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. 

The Indignity of Being Sued for Medical Malpractice.

Why Do Doctors Perceive Malpractice Lawsuits Differently Than Other Lawsuits?

A good question was posed on physician forum. Why do doctors treat medical malpractice differently than being in an auto accident? Shouldn’t we just turn it over to our carriers and be done with it?

Our blog has the details… 

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Scandal at Yale. Fertility Clinic Nurse Stole Fentanyl. Patients Received Saline.

A riveting podcast series (The Retrievals) highlights the stories of women who visited the prestigious Yale Fertility Clinic. Their allegations. For egg retrieval procedures, they received saline instead of fentanyl for pain.

The vials said fentanyl. Unbeknownst to everyone, a nurse was feeding her own habit, leaving the vials with no active ingredient.

When the egg retrieval procedures were performed, the patients had less sedation/analgesia than most dental procedures.

Yale settled with the Department of Justice. And lawsuits now abound.

Our blog has the details… 

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CPR Compressions with One’s Feet. A Clever Solution to an ADA Conundrum

A number of academic institutions mandate mastery of specific skills before graduation.

For years, universities required students to learn how to swim and demonstrate they would not sink. Cornell accepted 75 yards as the bare minimum.

In 1975 the school standardized the test required that students “jump into deep water and swim 3 lengths (75 yds) continuously. 25 yds on the front, 25 yds on the back, and 25 yds choice.

Columbia put the requirement on pause during COVID. In summer 2022, the test was put back on the list of to-do’s.

Our blog has the details… 

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Settling a Case Without Reporting to the Data Bank.  Colorado Style.

There used to be a saying, “As California goes, so goes the nation.”

This may need to be updated to “As Colorado goes, so goes the nation.”

Colorado was the first state to legalize recreational marijuana. Now, 23 states plus D.C. are in that category.

The Colorado legislature proposed a bill that was signed into law and took effect July 1, 2019. It provides a separate path to resolve disputes between doctors and patients related to adverse events.

Our blog has the details… 

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HIPAA and Abortions

Some updates to HIPAA may be around the corner.

Let’s start with the status quo.

The current Privacy Rule permits, but does not require, covered entities to disclose protected health information to law enforcement officials without the patient’s written authorization.

Our blog has the details…

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Ethical Conundrums: The Case of the Mature Minor

In the US, ages 18 and 21 are legal markers. Voting, drinking, serving in the military, buying a gun. A birthday changes rights, responsibilities, and obligations.

Medscape recently posted a case: A Teenage Girl Refuses More Cancer Treatment; Her Father Disagrees.

Here, the patient was a young woman, age 17.   Our blog has the details… 

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Staying Out of Prison – Good. Not Being Reimbursed Your Legal Fees – Bad.

On July 5, 2017, Dr. Mayura Kanekar was indicted by a grand jury in New York for federal healthcare fraud..

On June 13, 2022, after two weeks of trial, a jury found Kanekar not guilty. And her two co-defendants were also found not guilty—a positive outcome for her.

Kanekar filed a motion pursuant to the Hyde Amendment (more on that shortly) to be reimbursed for attorneys’ fees and other litigation expenses.

How much? $845,750.  Our blog has the details…

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Don’t Do This

As physicians, if you suspect child abuse, you are mandated to report to the appropriate authorities, such as Child Protective Services (CPS). In Texas, where our vignette played out, professionals are beholden to the following law.

Deric Cahill took his toddler to an urgent care center in Dallas. He alleged the doctor turned him into CPS for leaving a one-star Google review. In other words, the doctor weaponized the duty to report because of a nasty review.   Our blog has the details…

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Suspended for Unprofessional Behavior – MD with Tourette’s Syndrome

An employed physician had a challenging conversation with a family about a patient hell-bent on signing out against medical advice. The physician had been working a very long shift and was slammed left and right with non-stop patients. He was frustrated, stepped back, and under his breath muttered an obscenity. It’s not even clear the family heard the obscenity.

A chief resident did. Our blog has the details… 

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Who is Entitled to be Called Doctor? Round Two.

Around one year ago, we blogged about “Who is Entitled to be Called Doctor?”

At that time, we deciphered California’s existing rule.

What a difference a year makes. Our blog has the details… 

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Losing a Parent

I recently lost my father.

He died peacefully at the age of 94. That, in itself, is an achievement.  Also, he was mostly healthy until the last two months. That is also an achievement.

I have mixed feelings.

The obvious. I’m sad he is gone. I’m greedy. I would have liked another month – a week – even another hour to share life with him.

Still, I’m glad he did not suffer too long in his last hours.

And I was overwhelmed to learn of the people’s lives he touched, via their words and memories. There were literally thousands. I’m not exaggerating.

My eulogy to a wonderful man follows.  Our blog has the details…

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How Bad Can a Data Bank Report Be?

David Hetzel, a Gynecologic Oncologist in North Carolina, just filed a lawsuit against a healthcare facility where he worked. The lawsuit alleges, in 2020, he was placed on precautionary suspension. More on that shortly. At the time of suspension, he had one foot out the door. He was scheduled to assume Chief of Gynecologic Oncology at Texas Tech El Paso Tenet Hospitals. That offer was withdrawn. A negative National Practitioner Data Bank report related to the precautionary suspension was the ostensible reason.  Our blog has the details… 

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How to Gracefully Exit When You Don’t Want to Operate on an Elective Patient

In many elective surgical practices, patients are scheduled weeks to months out. I’ll use plastic surgery for my example here. But the principle applies more broadly.
Imagine that a patient presents for a facelift. Or rhinoplasty. Or tummy tuck. Doesn’t matter.
You know you can do the job. It’s obvious what the patient needs. And it is squarely within your skill set. The patient agrees. You set a date. The patient puts down a deposit.
Then, things change.  Our blog has the details… 

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Do You Need a Patient’s HIPAA Authorization to Respond to a Credit Card Chargeback?

It’s Friday afternoon. You receive a letter from an attorney. His new client obtained a blood test from your office. This now-former patient initiated a chargeback. He wanted his money back.
But, wait, you performed the test. You have the evidence. Our blog has the details…

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Board Certification and Labels You Can and Cannot Use Online

You passed your specialty Boards. Congrats! You’re Board-certified, right? And you can say so on your website, right?
Maybe.  Our blog has the details… 

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Leading Indicators of Future Bad Physician Behavior – Stabbing a Colleague in the Back to Multimillion-Dollar Fraud

Early detection is key to prevent or mitigate disease. Routine colonoscopy and mammography save lives. Or at least that’s what the literature suggests. Is there early detection for sociopathic or violent behavior?  Our blog has the details… 

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Is a Chaperone in the Exam Room Enough?

A physician’s greatest nightmare is being accused by a patient of sexual molestation in the exam room. It comes in all shapes and forms.
“The doctor groped me while examining my breasts.”
“The doctor ground his groin into my knee while listening to my heart and lungs.”  Our blog has the details…

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State Privacy Law as Rationale Used to Reprimand Physician Over Media Attention in Rape Case

The US has been abuzz in activity since the Supreme Court overturned Roe versus Wade in its Dobbs versus Jackson Women’s Health Organization decision. What was previously legal in all states soon became illegal in some states.  Our blog has the details…

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Getting PROPER Authorization to Use a Patient’s Photos on Your Web Site

Before and after photos are the lifeblood of an aesthetic surgeon’s marketing plan.

Nothing is as effective as a full library of high-quality before-and-after pictures. Particularly those showing substantive change. And a natural look.  Our blog has the details… 

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A Heartwarming Story. Resident Sues Hospital. And Wins.

Thomas Hobbes summed up life as a resident. Solitary, poor, nasty, brutish, and short. Did I leave anything out? Dr. Thomas Farmer learned all about Thomas Hobbes in his residency. Then he overcame all obstacles.  

Our blog has the details… 

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Would You Trade Your Leg for $20M?

An interesting thought experiment. Would you trade your leg for $20M?

The context. A med mal case with a jury verdict that delivered precisely that outcome.

Our blog has the details… 

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Reported in the Data Bank and You Never Even Knew

Most reports to the National Practitioner Data Bank (NPDB) are well-known to the doctor. Perhaps a medical malpractice insurance company paid a professional liability claim on your behalf. Or the Board of Medicine delivered a disciplinary order. Or you were convicted of Medicaid fraud. These would be obvious.

There is one type of sneaky situation where the doctor may be entirely oblivious to being reported. Resigning while under investigation. Our blog has the details… 

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Texas Judge Tells FDA to “Unapprove” Abortion Pill. Prediction: DOA in Supreme Court

This blog deconstructs the recent Texas federal court opinion, explaining its rationale for revoking FDA’s decade’s old approval of mifepristone. Mifepristone is a compound widely used for medication abortions. I’ll also explain why this case if hurtling to the Supreme Court, and in my opinion, will be DOA.

Un-trigger alert. This blog post says nothing about our country’s attitudes towards medical or surgical abortions. So, no reason to get apoplectic. We’ll be discussing “process.”

What happened?  Our blog has the details… 

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The Drama of Negotiating Consent Agreements with Board of Medicine. Stayed Revocation of Your Medical License.

Every state manages Medical Board complaints differently. It often starts with a patient submitting a complaint. But not always. Sometimes, it’s a hospital, an insurance carrier, or another doctor who took care of your patient. The list is endless.

If a case evolves to an investigation and continues to gather steam, it can be referred to the Board or Deputy Attorney General for consideration of discipline. Due process is implicated. You will get a chance to defend.

You may also be given an opportunity to cut a deal. A Stipulated Agreement…or a Consent Agreement. What you must know to avoid later pain. Our blog has the details… 

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MDs versus NPs. Who is More Productive and Cost-Effective? Well….

The AMA brought national media attention to a recent study, The Productivity of Professions: Evidence from the Emergency Department. This was a Working Paper by David Chan Jr. and Yiqun Chen for the National Bureau of Economic Research.

The study used data to study patient outcomes and utilization costs between nurse practitioners and emergency physicians rendering care.  Our blog has the details… 

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Cameras in the OR. And Promises Plaintiff’s Attorneys Will Never Get to Peek.

When an airplane crashes, the FAA uses the black boxes to deconstruct what happened. Was it a mechanical error? Pilot error? Weather? Terrorism? The black boxes help investigators make sense of the tragedy.

A device called OR Black Box is being used in 24 hospitals in US, Canada, and western Europe.

Would plaintiff’s attorneys be able to get their hands on the data? Our blog has the details..

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To Respond or Not Respond to Positive Reviews, That is the Question?

Hard to imagine Hamlet pondering that riddle.

Practices frequently ask whether they should respond to online positive reviews. We generally advise against it.

Why? Our blog has the details… 

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Yes, Even Doctors Occasionally Get Arrested. Self-Reporting to the Board.

There are close to 1 million physicians licensed to practice medicine in the country. The vast majority sidestep encounters with law enforcement.

Not all do.

If you are arrested, do you have a duty to self-report to the Board of Medicine? Our blog has the details… 

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Why Arbitration? Leveling the playing field for the DOCTOR.

The traditional path to resolving a dispute is litigation. Arbitration is an alternate way to resolve such disputes.
Arbitration takes place thousands of times a day in the US. It is a way for each side to quickly resolve a potential dispute.

But there are limitations and the laws change.  Our blog has the details… 

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Serving as an NFL Physician. When It’s Not Glamorous.

Being asked to serve as team physician or consultant to an NFL team is flattering. It’s high profile. A vote of confidence. Hell, it doesn’t even have to be the NFL. Any professional sports team.But with that vote of confidence comes risk. What does this have to do with doctors? Our blog has the details…

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Doctors Sued for Copyright Infringement Again and Again 

Here’s a Friday afternoon buzzkill. Many assume that if you find a picture on the internet, you can use it. The internet is free, right? Wrong. Many doctors fall into this trap, and the consequences can be disruptive and expensive. Our blog has the details…

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Moving Company Crushed By $125,000 Penalty Trying to Block Negative Reviews. Why Should Doctors Care?

First, the obvious. The subject of this article is a moving company, not a doctor’s office. But there are lessons to be learned by examining why this particular moving company is in the crosshairs. We recently published an article about an aesthetic surgeon accused of using similar tactics to control his online reputation. What do both businesses have in common? Our blog has the details…

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“Doctor, You Just Got Doxed.” What Does That Mean? And Why Should Doctors Care?

Online harassment of doctors is not a new phenomenon. Our long-time readers know this. What they may not know is that the tactics used to harass doctors online are changing. An increasing number of doctors are victims of “doxing.” It is critical doctors familiarize themselves with the practice. It is just as necessary for doctors to understand how they can protect themselves and their colleagues.

Let’s start at the beginning. What is doxing? Our blog has the details…

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Is This Elder Abuse?

A worrisome trend seems to be catching fire. To illustrate: A physician in his 70s may have raised his voice during surgery or a procedure. Perhaps he made a staff worker or hospital employee feel uncomfortable. The physician may have been diligently focused on completing the job during a make-or-break moment.

A staff worker or hospital employee then files a complaint. This morphs into a concern that the physician, deemed elderly, should be sent for neuropsychological testing. But here is where it goes from bad to worse. Our blog has the details…

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Spine Surgeon Who Fled the Country Can Still Be Sued For Med-Mal, Supreme Court Rules

The Supreme Court of Ohio just ruled the following: The cut-off date to file a med-mail suit can be extended if the accused flees the country. Plaintiffs typically have four years to file a lawsuit after alleged harm occurs. The Court ruled those who flee the country do not benefit from this layer of “protection.”

A valuable piece of trivia. The question on everyone’s minds: What sequence of events led to that declaration? Our blog has the details…

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Human Taxidermy: Wisconsin Nurse Accused of Elder Abuse, Unauthorized Amputation

A Wisconsin nurse is accused of, among other less exciting things, amputating a patient’s foot without authorization. She allegedly told her colleagues that she intended to stuff the patient’s foot and display it in her home to serve as a ward against frostbite.

While those allegations turn heads, the fact pattern (as we understand it) is more mundane than you’d think. There are lessons to be learned, however. Our blog has the details…

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Aesthetic Surgery Clinic Accused of Bribing and Threatening Patients Who Wrote Negative Online Reviews

A Washington attorney general is suing a Seattle-based aesthetic surgeon. And considering the facts as we understand them, if accurate as alleged, it’s difficult to imagine the surgeon’s career surviving the fallout. Time will tell. The attorney general alleges the practice used a combination of bribes and threats to prevent patients from posting negative online reviews. And that’s not all. Our blog has the details…

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HIPAA, an Eggplant Emoji, and 50 Cent’s Penile Enhancement Lawsuit

50 Cent is a prolific American rapper. He’s a celebrity. He just sued a Miami Beach medspa alleging misappropriation of his image (in this case, his picture on Instagram) without his consent and false advertising. What happened here? It’s complicated. Our blog has the details…

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Doc, Your Patient Just Walked Out with Her Chart

Real event. A surgeon saw his elderly patient in follow-up. They had a long-term doctor-patient relationship. It was a challenging relationship. The patient was high maintenance. She focused on alleged problems the doctor could not identify. She blamed the doctor. Over and over. Each visit was a new story. But the theme was unchanged.

The patient wanted a record of her chart. Fair enough. Instead of waiting for a copy to be made, she picked up the paper chart and scuttled out of the office. No good-byes.

The nurse witnessed the theft. But it was too late. She was gone. Who owns the chart? Who owns the data? What’s next? Our blog has the details…

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Will Massachusetts Non-Compete Law Become the New Standard?

In the past few years, more legislators have shown persistent hostility toward non-competition agreements in employment contracts. In adopting the Massachusetts Noncompetition Act (MNCA) in 2018, Massachusetts legislature played a major part in this catalyst movement of restricting non-competes.

The MNCA dramatically restricted and placed limits on non-competes within the State. As a result, non-competes in Massachusetts are now far more expensive to implement.

The bigger impact: By adopting the MNCA, Massachusetts provided a roadmap for several other states to restrict their own non-competes. How might this impact doctors across the country? Our blog has the details…

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Doctor Successfully Dodges Costly TCPA Suit – For Now. Why Was He in the Crosshairs in the First Place?

Doctors are wise to revisit the business of their practices from time to time. If made, changes require doctors to notify their existing patients, so they are also privy to the impending changes. A combination of text messages and phone calls is often the most effective method of raising awareness.

Do these messages put doctors at risk of litigation? The answer: It depends. But the cost of texting patients without their express written consent can crush practices outright. What’s the deal? Our blog has the details…

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Breaking News: Physicians Copy and Paste into EMRs

Recently, the Deputy Attorney General (DAG) in one state advanced an accusation against a licensed physician. The charge: He was using templates to document his notes. And the notes did not vary much from visit to visit. The doctor was also in the crosshairs for other alleged violations. But the documentation issue was the cherry on top of the Board complaint sundae.

Just how much of an outlier was this physician? Or any physician, for that matter, who copies and pastes into the EMR? Our blog has the details…

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Dominoes That Fall When You’re Sued

If you’re a doctor, you have many relationships. These relationships are defined in contracts. Your professional liability carrier, for example. In the event that you’re sued (or become embroiled in another medico-legal crisis), your insurance carrier wants to know. In most cases, there’s a duty to notify.

So what happens if a doctor forgets to notify a carrier of a crisis? Or chooses not to notify them? Does it matter? Short answer – it matters a lot. Our blog has the details…

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What Happens When a Surgeon – Or Anesthesiologist – Gets Sick or Dies During a Case?

With the amount of surgery that takes place across the country every day, the number may be low. It cannot be zero. A few months ago, the media reported on a pilot who collapsed at the controls. A passenger with “no idea how to fly” landed the plane. Commercial pilots have to pass a physical exam. Surgeons and anesthesiologists do not.

So, what does happen when a surgeon or anesthesiologist falls ill during a case? What are the fail-safes? Our blog has the details…

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When Are Doctors Obligated to Report a Patient for Bad (or Dangerous) Behavior?

A central tenet of medical practice is whatever a doctor learns about a patient in the course of medical care should be kept private. What happens in the doctor’s office stays in the doctor’s office.

This binding of doctors to confidentiality benefits patients, who must feel free to tell the truth about their condition. It also benefits the public.

However, confidentiality is not absolute when illegal conduct by the patient is involved. When are doctors obligated to report a patient? And what happens if they do not? Our blog has the details…

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Why Doctors Cannot Cut Corners with Patient Interpreters

Practicing medicine requires effective communication between doctors and patients. Some patients cannot hear their doctor. Others cannot understand their doctor. Interpreters play a pivotal role in not just serving the needs of patients but in preventing actionable errors by the doctor.

However, hiring an interpreter can be a financial and practical burden. Some doctors cut corners. Those who do create significant risk. It’s critical doctors prioritize effective communication between themselves and their patients. How? Our blog has the details…

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Opening the Med-Mal Floodgates: Pennsylvania Bucks Nearly 20-Year Malpractice Precedent

The state of Pennsylvania is experiencing a shift in malpractice law. We’ve written about a phenomenon in the past where legislation implemented in California eventually became the standard nationwide. Will we see the same play out in Pennsylvania? Hard to say. But doctors in all states should take note in case these laws manifest in their backyards. What’s changing? And why should doctors care? Our blog has the details…

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Doctors Slammed for Bad Behavior, Gucci Suits During Med-Mal Trial: Case Studies in How NOT to Behave

We’ve three vignettes to share. And not all these stories are downers – in two cases, the doctors prevailed, despite their best efforts to self-sabotage. In the third, the doctor lost a case he might have won. More importantly, there are lessons to be learned from each case. Our first vignette takes us to rural New Jersey – as you may have guessed already, it’s former patient vs. surgeon. Our blog has the details…

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Sham Peer Review: Recognizing When It’s Improper and How to Fight Back

In a peer review process, doctors act as evaluators. That’s the good news. However, peer review can still be used improperly to satisfy a personal grievance or propel a business gambit. And it is easy to disguise such a peer review as “proper.” Doctors, therefore, need to safeguard their interests and strongly defend themselves. How can doctors fight back when peer review is misused? Our blog has the details…

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California Governor Signs Bill Disciplining Doctors Spreading COVID Misinformation. Will Other States Follow?

A few weeks ago, we alluded to a piece of legislation on the docket in California. Its purpose: Punish doctors spreading COVID-19 “misinformation.” While well-intentioned, the practical reality of enforcing such a law raised the eyebrows of doctors and laypersons.

The question going around: “Well, how is this thing going to work?” We no longer need to wonder – we’ll know soon enough. California governor Gavin Newsom signed the bill into law at the end of September. Our blog has the details…

Our blog has the details…

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Surviving Sham Peer Review and Protecting Your License

Doctors are often angered by the knowledge they are judged in a medical malpractice case by a jury of laypersons, not by “their peers.” These individuals are not doctors, nor do they have any substantive medical knowledge. Even in a Medical Board hearing, some lay members will participate. A peer review, though, is just that: Doctors evaluating doctors.

It should be fairer, right? Perhaps – or perhaps not. Doctors must understand the process to avoid the traps and achieve the best outcome possible. How?

Our blog has the details…

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Navigating Board Investigation Landmines Without Losing Your License

Last week, we examined the procedural aspects of a Medical Board complaint. Now, let’s examine the pitfalls most likely to catch doctors off-guard – and how doctors can increase their chances of experiencing a positive outcome. The process is loaded with landmines. But there are ways doctors can emerge unscathed. How exactly? Our blog has the details…

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Surviving Medical Board Complaints: Understanding the Essentials So You Don’t Get Burned

An envelope from your state Medical Board arrives in the morning mail.  You open it, assuming that it will just be a ho-hum notice of yet another course the state requires for license renewal, or perhaps a COVID rules update. But as you begin to read it, your stomach knots: You are under investigation because a patient made a complaint about you. How can doctors survive this? Our blog has the details…

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California On Verge of Disciplining Doctors Spreading COVID Misinformation. Will the Nation Follow?

California doctors found “guilty” of spreading “misinformation” about COVID-19 may soon face disciplinary action if pending legislation is signed into law. Yes, you read that correctly. The governor of California is expected to make a final decision in less than two weeks. The name of this new law: Assembly Bill 2098 (AB 2098).

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

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Sometimes It’s Not Easy Being a Doctor

A fifteen-year-old patient sees a dermatologist for cystic acne. Conservative treatments fail. Isotretinoin would be a good option, but it dramatically increases the likelihood of birth defects. Mom and daughter are in the same room listening to the risks, benefits, and options. The daughter commits to abstinence.

Mom leaves to pay the bill. The daughter then tells the dermatologist, in private, that she will not commit to abstinence. Mom expects that daughter will receive pregnancy tests and eventually a prescription for isotretinoin.

Are there other options? What can or should the dermatologist tell Mom, if anything? What to do? Our blog has the details…

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Is Refusal to Get a COVID-19 Vaccine Reportable to the Data Bank?

The National Practitioner Data Bank (NPDB) has over one million reports. Most of these reports relate to a professional liability carrier making payment on behalf of a doctor for an allegation of malpractice. Disciplinary actions by state licensing entities are also reportable.

The Data Bank publishes a monthly newsletter with Q and A. Here’s a vignette from late 2021: “If my organization takes an action against a physician or other practitioner for not complying with our COVID-19 vaccination requirements, is it reportable?” Well, is it?  Our blog has the details…

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Face Veils on the Wards. Face Veils in the Exam Room.

I recently eyeballed a healthcare organization’s website featuring its staff. One picture that caught my attention was a staff physician who was wearing a niqab. A niqab is a face veil. This made me wonder: What might a typical ICU patient think about seeing a physician with a niqab? Or any face covering, for that matter? This was written pre-pandemic, by the way. That may (or may not) change people’s opinions. But it certainly makes it more interesting with the benefit of a COVID backdrop.

In one sense, that physician might appear similar to a surgeon wearing a surgical cap and mask. On the other hand, every staff member in the ICU generally shows their face. Anticipating patient reactions is complicated. Our blog has the details…

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Disclosing Medical Errors – How To Do It RIGHT

You are doing a cholecystectomy. You nick the common bile duct. You repair it immediately. The patient makes an uneventful full recovery from surgery, is feeling fine, and is ready for discharge.

Do you tell them what happened? Yes. In fact, you must tell them.

As good as your repair was, they are still now at a risk for stricture that they did not face before, and they must be informed. But there are ways to do this right. Our blog has the details…

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So, You Want to Set Up a Satellite Surgical Office in a Neighboring Community. What Could Go Wrong?

Many surgeons are entrepreneurial while pursuing excellence. Sometimes that means adding new services. Or adding capacity to serve additional volume. Sometimes it means expanding into a new community. All these actions create risk – but they are often worth the effort.

What can go wrong? A lot. But doctors CAN get this right. Our blog has the details…

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Medical Records: How Long Should Doctors Retain Them? 

I received a request for a patient’s medical records from the last century. A California woman is suing a shopping center, probably related to a slip and fall. I responded they likely had the wrong person. Then they defined the address I worked at in San Diego – decades ago.

The defense attorney was likely padding his bill by broadly searching all medical records. But the conversation raised an important question: How long should doctors retain a patient’s records? Our blog has the details…

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Psychiatrist Convicted of Exploiting Vulnerable Patients in $112 Million Addiction Treatment Fraud Scheme

The psychiatrist faces 54 months in prison. And he isn’t alone – the sentences of his associates range from 13 months to 188 months. What happened? More importantly, what can the rest of us law-abiding citizens learn from their circus?

Let’s start with their scheme. What did they do? Fraud is broad. Our blog has the details…

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Frankenstein Mail Fraud: Colorado Funeral Home Pleads Guilty to Trafficking Human Remains 

On the surface, “Colorado Funeral Home Owners Charged with Mail Fraud” seems uninteresting – until one considers the kind of “mail” defrauded.

If you read the headline, you already know – human remains. But what does all this have to do with doctors? We’ll reveal that shortly. Our blog has the details…

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$111 Million Shock Verdict: Orthopedic Hospital Sued by Injured Student-Athlete. But Can He Collect? 

This case is a record-breaker – at least on paper. Will the eye-popping verdict be thrown out? It’s likely. But the case is worth evaluating based on the sticker shock alone. And even if the case is tossed, the aftershock may ripple beyond state borders, impacting doctors in other parts of the country. Let’s discuss. Our blog has the details…

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What Does Med Mal Taste Like? Cancer, Probably. Dentist Sued for $6.6 Million After Patient Loses Half His Tongue.

The case began in 2013. The patient visited his dentist for a routine checkup. During the visit, the patient complained that a portion of his tongue was discolored. The dentist ordered a biopsy. According to the dentist, the biopsy returned negative. The dentist told his patient he did not have cancer. Great news. But if he didn’t have cancer, what was the discolored mass? Our blog has the details…

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Roe Versus Wade: Edge Cases for Exemptions

Plenty of ink has been spilled on Roe versus Wade since SCOTUS overruled its precedent, which stood for almost 50 years. This post addresses one of the exemptions to the restriction. Colloquially, to “save the life of the mother.” Physicians will face questions like the following: How imminent is the mother’s death? Is the condition emergent, urgent, or elective? Can the expectant mother travel to another state to receive care?

It’s critical doctors prepare to answer these questions. Our blog has the details…

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$1,300 Estimate, $300,000 Bill. Patient Sticker-Shocked by Hospital’s “Secret” Chargemaster Rates. Will She Pay?

In 2014, Lisa French underwent surgery to address her back pain. The hospital estimated French’s bill would be around $1,300 out of pocket. Sounded reasonable.

The hospital billed her over $300,000. That sounded unreasonable. How did this happen? Eight years later, the court ruled. The question: Was she forced to pony up? Our blog has the details…

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Surgeon Allegedly Reattaches Severed Fingertips to the Wrong Fingers. Is He Guilty of Malpractice?

An industrial accident cost Corey Cochran three fingertips. Emergency responders rushed him to a nearby hospital. A surgeon successfully reattached his severed fingertips. Or so it seemed.

After surgery, staff examined the patient’s fingerprints – and claimed the surgeon reattached the severed fingertips to the “wrong” fingers. Is the surgeon guilty of malpractice? Our blog has the details…

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Execution by Organ Procurement – China’s Transplant Tourism

Two years ago, a team of Australian and Israeli researchers teamed up to investigate forced organ procurement.  Their investigation led them to China. China is the second-largest transplant country in the world. Despite ranking number two, China has one of the lowest rates of voluntary organ donation. How can these contradictory data points coexist? Our blog has the details…

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Who Is Entitled to be Called Doctor?

Most of us intuitively conclude that once we graduate from medical school, we can call ourselves “Doctor.” That’s the impression my medical school’s dean gave our graduating class as we walked across the stage to collect our diplomas and congratulations.

Apparently, it’s not that simple. And the legal distinctions are worth understanding. Our blog has the details…

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Small Town Doctor Murders His Father, Sentenced to Life. Is There a Clinical Explanation for His Violence?

Dr. Vince Gilmer worked as a physician at the Cane Creek Clinic, located in rural Fletcher, North Carolina. His patients loved him and remembered him as a gentle, generous man. In 2004, Dr. Gilmer received a life sentence for the violent murder of his father. After years of investigation, his colleagues discovered a clinical explanation for his sudden change in demeanor. What happened? Our blog has the details…

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Nurse’s Error Leads to Patient’s Death, Threats of Jail Time: When Medical Errors are Criminalized.

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? Our blog has the details…

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California Tort Reform was Good While it Lasted. New Rules Are on The Horizon.

California has one of the longest track records in the US on substantive tort reform. For decades, California had a cap on pain and suffering. That cap was $250k and dated back to 1975. Before many of our readers were born.

What does that mean?

For doctors practicing in California, that cap kept professional liability premiums level and reasonable. Doctors argued raising that cap would trigger a physician exodus. Guess what’s now at risk of going up? Our blog has the details…

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The Line Between Comfort Care and Murder. Physician Accused of Murdering 14 Patients Found Not Guilty.

A jury in the Franklin County Court of Common Pleas just found William Husel, DO, not guilty on 14 counts of murder and attempted murder.

Husel faced charges of killing the 14 patients from 2015 through 2018 by ordering single large doses of the painkiller fentanyl — from 500 to 2000 micrograms — often in combination with other opioids and sedatives. Our blog has the details…

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$50k is One Reason to Resist the Impulse to Tell Your Side of the Story on Google

Dr. U. Phillip Igbinadolor runs a dental practice in North Carolina. In October 2013 and March 2014, a patient visited the practice for treatment. Around September 28, 2015, the patient posted a negative online review on Google, using a partial alias. Around September 28, 2015, the practice responded, disclosing the patient’s real name and unmasking the alias.

This sparked years of conflict between the practice and their patient. In the end, the practice paid a steep penalty. What can we learn, and why did they “lose” in the end? Our blog has the details…

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Terminating the Doctor-Patient Relationship When You Treat Both Husband and Wife

Sometimes, the doctor-patient relationship sours. It’s more than someone just having a bad day. The magic is gone. It’s time to part ways.

What happens when you take care of a family, for example, a husband and wife? How is that managed? Doctors need to do this correctly. Our blog has the details…

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Doctor on The Legal Road to Successfully Unmasking Who Wrote 23 One-Star Reviews

Suing a patient for defamation based on a negative online review is challenging. Such a lawsuit costs time, money, and delivers an uncertain outcome. Sweet deal, right?

But this hasn’t stopped one dermatologist in Colorado from investigating what she believes is a concerted effort to defame her practice. What are the odds she prevails? The answer may surprise you.

Our blog has the details…

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Jurors Show Up to Virtual Med Mal Trials Drunk, Weeping, Half-Asleep. Doctors Pay the Penalty.

Before the pandemic, virtual trials were less common. But many trials went virtual when the pandemic struck, taking doctors and attorneys into the digital courtroom kicking and screaming.

There is a growing body of evidence that jurors perceive virtual trials as casual affairs. And the more “relaxed” environment enables more casual behavior – sometimes leading to bigger penalties for doctors and bigger payouts for patients. How can doctors protect themselves?

Our blog has the details…

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Surgery Center Execs Plead Guilty to $44 M Fraud Scheme Coding Cosmetic Procedures as Medically Necessary

The surgeon lost his license. Both he and his wife will likely spend decades in prison. Both are in their early 70s. Their golden years are turning orange.

The practice fraudulently billed federal and private insurers for millions. They did this several years before fleeing to Israel to avoid jail time.

Trust us, there are lessons to be learned beyond the obvious. Let’s meet our “protagonists.” Our blog has the details…

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Dentist Found Guilty of Deliberately Breaking Patients’ Teeth for Profit

Dr. Scott Charmoli’s income jumped from one million dollars to over two million dollars in a year. Investigators attributed most of this surplus cash to a dramatic increase in the number of crowns he installed. Over a 20 month period, he installed over 1,600.

How did he justify the installation of so many crowns? Simple. He broke his patients’ teeth. Our blog has the details…

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Doctors Nailed in $7 Million Telemedicine Fraud Scheme

Demand for telemedicine services skyrocketed during the pandemic. This explosion in demand enabled a novel species of fraud. We call it “tele-fraud.”

Regulators recently nailed three Michigan doctors (and one nurse practitioner) for participating in a Medicare fraud scheme. This scheme has lots of moving parts – and they all hinge on telemedicine.

Our blog has the details…

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Criminals Posing as FBI Agents Scam and Extort Doctors – With Surprising Success

Most doctors won’t fall for a run-of-the-mill scam. But criminals ARE targeting doctors, and the FBI is acting. The FBI New York Office recently published a special notice detailing several scams targeting doctors. And these scams share a theme. So, why are doctors taking the bait?

Our blog has the details…

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Doctor vs. Doctor: Internist Sues Podiatrist Over Leg Amputation

Dr. Mario Adajar is an internal medicine specialist practicing in West Wyoming, Pennsylvania. He is (now) an amputee and the plaintiff in our story. His adversary is Dr. Michael Baloga Jr., a podiatrist practicing in the same area.

Dr. Adajar (the internist) sued Dr. Baloga (podiatrist) for the “needless amputation” of his right leg. It isn’t often we discuss a doctor suing another doctor for medical malpractice, but doctors are patients, too. And when they experience a negative outcome, they sometimes sue.

What happened here? Our blog has the details…

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Ophthalmologists Slammed with $170 Million Penalty in Alleged Fraud Scheme.

Dr. Mustapha Kibirige, 58, and Dr. Emelike Agomo, 57, are ophthalmologists. They operate the Outreach Diagnostic Clinic in Houston, Texas. Both doctors are accused of fraudulently billing Medicare millions. A former employee of the practice filed a whistleblower lawsuit under the False Claims Act, lighting the fuse.

What did these doctors allegedly do? And why did their actions result in such a huge penalty? Our blog has the details…

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Lost Crown. Septic Patient. Collapsed Lungs. $1.2 Million Med-Mal Settlement.

The 72-year-old patient underwent a crown procedure in May 2018. The dentist dropped the crown into her throat. The crown landed in her trachea – but the dentist believed the crown fell into her esophagus. An x-ray would have ended the mystery. The dentist did not order an x-ray, and instead recommended his patient drink water and eat some crackers. The patient didn’t cough up the crown – but the dentist coughed up $550,000. Our blog has the details…

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What’s Worse Than Burying Four of Your Children? Being Charged with Their Murders. 

Kathleen Folbigg is an Australian who had four children, Caleb, Patrick, Sarah, and Laura. Her children died at various ages, between 19 days and just under 2 years. Folbigg was ultimately convicted of murdering three of her infant children.

Over 20 years later, Professor Carola Garcia de Vinuesa sequenced the genomes of the four children from neonatal heel-prick blood cards. She identified a genetic mutation that can cause sudden cardiac death in infants. Did Kathleen actually murder her children? Our blog has the details…

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We Told You So. FTC Fines Business $4.2M for Review Gating.

In 2019, we alerted members to avoid the practice of “review gating.” Review-gating is the process of filtering candidates before asking them to write a review. Candidates first receive a message asking them if their experience was positive or negative. If their experience was positive, the candidate is asked to leave a review on a review site.

But if their experience was negative, they are prompted to leave private feedback. And the candidate is never sent the option to leave a review publicly. Businesses engaged in review-gating are getting slammed – and the fines are steep. Doctors and their practices are at risk. Our blog has the details…

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Your Patient Has a Plutonium Powered Pacemaker. Anything to Know?

Plutonium is a compact, long-lived power source. It’s not surprising that some medical device companies dabbled with nuclear-powered pacemakers. What is surprising is that some patients are still walking around with these devices in place. Due to the extremely long battery life, nuclear pacemakers tend to outlive their users. They also come with their own share of unexpected challenges. Our blog has the details…

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Raleigh ENT Doctor Accused in $46 Million Medicare Fraud Scheme

Dr. Anita Louise Jackson is an ENT specialist. Dr. Jackson runs several ear, nose, and throat clinics in the Raleigh, NC area. She helped several of her local health departments respond to the COVID-19 pandemic. She’s also named in a $46-million Medicare fraud scheme.

We’ve summarized the 20+ counts – which include the recycling of “single-use” balloon sinuplasty devices. What can we learn? Our blog has the details…

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$13 Million “Rapey Juan” Verdict Shatters California Med-Mal Cap

Aurora Vista del Mar is a psychiatric hospital in Ventura, California. Three of Aurora’s former patients sued the hospital in 2015 for sexual assault, emotional distress, and failure to protect them under the Elder Abuse Act.

The allegations: The rapist you hired raped us.

The damages awarded: You read the headline, didn’t you?

The case is a roller coaster. Let’s start with the perpetrator, known to his coworkers as “Rapey Juan.” Our blog has the details…

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Brain Surgeon versus Rocket Scientist? Has the Question Been Answered?

The British Medical Journal just published a piece called: “It’s not rocket science” and “It’s not brain surgery” — “It’s a walk in the park.” The authors included neurosurgical residents – a group with a stake in the outcome.

The objective: Compare cognitive testing scores in neurosurgeons and aerospace engineers to settle the age-old argument of which phrase is most deserved — “It’s not brain surgery” or “It’s not rocket science”. What were the results? Place your bets. Our blog has the details…

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“As goes California, so goes the rest of the nation…”

California’s Silenced No More Act takes effect in 2022. Many doctors are already taking notice. Here’s why you should, too.

It’s likely the law will make it harder for doctors to prevent their employees from disclosing information related to what they believe are acts of discrimination or harassment. It does not matter if the employee’s claims are meritless.

How will this impact doctors in California – and potentially the rest of the nation, if this spreads? Our blog has the details…

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Your Patient Just Submitted a Chargeback. Now What?

The world has changed. Once upon a time, you performed a service for a patient, perhaps surgery, and you were paid. You might be paid by personal check. By credit card. Or even cash. And that would be that.

Now, much more frequently than in days past, some patients feel entirely comfortable initiating a chargeback from their credit card company. Even if objectively the result was good – even excellent.

This is maddening. What to do? Our blog has the details…

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“I’ll Trade You.” Embryo Mix-Up Prompts Parents to Swap Babies.

A fertility clinic in California is being sued by one patient for medical malpractice, breach of contract, and fraud. Another patient is likely to file their own lawsuits in the coming weeks. The origin of the conflict warrants discussion.

If you monitor medical news outlets, you’re likely familiar with this story already; if you’ve missed it, we’ll fill you in. Our blog has the details…

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Surgeon Sues Patient for Defamation and Wins. $30,000 Payout.

We often advise doctors against suing patients for defamation – especially if the defamatory content originates online. Why? It’s hard to win a defamation case. It takes a long time. It’s expensive. And frequently the publicity of the lawsuit brings even worse attention to the business. You must also prove the review has damaged your business. Procuring this evidence is difficult and often not possible.

A plastic surgeon in Canada broke the mold. He sued his patient for defamation. And won. How’d he do it? Let’s meet our cast…

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Why So Many Doctors Self-Destruct During Their Depositions – and How to Nail Your Own (Part 2)

Many medical malpractice cases never reach trial. But almost all defendants are deposed. Critically, the defendant must ace their deposition. A deposition is the plaintiff’s chance to make his/her case as strong as possible; and the defense’s chance to see how the doctor performs when pressured.

Let’s examine several real-world vignettes to see where the traps may hide – and how doctors must sidestep them. Our blog has the details…

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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 positive, Mr. Spang and his wife discussed his options with his doctor. After seeking a second opinion with another doctor in the practice, 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. Our blog has the details…

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When a Doctor Has an Abnormal Blood Test

Two years ago, I fractured my left fibula. It was treated with 8 weeks of bracing. When I took the brace off, my calf was enormous. A doppler venous flow study showed extensive deep venous thrombosis. I did 12 weeks of Xarelto. I started wearing compression hose. All was well.

Ten days ago, I went cycling. We rode for 60 miles at a blistering pace. When we finished, my right calf was sore. No surprise. I figured it was a sore muscle and it would get better on its own. It didn’t. It was still sore 5 days later. And tender. This couldn’t be a DVT, could it? I ordered a D-Dimer test, fully expecting it to be negative. It was a DVT.

In one sense, we all live on borrowed time. How hard should we look for ticking time bombs? And when we find one, what should we do? Here’s the story…

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Vaccine Wars

Most agree that COVID will simmer in the population unless and until we reach herd immunity. And, yes, if SARS-COV-2 mutates “enough”, it will linger even longer, perhaps annually, because herd immunity will not have been achieved for the mutation in circulation.  As vaccines become accessible, employers large and small weigh the costs of vaccine mandates. Is there a solution that satisfies everyone? Or is this a pipe dream? Our blog has the details…

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Doctor Pleads Guilty to Selling “Misbranded Medication.” Who Pays Retail?

What practice doesn’t want to save money? That said, there’s a line that should not be crossed. In a Department of Justice News Release, Dr. James Heroman is identified as a physician who should have shopped locally. He just pled guilty to ordering and receiving “a misbranded medication.” This is a criminal offense with criminal penalties.

The charge of receiving and delivering a misbranded medication carries a maximum penalty of a year in prison and a $1,000 fine.

Dr. Heroman and his corporate entity also agreed to pay $450k to resolve they violated the False Claims Act.

Our blog has the details…

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Doctors Accidentally Start Fire During Open Heart Surgery

The patient was undergoing emergency surgery to address a torn aorta. The patient also had an “enlarged” lung, a symptom of the patient’s pulmonary disease. The patient’s lung was fixed to his sternum, and the surgeons needed to crack his sternum to access his heart. In doing so, they punctured a bulla within the lung.

The anesthesiologist responded by increasing the amount of oxygen in the patient’s anesthetic inhalant. You can guess what happened next. But what were the outcomes? Our blog has the details…

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Murder, He Spoke. Different Confidentiality Standards for Doctors and Lawyers.

In 1969, a University of California student told his psychologist that he intended to murder his ex-girlfriend. The psychologist wrote to campus police.

The student was detained but released as his mental state appeared improved. The ex-girlfriend received no warning. When she returned to campus, the ex-boyfriend befriended her brother. They even moved in together. Seriously. Not long after, the young woman was murdered.

In the resulting landmark case, the state Supreme Court held that mental health professionals have a duty to protect people who are threatened with bodily harm by their patients. It is critical doctors of all specialties study this case. Our blog has the details…

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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…

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Why So Many Doctors Self-Destruct During Their Depositions – and How to Ace Yours

Many medical malpractice cases never reach trial. But almost all defendants are deposed. Critically, the defendant must ace their deposition. A deposition is the plaintiff’s chance to make his/her case as strong as possible; and the defense’s chance to see how the doctor performs when pressured.

Let’s examine several real-world vignettes to see where the traps may hide – and how doctors must sidestep them. Our blog has the details…

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What Were They Thinking? Chapter 952.

Yes, it’s true, in the United States criminal justice system, one is presumed innocent until proven guilty beyond a reasonable doubt.

If the allegations in a recent US Department of Justice press release are true, two physicians will have a hard time staying out of prison.

What was the alleged scheme? It entailed insurance fraud, staged accidents, and the exploitation of the homeless, the poor, and the drug-addicted. Our blog has the details…

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Operating Room Shenanigans Lead to Lawsuit. Amazingly, the Hospital Prevailed.

In January 2020, Michael Sonnier, a charge nurse, underwent hernia surgery. He experienced no complications. Then he woke up and the “fun” started. Michael awoke to find himself wearing a diaper, despite the fact that most patients recovering from hernia surgery do not require diapers.

He then discovered someone had taped a plastic baggie containing mixed nuts to the diaper and written, “These nuts!” on the baggie. While he was unconscious, someone painted his fingernails and toenails scarlet. And that’s just the tip of the iceberg. Our blog has the details…

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Video Cameras in the Operating Room, Gangnam Style.

You think medical politics is contentious in the US? Let’s step over to South Korea for a moment. As I write, a legislative bill is about to be passed allowing for surgical procedures to be videotaped. The Korean Medical Association warned it will take legal action to prevent the passing or implementation of this bill.

What started this debate?

In 2014, medical workers at a famous plastic surgery clinic in Gangnam, Seoul were celebrating a birthday in the operating room, eating cake and playing with the implants. Our blog has the details…

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The Texas Heartbeat Act and M.C. Escher.

The Texas Heartbeat Act just took effect. It creates a private cause of action if a patient obtains an abortion in Texas after six weeks – when a fetal heartbeat can be identified. The private cause of action (meaning money) accrues to ANY citizen. In the past, state laws restricting abortion were pre-empted by litigation. Here, there is no public official serving as the enforcement arm. Such a public official would otherwise become a “defendant” in a lawsuit for an injunction to pre-empt the law taking effect. No public official defendant. No injunction. The law is ready to roll.

The law is clever on its face. Still, I’m going to take a crack at the gaping loopholes in the law. Please note, I’m only addressing the mechanics of the law and not taking a position on the pro-life versus pro-choice debate. If you want to debate the politics of pro-life versus pro-choice, please do it elsewhere.

Let’s discuss the gaping loopholes. Our blog has the details…

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Is It Worth Keeping a Medical License in More Than One State?

Last month I met two physicians with more than one medical license – actually each had over 40 medical licenses. They were both active in telemedicine and had a staff to assist with applying for and maintaining those licenses. Physicians who work locums and travel frequently also carry double-digit numbers of licenses. For these two groups, they use their licenses. They use these documents to earn a living. To them, it’s the cost of doing business.

What about the rest of us? Is it worth keeping a medical license in more than one state? Here’s what doctors need to know…

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Yelp Now Allows Businesses to Highlight Their Vaccine Policies. Review Bombing Follows.

This August, Yelp added two new features businesses can list on their profiles. A business can publicize that its staff is fully vaccinated against COVID-19. It can also indicate if it requires customers to provide proof of vaccination to receive services.

As of August 23, 26k businesses listed at least one of these two vaccine “badges” on their profiles. What does this mean for doctors and their practices?

Here’s what doctors need to know…

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Can You Mandate YOUR Patients be Vaccinated to be Seen?

Recently, a dentist asked us our thoughts on whether she can mandate her patients be vaccinated for COVID-19 as a condition to be seen/treated. The gist of the question was whether there were legal or regulatory prohibitions against pulling the trigger. It is important professionals of all specialties understand the medico-legal implications in play – this is a question you’ll have to address eventually. Here’s what you need to know…

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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 many 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. Learn how he does it. Listen to our two-part podcast.

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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 many 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. Learn how he does it. Listen to our two-part podcast.

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Someone Dropped the Ball. Thoughts on Wrong-Sided Groin Surgery.

On September 10, 2019, a patient was scheduled to have a left testicle varicocelectomy. This procedure addresses enlarged veins around the testicle, in this case, on the left side. Varicocelectomy is often performed to address male infertility, though there may be other reasons.

After speaking with the patient, the surgeon, a Tampa urologist, marked the right testicle just before the procedure. During the procedure, the urologist realized the patient had actually consented to a left-sided procedure.

Rut roh!

Here’s what happened next…

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How to Fire a Patient WITHOUT Getting Burned Yourself

Can a doctor fire a patient? Absolutely. And sometimes ending the doctor-patient relationship is the best path for both the doctor and the patient. Is firing a patient an easy, risk-free solution to a distracting patient conflict? Absolutely not. But there are ways a doctor can fire a patient while minimizing the risk of a bad outcome – such as an abandonment charge or a frivolous medical malpractice lawsuit.

Here’s what doctors need to know…

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Vaxed or Axed. So Wrote Dr. Ezekiel Emanuel.

In an opinion piece published on STAT, lead author Dr. Ezekiel Emanuel urged a vaccine mandate for all healthcare workers.

For healthcare organizations, the ostensible concerns persuading them to use carrots instead of sticks are employee retention and litigation. No healthcare organization wants to lose a significant portion of its staff en masse. And no healthcare organization wants to be sued.

But I expect more and more patients will ask doctors about their vaccination status.

Here’s what doctors need to know…

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Neutralizing Violent Conflicts in Your Practice: Life Lessons from the FBI

Most encounters with patients are conflict-free. That’s the good news. But not all patient interactions are conflict-free. Some can be deadly. Doctors must understand how to prevent violence in the medical practice – and what must be done when violence cannot be avoided. Many of these best practices come directly from two former FBI agents – it is critical doctors of all specialties internalize these techniques. They may save your life.

Here’s what doctors need to know…

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How to Survive Patients from Hell. Every Doctor Has at Least One – Including You.

Most patients love their doctors. And most doctors like (even love) their patients. Understanding how to de-escalate the outliers is critical. Medico-legal threats are frequently propelled by difficult patients. Applying this knowledge successfully can save you from an expensive and disruptive lawsuit, a meritless Board complaint, or worse.

Here’s what doctors need to know…

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Biological Parents of Child Born Via Surrogate Forced to Adopt Their Own Baby

Surrogate pregnancies are guided by state law. Each state is different. Michigan does not automatically recognize babies born to surrogates as the legal children of their biological parents.

That posed a problem for Jordan and Tammy Myers of Grand Rapid Michigan. Each provided the genetic material to produce an embryo; an embryo which was implanted in a surrogate.

When born, Michigan incorrectly labeled the surrogate (Lauren Vermilye) and HER husband as the legal parents of the twins. Note, the surrogate and her husband even filed a legal affidavit stating the Myers were the real parents.

What to do? Here’s what doctors need to know…

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Here We Go Again. United Health to Deny Some Emergency Department Claims.

United HealthCare, the largest private health insurer in the country, is playing Monday morning quarterback and denying some claims for what they deem to be non-emergencies in the emergency department.

Due to massive blowback from this ill-advised policy, United HealthCare is delaying the policy’s rollout.

Make no mistake. Winter is coming. And this comes on the heels of a year when EDs were underused for almost everything other than COVID-19. Here’s what doctors need to know…

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Avoiding Liability with Patient Photographs (Part 2)

We continue the discussion we started last week. Photography has been a part of medicine since, well, the advent of photography. However, with the dissemination of the smartphone camera, anyone can grab and disseminate an image with barely two screen taps.

In this setting, it is essential that physicians, who are fiduciaries for their patients’ medical information, including its confidentiality, be aware of the limitations that they need to follow to avoid not just a privacy breach but an ethical one.

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Avoiding Liability with Patient Photographs (Part 1)

Photography has been a part of medicine since, well, the advent of photography. However, with the dissemination of the smartphone camera, anyone can grab and disseminate an image with barely two screen taps.

In this setting, it is essential that physicians, who are fiduciaries for their patients’ medical information, including its confidentiality, be aware of the limitations that they need to follow to avoid not just a privacy breach but an ethical one.

There’s a lot to unpack here, so we’re addressing the major issues in two parts. With that said, let’s dive in. 

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Lawyer in Sizzling Water Over Courtroom Zoom Fracas

The list of Zoom courtroom challenges keeps growing. Most recently, a med mal plaintiff’s attorney was fined $3,000 and referred for further discipline after raising his middle finger to opposing counsel during an oral argument. The court was hearing a heated discussion about a challenge to the statute of limitations. The debate over stature of limitations will always ruffle some feathers. Here’s what happened…

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You Want a “Consent to Settle” Liability Insurance Policy. Here’s Why. (Part 2)

We continue the discussion we started last week. When reviewing your professional liability coverage, there are few elements as critical as the “consent to settle” clause. Why is the consent to settle clause so valuable to doctors?

Here’s what doctors need to know…

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You Want a “Consent to Settle” Liability Insurance Policy. Here’s Why. (Part 1)

Imagine you are sued for malpractice. You’re prepared to do everything necessary to defend your professional reputation. Based on the facts, you feel confident in prevailing. All you must do is speak up. But you can’t. This sounds like a nightmare. But if your professional liability policy is missing a “consent to settle” clause, that nightmare could become your reality.

When reviewing your professional liability coverage, there are few elements as critical as the “consent to settle” clause. Why is the consent to settle clause so valuable to doctors?

Here’s what doctors need to know…

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Employment Law and Your Office. A Thicket.

If you run a practice or evaluate candidates for your group, you know that there are interview questions under EEOC regulations and related laws that you cannot ask.

You want to avoid discrimination and implicit bias. But you cannot hire blindly. If the candidate is a bad fit (or a great fit), you need to know. The question: How far can you go? Where is the line between gathering relevant information and impermissible questioning?

Our blog has the answers. Here’s what doctors need to know…

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Prior Acts as Evidence in a Medical Malpractice Case

When the defense in the Derek Chauvin trial was permitted to introduce a video of George Floyd being arrested in 2019 (a year before he lost his life during a subsequent arrest) many doctors were confused. Physicians are generally told by their defense counsel that a basic rule in a medical malpractice action is what you did with another patient cannot serve as evidence in a current case.

They are correct – as a general rule. This is suited to medical malpractice actions because the issue is whether the defendant adhered to the standard of care. But the standard of care varies with circumstance. Each patient and each case is different. Here’s what doctors need to know…

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Manslaughter Versus Malpractice

A handful of recent cases, including a non-medical case, have doctors concerned that a medical claim could develop into criminal liability. All of these cases were charged as types of manslaughter, which is an unintentional killing. The charges were based on “reckless” conduct.  Of course, none of the defendants planned (intended) to kill. However, they all engaged in “reckless” conduct that carried a risk of serious harm to another. So, their conduct rose to potential criminal liability. Here’s what doctors need to know…

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21st Century Cures Act and Open Notes – Your Cheat Sheet

The 21st Century Cures Act was signed into law in December 2016. It was designed to help accelerate medical product development and bring new innovations to patients faster. It included modernizing clinical trial designs, expedited options for regenerative medicine therapies, and a “breakthrough devices” program. 21st Century. What’s not to like? It’s like Mom and apple pie.

Well, there’s a provision related to “information blocking” that took effect on April 5, 2021. It’s popularly referred to as the Open Notes Rule. If you’re a doctor who creates or uses medical records (that would include all practicing doctors)  here’s what you need to know now…

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It’s Not Discrimination to Tell a Patient “No.”

Man, the country has gotten so sensitive…

Patients are lashing out online, stating medical practices are “this phobic” and “that phobic.” Racist. Ageist. Ableist. Other “ists.” Some patients have filed lawsuits alleging discrimination. Oh dear. Let’s start with the basics. Here’s what doctors need to know…

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Patient Allegedly Woke Up in Body Bag. Hospital is Sued.

In 2017, a 99-year-old woman was declared dead at Olympic Medical Center in Washington state. Her daughter said her mother’s blood-stained sheets and apparent broken nose indicated she was alive up to two days after being declared dead. The mortuary noted the blood-stained sheets and the broken nose but stated there was no corresponding note from the hospital. This indicated a suffocating patient was trapped in a metaphorical coffin clawing to get out. A horrific image. Here’s what doctors need to know…

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Bullet-Proofing Your Medical Practice Against Unexpected In-Office Emergencies (Part 2)

We continue the discussion that started last week. Doctors are no strangers to emergencies – there’s a reason many of us specialize in “emergency care.” But not all emergencies are confined to the ER. Doctors of ALL specialties MUST have a plan for addressing unexpected in-office emergencies. And it’s not enough that doctors know how to act – we must train our staff as well.

A plan of action can save lives and absolve a doctor’s liability in the event of an in-office emergency. Here’s what doctors need to know…

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Bullet-Proofing Your Medical Practice Against Unexpected In-Office Emergencies (Part 1)

Doctors are no strangers to emergencies – there’s a reason many of us specialize in “emergency care.” But not all emergencies are confined to the ER. Doctors of ALL specialties MUST have a plan for addressing unexpected in-office emergencies. And it’s not enough that doctors know how to act – we must train our staff as well.

A plan of action can save lives and absolve a doctor’s liability in the event of an in-office emergency. Here’s what doctors need to know…

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How to Avoid a Report to the Data Bank (Part 2) 

Most doctors fear the destructive effect of a report to the National Practitioner Data Bank (NPDB). That concern is well-placed. A physician involved in such a situation must do the following: First, seek expert counsel. And second, seek education. Informed clients will get the most out of their representation.

Let’s examine what your lawyer must do to either prevent a report entirely or to blunt its impact. Here’s what doctors need to know…

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Black Doctor Asked to Speak About Racism. Fired Shortly After.

Dr. Aysha Khoury taught internal medicine at the Kaiser Permanente Bernard J. Tyson School of Medicine in Pasadena, CA. Dr. Khoury is black. During one of her classes, Dr. Khoury and her students discussed the Tuskegee syphilis study. Khoury also discussed several first-hand experiences as a woman of color in medicine.

Less than a day later, Dr. Khoury was suspended from her teaching role at the medical school. Four days later, she learned she was also suspended from her appointment at a Kaiser Permanente clinic. Why was Dr. Khoury canceled? Here are the details…

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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…

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How to Avoid a Report to the Data Bank (Part 1)

Most doctors fear the destructive effect of a report to the National Practitioner Data Bank (NPDB). That concern is well-placed. A physician involved in such a situation must do the following: First, seek expert counsel. And second, seek education. Informed clients will get the most out of their representation.

Let’s examine what your lawyer must do to either prevent a report entirely or to blunt its impact. Here’s what doctors need to know…

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Criminalizing Normal Doctor Behavior Must Stop! Now!

Dr. Hasan Gokal is a physician who worked for the Harris County Public Health department in Houston. He helped give COVID-19 vaccinations. He injected his 47-year-old wife with a vaccine, technically allowing her to “cut in line.” 47-year-old individuals living at home were not in the queue.

Dr. Gokal was fired. The district attorney filed criminal charges. A mug shot was taken. The world labeled him a bad person. In my estimation, Dr. Gokal did nothing wrong. He just practiced good medicine.

Details matter. So, here they are…

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Healthcare Execs Go to Jail. Good.

Henry McInnis was convicted by a federal jury of conspiracy to commit healthcare fraud and money laundering, obstruction of justice, as well as six counts of healthcare fraud in November 2019. He was sentenced to 15 years in prison. McInnis’ partner in the scheme, Rodney Mesquias, was also convicted in the November 2019 trial and was sentenced to 20 years in prison in December 2020. Two other co-conspirators have pleaded guilty and are awaiting sentencing.

Who were these people, and what did they do? Here’s what doctors need to know…

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Disabled “Hitmen” Setting Up Doctors for Disability Lawsuits

The Americans with Disabilities Act mandates reasonable accommodations to level the playing field for those with disabilities. The law was well-intended. While businesses often need a gentle nudge to come into compliance, some with disabilities (and their lawyers) are turning this gentle nudge into a cash cow. Doctors are among their targets.

Some attorneys are paying disabled “testers” to visit businesses – including medical practices. If the practice is not ADA compliant, the practice is sued. One firm in Georgia has filed hundreds of these federal lawsuits. Here’s what doctors need to know…

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Dude, Those Are MY Patient’s Photos on YOUR Website…

It’s Friday afternoon. You check your mail before calling it quits for the weekend. There’s a note from an attorney. It’s a cease and desist letter. Plus, a demand for money. Lots of money. The lawyer alleges your website and social media accounts are peppered with unlicensed pictures of patients from a practice he represents. He claims your practice committed copyright infringement, false advertising, and more. This is not how a restful weekend begins. Now what? Here’s what doctors must know…

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When Patients Go to War with Doctors Over “Failed” Procedures, Here’s How Doctors Win…

A classic example is a plastic surgeon who performs a facelift. The outcome is good. Is it perfect? No. But it was done at or above the standard of care. Yet the patient is dissatisfied. The surgeon says he’s happy to do a revision where he waives his professional fee. The patient says, “No dice.” She wants her money back. How to resolve? Here’s what doctors must know…

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Runaway Patients. Medicolegal Issues When Patients Leave AMA.

“Doctor, the pneumonia patient in cubicle 4 is trying to get up and leave!” Now what?

Forcing unwanted care on the competent patient might actually constitute battery, but in medico-legal reality there are quite a few layers in that simple answer. Let’s take a look at those. Here’s what doctors must know…

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Doctors Slapped by Anti-SLAPP Legislation. Why Suing Some Patients for Defamation Doesn’t Pay.

We understand the impulse. Someone said something ugly about you. It might be a patient. Another doctor, perhaps. They said it publicly. Online. You want to even the score. Sue them. Teach them a lesson.

There is no shortage of attorneys willing to take your cash to help you in your mission. Before jumping off the cliff, ask your attorney this one question. “Can I be burned under anti-SLAPP?” If your attorney answers, “What’s that?” or “Huh?”, don’t walk away. Run.

We’ll answer that question for you. Here’s what doctors must know…

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When the DEA Comes Knocking

“Doctor, there is a DEA agent at the front desk. He wants to speak with you.” What now? We got a call from a member doctor not long ago that sounded just like that. It raised an important point: What should doctors do when the DEA visits their practices?

The DEA is empowered to perform unannounced site inspections. However, that does not mean that these visitors can have immediate unfettered access to your office. Knowing your own rights is the most effective way to avoid being pulled into a more serious problem. Here’s what doctors must know…

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Doctors Who Purchase Fake Online Reviews from Bangladesh

Kathryn Dean is the creator of FakeReviewWatch.com and its eponymous YouTube channel. She’s exposed a large international marketplace for purchasing and posting fake reviews. She’s also discovered a domestic marketplace for trading reviews between businesses. One such review trader teaches law and ethics at a major US university. And physicians are participating. Here’s what doctors must know…

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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…

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Doctor Screwed by Med Mal Carrier: How to Prevent It From Happening to You.

You know what’s a bummer? Getting sued for med mal. You know what’s a double bummer? Having your carrier deny the claim. This nightmare became one doctor’s reality. Overlooking small (but critical) details in your policy can land you in the same boat. Here’s how one doctor got screwed by his med mal carrier – and how to prevent it from happening to you…

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C-Section. No Anesthesia. $5.75 Million in Damages. Ouch.

In 2018, an interesting medical malpractice lawsuit was filed in California. Well, interesting if you are not the defendant. The plaintiff delivered a healthy baby girl. The allegation is that her C-section was performed without anesthesia forcing her to suffer horrific pain.

The new mom was 41 weeks pregnant and was rushed to Tri-City Hospital in Oceanside, California for a C-section. The anesthesiologist allegedly did not arrive to administer anesthesia after several pages were sent.

But what actually happened here? Here’s what doctors must know…

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Sued for Leaving Cancer Patients High and Dry.

St. Peter’s Health is a healthcare system in Helena, Montana. If you can’t get timely cancer care in Helena, you’re driving. Far. Dr. Tom Weiner was one of four oncologists employed by St. Peter’s Health. Dr. Weiner was unexpectedly shown the door. Patients were not warned of his impending departure.

At least 96 cancer patients left in the lurch by his unexpected departure are suing St. Peter’s Health. How did this happen? And could this happen to your practice? Here’s what doctors must know…

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Dealing with Non-Maskers in Your Office

As COVID-19 cases increase across the United States, there has been great focus on mask mandates by governmental authorities, but not much attention on how individual businesses, including medical practices, can respond.

The basic rule is simple: A private business must conform to a regulation on masking set by a governmental authority, but if there is no such regulation, or if it is weak, that business can set up its own policy.

A medical practice is unique in several ways. Here’s what doctors need to know about dealing with non-maskers in the office…

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Doctor Prevails in Sham Peer Review: How He Did It.

Not infrequently peer review is parried as a sword to attack doctors. These confrontations often stem from disagreements between doctors and leadership governing a large hospital. This was the position an anonymous doctor found himself navigating. Ultimately, this doctor prevailed – but it wasn’t easy. We’ve distilled the highlights.

Here’s what doctors must know about sham peer review…

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Surviving a $1.5 Million (or More) Medical Records Breach

Here’s what doctors must know: Medical records are breached more often than you think. It’s not a matter of if, but when. Penalties are steep and go beyond cash payouts. If 500+ patients are affected by the breach, you are required by law to inform patients and the media.

It’s critical that sensitive information is kept under an impregnable lock and key. Here’s what doctors must do to protect themselves from a breach…

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Lessons from a Neurosurgeon-Attorney-CEO with Jeff Segal, MD, JD

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.

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How Doctors Risk Becoming Casualties of Casual Care…and Solutions

What is casual care? Broadly, it refers to informally consulting with an individual who is not your patient. A neighbor, a family member, a co-worker, etc. Many well-intentioned doctors are catapulted into court over an informal consult with a neighbor. They say no good deed goes unpunished. Let’s discuss how doctors can do a good deed without getting punished…

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Unauthorized Penis Surgery Spawns $9M Judgment. Careful Where You Cut!

A patient was suffering from a small scrotal mass. While operating, the surgeon discovered the mass extended into the patient’s penis. The surgeon believed leaving the mass unchecked endangered the patient long-term.

Because the patient was under anesthesia, the surgeon did not obtain additional consent from the patient. The surgeon also did not obtain consent from the patient’s designated healthcare power of attorney – his ex-wife. You read that right.

We won’t spoil the rest. Read on…

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Yelp Will Now Adjudicate Claims of Racism.

On October 8^th, Yelp released “New Consumer Alert on Yelp Takes Stance Against Racism.” In short, Yelp appointed itself judge, jury, and executioner by placing warnings on the pages of businesses alleged to be associated with overtly racist actions. What could go wrong?

Adjudicating race relations can be tricky. Can Yelp be trusted to manage a delicate dance on such a volatile issue? Here’s how doctors will be impacted…

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Abortion, Physicians, and Changing Jurisprudence. Fasten Your Seatbelts.

The makeup of the Supreme Court is changing. Abortion jurisprudence is also likely to change and the issue may revert to the states. If so, what does this mean for physicians who never performed the procedure and never will?

This post takes no position on the Supreme Court’s judgment, now, or in the future. But physicians may get sucked into the drama.

Let me explain…

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Sex with Patients, Opioids, and Vaccine Waivers. Riling Up the Board.

A “love letter” from the Board of Medicine can kick-start a very stressful experience. Board complaints have evolved over the years. The primary purpose of the Board is to protect the public from unsafe doctors. That role has evolved to address “undesirable” behaviors, which may or may not impact patient outcomes. Board priorities often reflect what’s making the news. These are the issues catching doctors off-guard…

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Hoverboarding Dentist Sentenced to 12 Years. Lessons on What Not to Do. 

An Alaska dentist was sentenced to 12 years of prison for 46 charges including Medicaid fraud, embezzlement, reckless endangerment and unlawful dental acts. His prior claim to fame? Extracting a tooth while on a Hoverboard. Illegal? No. A bad idea? Yes.

Back to the big charges. He supposedly fraudulently billed Medicaid $1.8M and stole approximately $250k from his partners.

How was he caught? We’re unpacking it all. Here’s what doctors can learn…

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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. 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.

The malpractice landscape is changing. Here’s what docs must know…

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No Good Deed Goes Unpunished – When Docs Are Bitten by Curbside Consults

An ER doc was treating a patient suffering from chest pain. The ER doc phoned a colleague (a cardiologist) for advice. The cardiologist was happy to lend a hand – only to become embroiled in litigation a short time later.

Collaboration is a critical (and inevitable) component of medicine. And  collaboration often benefits both doctors and patients. But what many doctors don’t know is how easily a “curbside consultation” can catapult them into litigation.

Can doctors really “curbside” safely? It’s possible. Here’s how you do it…

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Nailing Your Med Mal Deposition – So You Don’t Get Nailed in Court

Many medical malpractice cases don’t go to trial. But most defendants (doctors) are deposed. Knowing how to comport yourself during a deposition is critical.

A strong deposition often deters an opposing attorney from proceeding onward. A poor deposition will give your opponents an edge in the event your case is tried. Here’s what you need to know to nail a med mal deposition – so you don’t get nailed in court…

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Surviving Medical Board Investigations from Hell

A Board complaint can feel like a bolt of lightning. But there is one key difference: Medical Board complaints don’t fall from the heavens. They seem to rise from the depths of hell.

And doctors fear Board complaints for good reason. They have the power to permanently alter the trajectory of our careers, and frequently for the worst. Here’s what you need to know survive a board complaint from hell…

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Can Doctors Be Fined for Buying Online Reviews?

Your practice is running a promotion. Patients are entered into a small sweepstakes if they write a review for your practice. The winners (chosen at random) receive a gift card. The amount is modest. And the gambit is a success. New patient revenue increases as a result. All seems well. Until the Federal Trade Commission knocks on your door. Can doctors really be fined by a regulatory body for buying online reviews? Absolutely. And the fines can be steep. Here’s what you need to know…

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No Bulls**t. America’s Leading Voice on COVID Speaks from the Frontline.

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.

His insights are invaluable.

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Bikinis and Unprofessional Doctors. 

The fastest way to piss off doctors is to call them unprofessional. Case in point: Several surgeons recently authored a paper in the Journal of Vascular Surgery. The authors researched how young doctors use social media. Their goal was to identify bad habits and help their younger colleagues “course correct” before their careers got off the ground.

What put the authors in a vat of boiling water was their loose definition of unprofessional conduct. What was the problem with their definition? We have the details of the firestorm…

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

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. Let’s dive in…

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The Enemy of Good is Better. The Case for $1/Day COVID Test.

Michael Mina, a Harvard public health expert, recently explained why a daily rapid home-based test for COVID-19 will tame the pandemic. He argues the test sensitivity only needs to be surveillance grade. And the estimated cost? A dollar a day. Has he hit the jackpot? Let’s assess his assessment…

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Cutting Your Losses. Staged Procedures and Patients from Hell.

Not all patients love you. Or some love you today; not so much tomorrow. In most elective situations, you do not have to accept an ogre into your practice.

But what happens if you plan a staged course of treatments over time and the doctor-patient relationship sours in the middle? What are your options? Here’s the deal…

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Doctor or Bomb Squad? Defusing Patient Conflict Before It’s Too Late

“I expected you to make me better. You made me worse. I’m thinking about speaking to an attorney. Also, I want the whole world to know so they can be forewarned.” Yikes.

Doctors want to treat as many patients as reasonably possible. But if you practice long enough, you’ll treat them. Who? Angry patients. It sucks, but it’s an inevitable part of the job.

The “good” news: Doctors can do a lot to de-escalate conflict with an angry patient. The “even better” news: This article shares general tips and will set you on the right track. Here’s what you need to know…

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To Mask or Not to Mask. That is the Question.

For decades, surgeons have performed elaborate rituals to minimize risk of infection to patients. We wash our hands. We don gloves and gowns. We cover our hair. We avoid reaching over our heads or below our waist. And it works.

I cannot recall a single surgeon ever making a libertarian argument that it’s his choice whether to adhere to these rituals. But that was not always so. Ever heard of Dr. Ignaz Semmelweis? Here’s a history lesson…

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

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. Here’s what happened…

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Carrier Threatens Doctor with Discipline for Ordering Too FEW Tests

How many of us have received a letter from a carrier asking us to justify the medical necessity of our decisions? Assuming you have been in practice for more than one day, your answer, based on probability, is predictable. Insurance carriers generally demand doctors order fewer tests. One doctor was “beaten up” by a carrier for NOT ordering more tests. Here’s what happened…

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Impostors: Dealing with Medical Identity Theft

Doctors are targets for identity thieves. Our patients are also targets. And the interconnected nature of the cyber-world makes the threat of identity theft omnipresent. As more doctors move into telemedicine, the risk of becoming a victim of medical identity theft increases. How can doctors deal with medical identity theft? Here’s what you need to know…

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Revoking Her License? That Seems Harsh.

A male patient was referred to a female oncologist. The oncologist ordered bone marrow testing and diagnosed the patient with cancer. As the patient’s treatment developed, so did his relationship with his doctor. Eventually, the oncologist gave the patient her personal contact information. One thing led to another. A blossoming romance. Not long after, their romance soured. If you’ve read the title of this piece, you can guess what happened next.

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Every State Determines Brain Death Differently. Really.

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.

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The Ethics of Vaccine Efficacy Trials Using Prisoners Challenged with SARS-CoV-2

The race is on to create and distribute a safe and effective vaccine against SARS-CoV-2 for the world. A thought experiment.

What if the FDA learns the best vaccine candidate was tested overseas using prisoners challenged with SARS-CoV-2 exposure? Assume the safety profile and evidence of efficacy are excellent. Should the FDA allow the compound to be marketed and distributed in the US? This week’s blog weighs the implications…

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Your Colleague’s Keeper: Vicarious Liability

In the midst of COVID-19, some states are starting to loosen up. Before long, many practices will have clearance to return to work. But the universe in which we’ll all be working will look different. As we’ve discussed in past blogs, plaintiff’s attorneys are gearing up for a COVID specific litigation tsunami.

Understanding under what circumstances you may be held liable for a colleague’s error will help you take action to prevent those errors – which protects everyone at your practice against frivolous COVID litigation…

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Trial Bar’s Bonanza: COVID-19

Here’s a formula for the trial bar’s wet dream.

A high frequency, high severity condition where no consensus standards are fully accepted or in place.

High frequency means the “triggering event” is common. COVID-19: Check.

High severity means the damages are significant. COVID-19: Check.

A pandemic causing hospitalization, disability and death satisfies both conditions. Two big double checks. So, what does this mean for doctors?

Two words: Litigation tsunami. Medical Justice will help you prepare…

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A Deal is a Deal

Senator Ron Johnson’s April 23rd op-ed was a buzzkill. Even if it has zero chance of being implemented into law.

Unless you’ve been living under a rock for the past two months, the federal government launched the largest economic stimulus package in history (CARES). Included in that behemoth was the Paycheck Protection Program (PPP), a godsend to small businesses.

Many healthcare practices took advantage of the offer. Candidly, with the pandemic still in gear, the PPP (rounds one and two) may not be enough. But the program was popular and well-intended.

So – what’s the problem?

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Doctors, Divorce, and COVID-19

Dr. Theresa Greene is an ER physician in Miami.

Greene and her ex-husband have been divorced for two years. They have a daughter and split time with her evenly.

Her ex-husband challenged the custody order and the court ruled the child should stay with her father to limit the risk of exposure to coronavirus. Dr. Greene is appealing the emergency order granting full custody to her ex-husband.

The court stated it based its decision on the welfare of the child.

Did it? Or is this just a grab for power? It’s complicated…

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COVID-19: Want to Help Via Telemedicine? You’re Immune

I’ve received a number of calls from doctors whose offices have slowed down. These same doctors have years of experience. They want to help screen and inform patients about COVID-19. These same doctors have asked how to help and not be sued. No good deed goes unpunished.

In helping our brothers and sisters on the front line, we don’t want to be a plaintiff’s lawyer’s next meal. Well, you’re immune.

Not from COVID. But from litigation. Mostly. Here’s the deal…

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Asset Protection and Wealth Creation for Doctors – Protecting Your Nest Egg from COVID-19

The COVID-19 pandemic has turned our world on its head – both in terms of our health and our finances. To help our audience thrive, we are speaking with David Mandell, JD, MBA, partner at the OJM Group, a multi-disciplinary wealth management firm.

What distinguishes the OJM Group? Their focus on physicians.

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The Nation’s Largest Clinical Trial Ever. Let’s Roll.

Coronavirus is a tough opponent. It spreads easily and aggressively. Our brothers and sisters providing healthcare around the world are working tirelessly to deliver care, preparing for the worst, and staying true to the Hippocratic oath. Those in non-clinical fields are researching paths to treatment and prevention.

Everyone has a role to play. As a population, can we do more? Yes – we should embark on the largest clinical trial ever.

But first, some background…

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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 12^th…

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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

Freckles and Lawsuits

How Facebook Saved My Patient’s Life 

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

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

The Tax Man and Med-Mal Settlements

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

What NOT to do…

Damn, that’s awkward…

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

Thorny Vignettes and Patient Abandonment

Political Correctness Over-reach in the Exam Room

When Your Competitors Will Not Cross Cover for You

Medicolegal Issues in Dealing with Aging Physicians

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

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

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

Paid Reviews Cost Companies $175,000 Enforcement Action

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

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

No Good Deed Goes Unpunished

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

When a Lawyer “Just Wants to Speak” to You

Positive Change Regarding Medical License Renewals

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

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

Death and Donuts

The Insanity Defense: Medical Versus Legal Issues

The High Cost of Medications in Prison

Doc, What Would YOU Do?

Whose Baby Was It, Anyway?

Medico-Legal Issues in Restraining Patients

Crazy Cases Against Doctors — and Inexplicable Settlements

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

When a Doctor Becomes a Patient

Avoiding Liability When Dealing with Brain Death Cases

Dealing with Medical Marijuana

Those Damn Jackson-Pratt Drains

Plastic Surgeons as Psychiatrists.

Simple Procedures: An Occasional Multi-Million Dollar Lawsuit

Credentialing and Answering Touchy Questions

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

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

NC Medical Board Disciplines Doctor for a Lease Dispute.

HIPAA Conundrum. War of the Roses After Death.

Deporting Hospital Patients

Two Counterintuitive HIPAA Scenarios

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

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

Avoiding Liability When Sending Specimens

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

Which Workplace Bathroom to Use?

Those Pesky Signatures

A Good Samaritan Saves the Day

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

Is Pimping Really Abusive?

Easy New Year’s Resolutions for Cybersecurity.

⇨ Onward to Page 2