Evidence based malpractice

[Perrotfish]

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I figured the EM guys would know this if anyone would

So my various and sundry attendings over the years have given me literally hundreds of pieces of completely contradictory advice about how to avoid lawsuits. I've been told to write short notes (so as to limit what can be used against me in court) and long notes (to make my thought process clear to the jury). I have been told to over test (because you are never allowed to miss anything) and to test minimally (because you can't be held accountable for incidental findings if you don't discover them). I have had attendings tell me, with a straight face, that I need to wear a particular kind of clothing to protect myself from lawsuits (ties, white coats, tucked in scrubs, whatever). I feel like 'malpractice' ties 'professionalism' as the number one reason your attending will give for you to do the thing he wants you to do for no good reason, which is strange because malpractice is actually a huge concern for our normally very evidence based profession. The only actual evidence I've seen concerning malpractice is that physicians that are liked by their patients are sued less, and people who are drunk on the job are sued more.

So my question: is there a evidence based resource for malpractice law out there? There are a lot of law professors, they must be publishing something about outcomes for malpractice cases. Variables that negatively influence outcomes. Does anyone have any real, evidence based strategies to minimize lawsuits?

 

[Daiphon]

I would argue that it wouldn't be in the lawyers' best interests to publish this information, as it would essentially be "showing their hand" and tilt the odds out of their favor.

That said, a quick Google search on the issue popped up 2 articles I think may get to your question.

First is the ACEP Risk Management primer.

http://www.google.com/url?sa=t&sour...fwREaH7hkEgvG7Bvw&sig2=JZ62kRWkAr4TD7kwhNta0Q

Second is a study on what increases *hospital* likelihood of being sued... as we are mostly hospital dependent, looks like your actual practice location can be an issue.

http://www.google.com/url?sa=t&sour...L9ssV0JuWgTgMDt0w&sig2=rBKVwtqrEColNXAOptbH9g

Cheers!
-d

ps - sorry about the long links. On mobile so cut & paste w/o URL hypertext

 

[Arcan57]

I figured the EM guys would know this if anyone would

So my various and sundry attendings over the years have given me literally hundreds of pieces of completely contradictory advice about how to avoid lawsuits. I've been told to write short notes (so as to limit what can be used against me in court) and long notes (to make my thought process clear to the jury). I have been told to over test (because you are never allowed to miss anything) and to test minimally (because you can't be held accountable for incidental findings if you don't discover them). I have had attendings tell me, with a straight face, that I need to wear a particular kind of clothing to protect myself from lawsuits (ties, white coats, tucked in scrubs, whatever). I feel like 'malpractice' ties 'professionalism' as the number one reason your attending will give for you to do the thing he wants you to do for no good reason, which is strange because malpractice is actually a huge concern for our normally very evidence based profession. The only actual evidence I've seen concerning malpractice is that physicians that are liked by their patients are sued less, and people who are drunk on the job are sued more.

So my question: is there a evidence based resource for malpractice law out there? There are a lot of law professors, they must be publishing something about outcomes for malpractice cases. Variables that negatively influence outcomes. Does anyone have any real, evidence based strategies to minimize lawsuits?

The Bouncebacks book has some solid info (not evidence based per say, but collective experience). Not discharging unexplained abnormal vital signs is probably the number one way to avoid being sued in the ED.