AMA Report: The Almost Inevitability of Medical Malpractice Lawsuits
Learning Objectives and CME/Disclosure Information
This activity is intended for healthcare providers delivering care to women and their families.
After completing this activity, the participant should be better able to:
1. Recall results from the AMA Division of Economic and Health Policy Research on medical malpractice rates 2. Discuss the role of ‘physician apology’ in the setting of an adverse outcome
Estimated time to complete activity: 0.25 hours
Susan J. Gross, MD, FRCSC, FACOG, FACMG
President and CEO, The ObG Project
Disclosure of Conflicts of Interest
Postgraduate Institute for Medicine (PIM) requires faculty, planners, and others in control of educational content to disclose all their financial relationships with ineligible companies. All identified conflicts of interest (COI) are thoroughly vetted and mitigated according to PIM policy. PIM is committed to providing its learners with high quality accredited continuing education activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of an ineligible company.
The PIM planners and others have nothing to disclose. The OBG Project planners and others have nothing to disclose.
Faculty: Susan J. Gross, MD, receives consulting fees from Cradle Genomics, and has financial interest in The ObG Project, Inc.
Planners and Managers: The PIM planners and managers, Trace Hutchison, PharmD, Samantha Mattiucci, PharmD, CHCP, Judi Smelker-Mitchek, MBA, MSN, RN, and Jan Schultz, MSN, RN, CHCP have nothing to disclose.
Method of Participation and Request for Credit
Fees for participating and receiving CME credit for this activity are as posted on The ObG Project website. During the period from March 12 2018 through 07/15/2022, participants must read the learning objectives and faculty disclosures and study the educational activity.
If you wish to receive acknowledgment for completing this activity, please complete the post-test and evaluation. Upon registering and successfully completing the post-test with a score of 100% and the activity evaluation, your certificate will be made available immediately.
For Pharmacists: Upon successfully completing the post-test with a score of 100% and the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.
Joint Accreditation Statement
In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and The ObG Project. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Physician Continuing Medical Education
Postgraduate Institute for Medicine designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Continuing Nursing Education
The maximum number of hours awarded for this Continuing Nursing Education activity is 0.2 contact hours.
The AMA’s Division of Economic and Health Policy Research reported that one-third of physicians will have been sued for medical malpractice. If you’re over 50 years old, then the rate jumps to almost 50% while for those under 40 only 8% have been sued. Female physicians are less likely than their male counterparts to have been sued. Not surprisingly, 63% of ObGyns have had to deal with a lawsuit, compared to psychiatrists who reported a 16% rate. While the plaintiff does not prevail in the vast majority, that is cold comfort for the emotional toll it takes on the provider and the attendant economic costs to the insurance and legal industries.
Medical liability tort reform including measures such as affidavits of merit to weed out frivolous claims, limits on noneconomic damages, and medical review panels have had some measure of success. There is research that ‘apology and disclosure programs’ may be successful, including in those cases where an adverse outcome could not have been prevented. There are some states that have laws governing apology for medical malpractice, where a physician apology cannot be used as an admission of fault in court. With these laws, an apology can mitigate the results of an unanticipated or poor medical outcome. All these measures must be balanced with both providers’ and patients’ constitutional rights to due process.
In addition, assumptions about provider practice in relation to fear of medical liability are not always based in fact. For example, the New England Journal of Medicine reported on outcomes in three states where legislation altered malpractice standards for emergency physicians. The hypothesis was that providers over-ordered studies because they were practicing ‘defensive medicine’. With new legislation in these states that raised the bar for plaintiffs, a patient now needed to demonstrate that the doctor had “actual, subjective awareness” of “the likelihood of serious injury” but nevertheless proceeded with “conscious indifference.” There was no change in physician practice as measured by imaging rates, average charges, or hospital admission rates.
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Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
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