Unfortunately, medical malpractice suits are a part of the medical landscape. Our Sermo physicians talk about “defensive medicine,” and regularly discuss ways to minimize lawsuits. The ultimate goal is always to treat patients at the highest level of care, but often simple mechanisms can be put in place to minimize lawsuit risk.
Our guest post today is from Michael Matry of Medical Liability Monitor. His simple idea can possibly eliminate 25 percent of all lawsuit risk.
A popular theory of medical negligence employed by today’s plaintiff bar is the claim that a physician failed to adequately track and inform a patient of his or her diagnostic test results, ultimately leading to a failure to diagnose or delay in diagnosis. A full one-quarter of all medical professional liability claims are for a failure to diagnose and/or delay in diagnosis.
A typical general practitioner may review as many as 750 chemistry and hematology reports, 50 radiology reports and a dozen pathology reports each week. Add to that the number of patients who fail to keep follow-up appointments and the fact that one in three physicians has no set policy for informing patients of their diagnostic test results, it’s no wonder some patients fall through the cracks. In fact, a recent study found that a failure to follow-up and give patients test results is fairly common, affecting one of every 14 tests. Because patients are conditioned to believe their test results are normal if they don’t hear otherwise, it’s imperative to establish a policy for informing patients of their test results and recording those communications in the medical record.
- For tracking and conveying test results, risk managers suggest establishing policies and procedures that make certain:
- All test results are returned to the physician who ordered them.
- Test results are verified and reviewed in a timely fashion
- Patients are always informed of their test results — both normal and abnormal — within predefined time frames.
- The patient’s medical record is updated to note that test results were received, the patient notified and a course of follow-up treatment recommended.
- Patients are encouraged to call and request results after a certain interval if they have not been notified.
These policies and procedures may sound fundamental, but a recent physician survey discovered that only 55 percent of physicians queried reported “always” documenting patient notification of test results in their medical record. Follow-up is an essential part of responsible care and must be tracked and documented. To do otherwise opens the physician to a future claim of failure to diagnose and/or delay in diagnosis.
Most of us would agree the patient carries a certain degree of personal responsibility when it comes to their healthcare, diagnostic test results and course of treatment; the problem is, that degree of responsibility is not clearly defined. Every effort should be made to inform the patient of his or her test results.
If a patient fails to keep a follow-up appointment to learn of his or her test results, it is necessary to contact the patient by telephone. That telephone contact must be documented in the patient’s medical record. If contact via telephone is unsuccessful, a letter should be sent, explaining the test results and recommending follow-up treatment (if necessary). That letter should likewise be entered into the patient’s medical record.
If your practice has clearly defined policies and procedures for informing patients of their test results, and those policies and procedures are executed, it is much more difficult for a plaintiff attorney to argue the physician failed to meet his or her duty to inform the patient. It is also more difficult to allege the failure to inform led to a failure to diagnose and/or delay in diagnosis.
We’re wondering what the Sermo community thinks about this post. What are your practice’s policies and procedures to inform patients of their diagnostic test results? What are the hazards your practice faces when trying to locate and inform patients of their diagnostic test results?
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