A lawsuit can take a massive toll on a physician’s confidence and reputation. Every day, physicians are faced with the risk of making mistakes that can potentially end up in a lawsuit, such as diagnostic errors or incomplete follow-ups. However, by creating procedures and policies to protect their practices, physicians can mitigate patient injuries, and save themselves from unnecessary lawsuits.

PIAA (formerly: Physician Insurers Association of America) reports that 70% of the claims finalized in its Data Sharing Project (DSP) have no indemnity payment. The 30% which result in indemnity payments are mostly due to diagnostic errors. The association has processed nearly 300,000 liability claims since 1985.

While reflecting on claims closed between 2003 and 2012, Divya Parikh, director of research and loss at PIAA, said, “Obstetrics still is a top medical specialty that has claims reported, but others include internal medicine, orthopedic surgery and general surgery,” Parikh went on to say that, “Within the DSP, the majority of claims reported are by the patients themselves, except in the pediatric cases and in cases of patient death or long-term injury.”

Here are six risks that physicians need to mitigate:

1. Faulty communication

If patients feel that a physician’s top priority is the patient’s best interest, they will be more forgiving of errors. During the last decade, medical malpractice claims have decreased significantly because more physicians are offering explanations to patients in case of an unexpected outcome.

Unexpected outcomes do not generally result in lawsuits. However, unexpected outcomes, combined with poor communication, are often the biggest reason when patients consider lawsuits. Physicians must listen carefully, offer clear answers and instructions, address complaints, set realistic expectations and involve family members in the care process. In case of an error, a formal apology may help in some cases, but being empathetic to the patient and the families, is a much better approach. Physicians need to be very careful with the elderly or patients from foreign countries, as there may be a higher likelihood of disruptive behavior.

2. Lack of informed consent

It is critical to take patient consent before a procedure is performed. Patients must have full understanding of the associated risks. All risks must be clearly communicated to the patient in writing before the procedure, and not afterwards. Preferably, you should get patient signatures on consents developed by a professional attorney.

3. Failure to stay up-to-date on standards

Physicians must stay up-to-date on best practices and the industry standards. They must be aware of any changes in disease management for chronic conditions, technological innovations, latest research and government mandates. Often, physicians are asked if they follow the latest standards. Sometimes, their busy schedules keep physicians from participating in conferences and other educational opportunities.

Physicians must make sure that they are educated on EHRs, and have received adequate training on the systems they use. They must understand how to use templates, clinical decision support systems and electronic prescribing.

4. Inadequate follow-ups

Inadequate follow-up of diagnostic test results, and specialist referrals are one of the most frequent reasons for litigations. Sometimes, test results are not received by the ordering physician, or are filed away before review. On other occasions, patients do not follow through with tests as instructed, or are not briefed about the findings.

Physicians should also follow-up with specialists when referring patients. They must have a reminder when to expect the specialist’s report. In case the report is not received on time, the referring physician should alert the patient and the referring provider, in addition to making a note in the patient’s medical record.

5. Variation in policies and procedures

Practice policies and procedures should be available to all the staff members. They must be kept in a format that is easy to access, and must be reviewed periodically to make sure they reflect changing preferences and requirements.

Policies should include set of rules for ordering new prescriptions or refills. Rules to deal with cancellations and no-shows should also be part of the policies. These would come in handy when addressing a wide range of patient or family complaints.

Best office practices regarding social media, employee conduct, emergency response and other issues should be part of policies as well.

6. Avoidance behavior

Physicians must understand that avoiding a patient in case something goes wrong is never useful. Putting oneself in patient’s shoes and their families would really help a physician sympathize. Physicians should not be afraid to face them and let them know how they feel.

Risk management is an on-going process, and as new technology emerges, risks will continue to evolve as well. Practices and physicians need to constantly reassess quality and safety to protect themselves.