of 2017. His words of wisdom resonated far beyond the typical platitudes pushed onto graduates. Further, his personal experience as a father of an ill child delivered unasked-for-insights that, when practiced, can make all doctors even better. Heads up: it’s longer than our typical blog post. But, it’s worth the entire read. Make time to read it from top to bottom…

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 HIV Positive Man Charged With Murder After Mistress Dies from AIDS 

Robert Murdock was charged with murder in Ohio for not telling his mistress, Kimberly Klempner, he was HIV positive.  The indictment alleges that Murdock knew he was HIV +positive but failed to tell his mistress.

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Florida Takes a Step Backward

Let’s go down memory lane. As the new millennium dawned, Dade and Broward Counties were in the midst of a professional liability crisis. Insurance was not only unavailable. It was unaffordable. Neurosurgeons were being asked to pay $250k/yr in coverage. Many policies topped out at $250k in benefits…

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Freckles and Lawsuits

Virtually every physician knows that patient privacy is sacred. One needs a patient’s affirmative consent to disclose what is known as protected health information. This is covered by state and federal (HIPAA) privacy laws. If a doctor posts the medical record, that is disclosure of protected health information. If a doctor acknowledges a particular patient […]

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How Facebook Saved My Patient’s Life 

Sometimes you need a nugget of medical information – pronto. If your patient has been in a hospital, you likely have access to reams of data. Finding your nugget may take seconds, minutes, or hours. You may never find it.   A number of years ago, Dr. Kamal Thapar, a Wisconsin neurosurgeon, gave a talk on […]

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Upside-Down World – A Patient Sues You to Keep Taking Care of Them

Normally, when a patient sues a doctor, he is unhappy with the care. He wants money for damages the doctor allegedly caused. Most rational people do not continue to see the same doctor if they believe that doctor negligently harmed them  As Einstein once said: The definition of insanity is doing the same thing over […]

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Jewelry Store Owner’s Son has to Pay Competitor Because of Fake Review

The jury has spoken. Stephen Blumberg owns Stephen Leigh Jewelers in Massachusetts. Toodie’s Fine Jewelry is a competitor. Allegedly, Adam Jacobs, a Toodie’s employee, wrote a multi-paragraph negative Yelp review about Stephen Leigh Jewelers. The review said he was looking for a 1.5 karat engagement ring and he had a negative experience. He then advised […]

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The Tax Man and Med-Mal Settlements

First, the obvious. This is not to be construed as tax advice. Now for some interesting nuggets. When people sue one another (or even threaten litigation) and money changes hands, there are tax implications. A recent article by Robert Wood dives deeper. (A) Settlements and judgments are taxed similarly. Whether you come to a meetings […]

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Preventing a Lawsuit – Always Seek Consent Before Searching a Patient’s Anus: Part 2

Here’s follow-up from a blog we posted in 2013. It was titled “Preventing a Lawsuit – Always Seek Consent Before Searching a Patient’s Anus”. Now we know its full title should have included “Part 1.” Two doctors were among many defendants sued by the American Civil Liberties Union. To recap this madness, see below. The […]

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What NOT to do…

A Texas physician who performs aesthetic treatments recently agreed to disciplinary action by the Board of Medicine. In 2015, a patient underwent a series of non-invasive laser treatments with Dr. Tinuade Olugesugun-Gbadeham. Around May 27, 2015, the patient made a video testimonial on the results of these procedures. The patient gave consent to have photos […]

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Damn, that’s awkward…

Ars Technica and the Minneapolis Star Tribune recently reported that Mayo Clinic is considering prioritizing patient care with private insurance over those with Medicare and Medicaid. The Minnesota Department of Human Services (which oversees Minnesota Medicaid), stated: “Fundamentally, it’s our expectation at DHS that Mayo Clinic will serve our enrollees in public programs on an […]

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These Docs Behaved Badly, but Should They Have Been Sued?

Jeffrey Segal, MD, JD Published in Medscape: May 20, 2015 (reprinted with permission)  http://www.medscape.com/viewarticle/844251 Three Highly Unusual Lawsuits If you practice medicine, odds are that eventually you will be sued, face a medical board complaint, or experience some other legal headache. If you practice in a high-risk specialty such as neurosurgery, the likelihood that you will be […]

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Thorny Vignettes and Patient Abandonment

Most doctors understand that once you have agreed to treat a patient, and you are in the middle of a treatment plan, you must either complete the treatment or find an acceptable alternative to the patient. The reason is to avoid a charge of patient abandonment. Vignette #1: Doctor receives a consult from the emergency […]

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Political Correctness Over-reach in the Exam Room

  A general surgeon in Florida evaluated a patient for hernia repair. The patient confided he was HIV positive. The surgeon asked about the patient’s medication regimen. The patient explained that on the medication his viral titers were non-detectable. The surgeon stated that that was good for both of them. For the patient, of course. […]

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When Your Competitors Will Not Cross Cover for You

A neurosurgeon based in a large metro area in California used to be part of a large group. For a variety of reasons, he’s in solo practice now. He’s still busy. Doctors refer to him. Patients seek him out. He has a strong online presence. And he’s escaped petty intra-group politics. One problem, though. He […]

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Medicolegal Issues in Dealing with Aging Physicians

  We continue with our series of general educational articles penned by one attorney, an MD, JD, giving you a view of the world through a malpractice plaintiff attorney’s eyes. This attorney is a seasoned veteran.  The series includes a number of pearls on how to stay out of harm’s way. While I do not […]

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Why No Med-Mal Defendant Wants His Defense to Boil Down to “S**t Happens”

  Dr. Jha is a radiologist who also blogs. Virtually every one of his posts hit the mark on multiple levels. Plus, he’s a brilliant writer. He gave me permission to re-publish the following blog he posted on KevinMD.com on January 3rd.  Happy reading. Does lead-time bias have a place in court? SAURABH JHA|PHYSICIAN | JANUARY 3, […]

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How Language in an Operating Report Can Lead to a Trip to the Courtroom

Sometimes, the specific language in an op-report can lead to misunderstanding and litigation. I’m not talking about using words like “suddenly” or “to my unexpected surprise” in the document. I’m talking about how you label anatomic structures. Surgeons start with a clinical diagnosis. This diagnosis is often reinforced or guided by an imaging study. Then, […]

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Preparing for a Rotten Day – or Year – at Peer Review

  Guest Post by Dr. Michael Rosenblatt For many doctors, they will experience peer review as a benign process. Cases are presented. Lessons learned. The beat goes on. Some “unlucky” physicians experience a different reality. Over the years we have been “trained” to try to avoid malpractice suits. But “peer review emergencies” are no less […]

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Paid Reviews Cost Companies $175,000 Enforcement Action

Two companies have settled with the New York Attorney General’s Office after being accused of paying consumers for positive reviews by agreeing to increase their transparency and pay a total of $175,000. MedRite Care, LLC, a medical emergency care service, paid thousands of dollars to Internet advertising companies and freelance writers over a two-year period […]

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How to Keep Lawyers from Circling Your Practice: Lessons for New Doctors

  I am frequently invited to speak to medical students and residents. I’m often the first person to introduce them to the wonderful world of medico-legal headaches. It’s a topic they typically don’t think about while they’re studying and training. Why? It’s hard enough learning the Kreb’s cycle, the anatomy of the brachial plexus, and […]

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N=1. Congress Takes Action. Consumer Review Freedom Act

If pro is the opposite of con, what is the opposite of Progress? Congress. It’s an old joke, but, what exactly did Congress just do? By unanimous consent, it passed the Consumer Review Freedom Act (H.R. 5111). As of this writing at year end, it still needs to be signed by the President. But, there’s […]

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No Good Deed Goes Unpunished

  “No good deed goes unpunished” is an aphorism attributed to more than one origin -Oscar Wilde and Clare Booth Luce. The origin may be a mystery. Its meaning to an Iowa anesthesiologist is not. An obstetrician performed a C-section on a patient who was 35 weeks pregnant. The patient had persistent vaginal bleeding, so […]

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There’s a Fine Line Between Aggressive Questioning of a Witness and Being an A-Hole

The vast majority of doctors wake up every morning intending to do the best possible job for their patients. It’s in our DNA. If and when a patient experiences a complication, no one beats us up harder than we do ourselves. It gnaws at us. We’ll remember it. We hope never to repeat that outcome. […]

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When a Lawyer “Just Wants to Speak” to You

The office staff of Medical Justice member received an unexpected call the other day. A lawyer said he represented the estate of the practice’s recently deceased patient.  The lawyer just wanted to ask the doctor a few questions. No other context. Zip. Nada. First, a doctor cannot just speak with a lawyer who just happens […]

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Positive Change Regarding Medical License Renewals

Medical license renewals have morphed over time to be quite involved. The Board of Medicine is charged with keeping the public safe. This includes making sure that licensees have no medical or mental health conditions which, with or without treatment, could impact taking care of patients. In a prototypical renewal form, the following question was […]

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Your Patient Bolts in the Middle of a Treatment Plan. Now What?

Not all medical and dental procedures are completed in one setting. They are staged. A common example is a patient needs new teeth. Impressions are taken. Temporaries are placed. The lab fashions the new implants. They are placed down the road. Patients often pay upfront for the bundled procedures. And the work is front-loaded. The […]

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A Carrier Tells Its Insured Doctor He’s Not Covered. WTF?

The reasonable interpretation of language in an insurance policy dictates its coverage. Sometimes the definition of a word can cost a carrier or an insured millions, if not billions. When the World Trade Towers were destroyed in a terrorist attack in 2001, there were a number of insurers who covered the risk for damage to […]

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Death and Donuts

When I was a resident, we had a weekly Morbidity and Mortality Conference. That was the euphemism for what most called it, Death and Donuts. That moniker was not meant to be disrespectful. It was merely an acknowledgement that death did happen at the hospital. High risk procedures were indeed risky. And a normal part […]

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The Insanity Defense: Medical Versus Legal Issues

We continue with our series of general educational articles penned by one attorney, an MD, JD, giving you a view of the world through a malpractice plaintiff attorney’s eyes. This attorney is a seasoned veteran.  The series includes a number of pearls on how to stay out of harm’s way. While I do not necessarily […]

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The High Cost of Medications in Prison

A recent Wall Street Journal article reported that only 3% of patients with Hepatitis C in prisons are receiving the newest medications which have a cure rate over 90%. This means most are not receiving these medications. The reason is cost. Each treatment cost up to $1,000/day for a number of weeks. A commitment to […]

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Doc, What Would YOU Do?

As physicians, we learn we must inform the patient of their options. Each patient has a different tolerance for risk. Some want aggressive treatment. Some want conservative management. The patient decides what should be done. I always thought it awkward to merely present a smorgasbord of options and then stare at the patient asking – […]

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Whose Baby Was It, Anyways?

I spent some time over the weekend scanning physician responses to this ethical conundrum. An endocrinologist was caring for a man who spent years taking anabolic steroids. He developed hypogonadotropic hypogonadism with a low sperm count. He was now living clean and ready to start his family. The endocrinologist replaced the patient’s testosterone and achieved […]

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Medico-Legal Issues in Restraining Patients

  We continue with our series of general educational articles penned by one attorney, an MD, JD, giving you a view of the world through a malpractice plaintiff attorney’s eyes. This attorney is a seasoned veteran.  The series includes a number of pearls on how to stay out of harm’s way. While I do not […]

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Crazy Cases Against Doctors — and Inexplicable Settlements

Jeffrey Segal, MD, JD Published in Medscape: May 14, 2015 (reprinted with permission) http://www.medscape.com/viewarticle/844060 How Would You Have Handled Patients Like These? Being sued for malpractice is a traumatic experience. The odds of being sued at least once over one’s career are high.[1] Doctors typically have sufficient professional liability coverage to prevent financial loss. But not all […]

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Liability in Telemedicine: “Can you sue me now?”

Notes from a Plaintiff’s Attorney: Liability Issues in Telemedicine By Dr. JD, a plaintiff’s attorney, practicing in the Northeast We continue our series of articles penned by one attorney, an MD, JD, giving you a view of the world through a malpractice plaintiff attorney’s eyes. This attorney is a seasoned veteran.  The series includes a […]

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When a Doctor Becomes a Patient

Hundreds of articles have been published on the theme of a doctor becoming a patient.  I’d like to add one more to the literature.  But only to express my gratitude. Over the years, I’ve cataloged many of the headaches faced by professionals in health care.  This includes the countless challenges doctors face each and every […]

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Avoiding Liability When Dealing with Brain Death Cases

We continue with our series of articles penned by one attorney, an MD, JD, giving you a view of the world through a malpractice plaintiff attorney’s eyes. This attorney is a seasoned veteran.  The series includes a number of pearls on how to stay out of harm’s way. While I do not necessarily agree with […]

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Dealing with Medical Marijuana

We continue with our series of general educational articles penned by one attorney, an MD, JD, giving you a view of the world through a malpractice plaintiff attorney’s eyes. This attorney is a seasoned veteran.  The series includes a number of pearls on how to stay out of harm’s way. While I do not necessarily […]

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Those Damn Jackson-Pratt Drains

As Shakespeare once posited: “To drain or not to drain. That is this the question.” Perhaps it wasn’t him. Surgeon preference typically dictates whether a drain makes sense. Keeping a hematoma from forming means avoiding one additional nidus of infection. But, a drain (even a closed drain), can also serve as a nidus of infection. […]

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Plastic Surgeons as Psychiatrists.

Many years ago, a mentor taught me a surgeon spends an entire residency learning how to operate. Then the surgeon spends the rest of one’s career learning how NOT to operate. This includes when not to operate. A plastic surgeon called me recently, and described a recent patient visit. The woman, in her mid-40’s, confessed […]

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Simple Procedures: An Occasional Multi-Million Dollar Lawsuit

We often worry about complications from difficult procedures. What might happen if a patient has anesthesia for 12 hours. Or, operating on a redo-redo cervical spine. And we’re right to be cautious. But, even simple things can be fraught with hazards; hazards that are easily prevented.

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Credentialing and Answering Touchy Questions

I received a call from a general surgeon in California. He was re-credentialing for hospital privileges. He was re-credentialing for his in-network status with insurance companies. And, renewing his medical license was around the corner. Credentialing questions have gotten longer and more detailed.

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Suture Around the Ureter. Clip on the Common Bile Duct. Complication or Malpractice?

Over the years, I have seen many lawsuits where a specific operation ended in a complication. Two come to mind. An ob-gyn performs a hysterectomy or uterine repair and a ureter is sutured. A general surgeon performs a laparoscopic cholecystectomy and the common bile duct is clipped. Some of these cases turn into lawsuits. Some […]

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Doctors Strive to Avoid Being Labeled Outliers – Except When it Comes to Schedule II Drugs

Every month I receive a letter from my electric company. It shows how much power I am consuming relative to my peers – my neighbors. Studies have shown such data, when presented in a non-confrontational way – can impact behavior. In those studies, total energy consumption went down. In the letter I receive, no allowance […]

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NC Medical Board Disciplines Doctor for a Lease Dispute.

I can understand why a Medical Board investigates a practice for allegations related to patient safety. I get it when the Board responds to concerns a doctor may be taking advantage of patients sexually. The main purpose of the Medical Board is to protect the public. What I don’t understand is when a Medical Board […]

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HIPAA Conundrum. War of the Roses After Death.

Remember the movie War of the Roses.  Kathleen Turner and Michael Douglas play married characters. They hated each other. But, neither wanted to part with their opulent house. So, they stay put. No one moved. They continue to spew hate and back it up with hateful actions. Recently, a Medical Justice member said they cared […]

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Deporting Hospital Patients

Illegal immigration is now the buzz of the political ball. Candidates are talking about building a wall, rounding up and deporting undocumented immigrants, and its economic ramifications. What happens when undocumented workers are injured and need long term medical care? What must hospitals do? What do hospitals do?

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Two Counterintuitive HIPAA Scenarios

Scenario #1: Some doctors believe, incorrectly, that if a patient has already disclosed protected health information on the Internet, his doctor can “correct” the record online. In other words, if a patient slams a doctor online, and attaches his name or picture to the review, many doctors believe the toothpaste is out of the tube, […]

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If You’re Not a Psychiatrist, What Do You Do if Your Patient Threatens Suicide?

A few of our members are psychiatrists. Most are not. On rare occasion a surgeon will get a call or email from a patient suggesting they are considering suicide. Or they have a detailed plan to take their life. Or they’ve posted this nugget of info on Facebook or a doctor review site and you […]

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David versus Goliath. One Doctor’s Quest for Justice.

Physicians regularly renew their medical licenses. A typical question on the application reads: Since you last renewed have you become aware of any medical condition that impairs or limits, or could possibly impair or limit, your ability to practice medicine safely? (If you are an anonymous participant in the Physician Health Program and in compliance […]

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Avoiding Liability When Sending Specimens

Doesn’t happen often. But, when it does, expect a potential s*%#storm. Patient is anxious about the mole on his back. A dermatologist removes the mole and sends the specimen to the lab. Rule in or rule out melanoma. The lab says it never received the specimen. The dermatologist then does full excision. Then the doctor […]

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Why Not Bring The Entire Staff Into the Exam Room for My Prostate Exam?

I live in North Carolina. Each year I have a general physical exam. This includes the ritual known as the prostate exam. I don’t particularly look forward to it. But, it takes a few seconds and I’m reassured knowing that there are no lumps or bumps. My internist is male. And, in the exam room, […]

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Which Workplace Bathroom to Use?

The question is not so simple anymore. According to the UCLA School of Law’s Williams Institute, there are approximately 700,000 transgender individuals in the United States. In a recent Equal Employment Opportunity Commission ruling (Lusardi v. McHugh, EEOC, No. 0120133395, 4/1/15), the US government ruled that a government employee who transitioned from male to female […]

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Those Pesky Signatures

How many of us has received the dreaded notice that medical records are not complete; or worse, that records are complete but need to be signed. The absence of a “proper” signature gums up the works for getting paid. This following is what CMS considers to be a valid signed order/record. I won’t belabor the […]

Posted in Healthcare Reform | 1 Comment |
 

A Good Samaritan Saves the Day

We’ve heard plenty of horror stories where someone tried to do the right thing – and got screwed. Everyone knows the saying, “No Good Deed Goes Unpunished.” Still, my faith in humanity was renewed on January 10th.

Posted in Healthcare Reform | 12 Comments |
 

What Can Happen When Patient Consent Is Fuzzy? A Bizarre Odyssey…

Dr. Philip Taylor was employed by Spectrum Health Primary Care Partners. He practiced as an ob-gyn. His employment agreement with Spectrum defined how they could terminate the relationship. Summary Termination. If your employment … is terminated by its Board of Directors [the “Board”] for a serious, intentional violation of the standards of patient care (i.e., […]

Posted in Healthcare Reform | 4 Comments |
 

Is Pimping Really Abusive?

Yesterday, I read two articles in JAMA on pimping. (Yes, I still get JAMA.) The article suggested that pimping medical students and residents may be “old school.” Used inappropriately, it may serve more as a tool off abuse and humiliation as opposed to a pedagogical art. Duh.

Posted in Healthcare Reform | 23 Comments |
 

Easy New Year’s Resolutions for Cybersecurity.

Some say there are two types of online sites. Those that know they have been hacked. And those that have been hacked, but don’t know it. Sobering. Everyone is busy. The important question is what can be done to mitigate the downside of sites being hacked. You want two outcomes: (a) minimize the likelihood malicious […]

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