Risk Management - Medical Justice

The Migration from Third Party Insurance to Accepting Risk

August 15, 2024November 13, 2017 by Jeffrey Segal, MD, JD

This is not a story of medical practices becoming insurance-free. This year, a number of friends and colleagues explained they received a note from their long time health insurer. These were all people insured on the individual market. Their insurance plans were “grandfathered” so they did not have to purchase a policy on the exchange. … Read more

Cease and Desist

August 15, 2024October 16, 2017 by Jeffrey Segal, MD, JD

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 looked back and wondered “What was I thinking?” Never overruled your staff when they detected “red flags.” Never talked yourself into accepting a patient for the operating room when you’ve had … Read more

Physician Warns Medical Students How Easy it is to be Bribed

August 15, 2024June 12, 2017 by Jeffrey Segal, MD, JD

In 2014, an internist pled guilty to violating anti-kickback laws for illegal referrals. She accepted monthly cash payments of $5,000 to refer patients to a New Jersey lab, Biodiagnostic Laboratory Services. Apparently a total of 30 doctors have been snagged in the roundup. Biodiagnostic Laboratory Services is now out of business. Dr. Martinho accepted … Read more

Male physician working in operating room

Defensive Medicine: Everyday Life in the ER

September 17, 2024June 16, 2011 by Jeffrey Segal, MD, JD

Michael J. Sacopulos, Esq.

According to a poll conducted by the American College of Emergency Physicians, nearly half of emergency physicians, 44 percent, say the biggest obstacle to cutting costs in emergency departments is overcoming the fear of lawsuits. The poll, made up of 1,800 emergency physicians, also found that more than half of physicians, 53 percent, state that the reason they conduct the number of tests they do is due to the fear of being sued.

The study also stated that specialists cite the fear of being sued as one of the top reasons they will not treat emergency patients.

I Can’t Remember Any Risky Patients. Do I Need Tail Coverage?

August 15, 2024March 15, 2011 by Jeffrey Segal, MD, JD

Jeff Segal, MD, JD, FACS

When times are challenging, you must spend your money wisely. A Physical Medicine and Rehabilitation doctor recently posed this question on a physician social networking site.

Had professional liability coverage with his carrier for 21 months. Now moving to another state to work for the federal government. Worked at a chiropractor’s office – saw about 25 patients. Then opened a solo practice – saw about 120 patients: mostly worker’s comp or personal injury cases.

The carrier wants $12k for tail coverage. “I can’t think of any patient that would have a reason to sue me, but you never know…. Am I taking too much of a risk?”

The answer:

How To Save On Malpractice Insurance

August 15, 2024July 3, 2010 by Jeffrey Segal, MD, JD

In these tight economic times, no one is immune from the pressures to reduce costs. Major corporations are looking for ways to save money anywhere they can. Airlines are cutting even such seemingly trivial expenses as peanuts on domestic flights and charging ‘extra’ premiums on just about everything. In some ways, the medical profession stands unique and alone. It’s simply not acceptable to reduce the quality of care to save a buck or two. A doctor cannot afford to cut corners when lives are on the line. But there are ways to cut costs.

Just as being proactive about one’s health can reduce costs and suffering by eliminating the problems before they occur or escalate, physicians can lower their expenses with a proactive approach. One of the most sensible and affordable ways to do that is a membership in Medical Justice. Like a few other things in the business world, a Medical Justice membership doesn’t actually cost money. It saves money. Here’s how:

From The Trenches #5 — Taking Personal Responsibility

August 15, 2024March 18, 2010 by Jeffrey Segal, MD, JD

From The Trenches

(Healthcare Reform for the Real World)

#5: Taking Personal Responsibility

This is the fifth in a series of articles examining the problems in our health care system from the real world where patients get sick and injured, and doctors and other health care providers work to heal them. In the series, we’ll identify the actual non-political problems, and offer sound, sensible solutions that we can ourselves enact to reduce risk and increase patient safety.

People rely upon professionals to take care of them, and it is reasonable for them to do so. Though we come from a world of generalists, medicine is a world of specializations, and we defer to these experts. Perhaps this is wise; a specialist can afford to dig into the depths of his or her field of expertise and gain greater understandings of those detailed workings. But that doesn’t mean that we have become impotent, or that we shouldn’t still have a generalist who can see the forest while standing amongst the trees. More importantly, that doesn’t mean that we delegate or relegate our responsibility for our own health and well being; We can rely upon the expertise of specialists without giving up control of our lives.

Medical Malpractice Attorneys Dislike Medical Justice – Here’s Why

August 15, 2024December 30, 2009 by Jeffrey Segal, MD, JD

If Medical Justice files a countersuit, it could very well be a lot more on the line than not being able to collect contingency fees. He could end up having to pay Medical Justice money — cash out of pocket!

Defining Frivolous Lawsuits

August 15, 2024December 2, 2009 by Jeffrey Segal, MD, JD

In English, a word can have many meanings. It’s important that we understand the term “frivolous,” as it relates to medical malpractice claims. “Frivolous” is at the heart of the problem and is a core concern of the system by which we provide our nation with wellness.

According to Merriam-Webster, the term comes from Middle English, from the Latin “frivolus,” about the 15th century. There are two root meanings:

1) Having little weight or importance, or no sound basis in fact or law

2) Lacking in seriousness, or marked by unbecoming levity.

When we use the term in regards to claims of medical malpractice, we generally employ the first meaning, that the suit has no sound basis in fact or law. Contrary to the first part of that definition, though, any medical malpractice claim is important and constitutes a considerable burden, so it does have weight, and is serious. There’s nothing funny about being named in a baseless lawsuit.

Demands For Refunds on Dental Work? Yes, they ARE serious!

August 15, 2024September 25, 2009 by Jeffrey Segal, MD, JD

When it first started, most thought it was a joke, a hoax or a fluke. Could someone seriously be demanding a refund because they didn’t like the way their dental work turned out? Never underestimate the power of greed and ignorance. Some patients have attorneys trying to get them refunds for dental work now. If you don’t think this is preposterous, you may want to have a closer look.

To be fair, let’s put this into neutral ground. Say you’re a mechanic. The client brings in their vehicle wanting new tires, and asks you to check out a “clunking” sound heard in the front end when cornering. You find the problem, change out the part, install their tires, balance it, and send them on their way. Then, weeks or months later, you get a letter from their attorney. They’re saying they don’t like the way their car looks with the new tires, so they want you to refund the money paid — all of it. Does that seem fair or make sense to you?

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