The majority of physicians will be sued during their career, yet the topic is largely taboo. This podcast for physicians discusses malpractice litigation and litigation stress, with the voices of doctors who have been through it. Music by @BenJamin Banger. Learn more about creator Gita Pensa M.D. at doctorsandlitigation.com Also available on Apple Podcasts and Spotify
Episodes
Sunday Apr 05, 2020
Special Episode: Litigation Risk and COVID-19
Sunday Apr 05, 2020
Sunday Apr 05, 2020
Many listeners have sent in questions about litigation in this new era of COVID-19. They are infuriated after seeing advertisements from plaintiff's attorney firms already soliciting COVID-19 cases, while physicians and other front line health care providers risk our lives and the health of our families in an unprecedented crisis --when litigation should be the last thing we have to worry about. Physicians now wonder how protected will they be if their usual practice is disrupted, and there are delays in diagnosis or treatment. Or what if we send a patient with suspected COVID-19 home when they are stable, but they later worsen or die due to the unpredictability of this horrible virus? What if we are forced to ration ventilators or other scarce resources? Or if we are asked to practice outside our usual scope -- if an OB-Gyn is now working on the medicine floors, or a general internist is now working in the ICU, and there is an adverse event in that setting?
In this episode, Dr Pensa speaks with two malpractice defense attorneys about some general principles, and gets some reassurance.
Some states are adopting emergency measures that provide practitioners with additional protection, changing the standard for civil cases to 'gross negligence or willful misconduct'. But this does not mean the provider has blanket immunity from being sued at all. Lawsuits might still be filed that will need to be defended, even with this new standard (though likely fewer cases will be brought forth, because they will be much harder for plaintiffs to prevail). Because lawsuits can still be filed, and there are large costs associated with defending them from the start, it is imperative that you are properly insured for however your practice changes in this pandemic. We discuss considerations for retirees and volunteers, physicians who are changing the manner in which they see patients, and the importance of documenting circumstances in general.
More about Dr. Pensa: doctorsandlitigation.com
Monday Apr 11, 2022
Special Episode: The RaDonda Vaught Case
Monday Apr 11, 2022
Monday Apr 11, 2022
In this special episode, Dr. Pensa has a conversation with attorney T. Marc Calvert about the criminal trial of RaDonda Vaught, a Vanderbilt nurse who was found guilty of negligent homicide due to a medication error.
Attorney Calvert has specialized in medical malpractice defense for over thirty years, and brings a nuanced perspective to a case which has rocked the medical world since the verdict in March 2022. Some of the questions we discuss:
- Will we see more criminalization of adverse events and medical error after this trial?
- Will malpractice insurance cover the costs of a criminal defense?
- What is the institutions's role in this error, and why are they not bearing more responsibility?
- What might happen to safety culture and the self-disclosure of error in the wake of this verdict?
- What lessons should we take away from this terrible and tragic event?
Wednesday May 10, 2023
Life After Litigation: Part One
Wednesday May 10, 2023
Wednesday May 10, 2023
Although you might expect life to go back to 'normal' as soon as the litigation process is complete, it often doesn't work that way. Lingering distress, if left unaddressed, can lead to behaviors like over-documenting or over-testing, avoidance of certain procedures or case types, PTSD symptoms, disillusionment, burnout, and career abandonment. In part one of 'Life After Litigation', Dr. Gita Pensa speaks with Tracy Sanson MD, Stacia Dearmin MD, and Marge Paccione, PhD, about their insights.
Thursday Feb 08, 2024
Life After Litigation: Part Two
Thursday Feb 08, 2024
Thursday Feb 08, 2024
Dr. Pensa tells the story of her own life after litigation in an interview with Dr. Mel Herbert.
This is the last episode of Season One. But follow along -- a new season is in the works! We'll talk about topics at the intersection of litigation, coaching, risk, and medicine -- and how to stay human through all of it.
Saturday Mar 09, 2024
The EMR Audit Trail: Friend and Foe
Saturday Mar 09, 2024
Saturday Mar 09, 2024
In this first episode of Season 2, Dr. Pensa talks with attorney Saira Pasha, an EMR audit trail expert. What else besides the words in your chart does your electronic medical record track? Are 'secure messages' discoverable? (Spoiler: yes, they can be!) How can an audit trail help your case -- or hurt it? How does an audit trail expert 'read between the lines' of who's looking at what entries in the record, and when, and for how long?
Take home points:
- The EMR creates a trail that tracks not only your substantive words on the chart, but evidence of all the people who were in a given chart, at what time, looking at what, for how many seconds or minutes, what they did next in the chart, whether a template or smart phrase was deployed. It tracks and times views, edits, additions, deletions, changes, and any printing or searches. These are not part of the initial requested 'medical record,' but can be obtained through the request of an EMR audit trail.
- The timing of changes to the record can imply that charting was slanted in a way to be defensive or misleading (or at least, a plaintiff’s attorney is going to try to do that, even if your intention was well-meaning.)
- Attorneys may infer the importance of a part of the record by seeing how many people were in a chart at a given time, and what they were all looking at, for how long. This information can act like a big red arrow pointing at a specific medication order or radiology result, for example, even if there is no explicit mention of it in anyone's notes.
- Secure messages, FYI's, Best Practice Advisories, and other prompts are all discoverable (with a little sleuthing) as part of an EMR audit within a few years of their appearance in the chart.
- If you cosign notes using a template that suggests you did a substantive review of another clinician's care (such as an APP or midwife), be mindful of the fact that the EMR tracks how long you spent in that note, or reviewing that patient's chart or imaging.
Dr. Pensa references this 2021 case in which efforts to alter EMR records were exposed.
More about Dr. Pensa and how to contact her can be found at doctorsandlitigation.com.