An attorney's perspective: What drives a patient to sue?
Most practicing physicians will have to deal with the medical malpractice industry at least once in their career despite their best efforts to employ standards of care and reasonable risk management.
Key Points
Motives for seeking a claim
According to Kolpan, it is rarely a bad outcome alone that creates an unhappy patient, but rather an unexpected course of events that includes a major lapse in communication between the physician or physician's agent and the patient. When Kolpan hears a patient's story for the first time, it usually includes one or more of the following themes:
Lack of response. Examples of this include an unreturned phone call, a missed meeting with family, or even withdrawal of the physician after a complication.
Lack of bedside manner. A physician's communication skills are tested when dealing with an unexpected outcome, an unhappy patient, or both. Physicians may be feeling guilty, defensive, or even afraid. Patients are looking for sympathy, compassion, and explanation; if they don't receive the right signals, they may seek resolution through other means.
Challenging a patient's rights. This frequently manifests itself in the physician's office response to a records request. A well-intentioned medical records clerk who is perceived to be less than helpful or courteous can make a bad situation worse.
Outstanding bills. An unhappy patient who might not otherwise pursue remedy in a claim may react strongly to aggressive collection tactics, including standard letters from the physician threatening "further action."
Potential code for prior authorizations on AMA CPT Editorial Panel meeting agenda
March 28th 2024"Good public and economic policy must align costs, benefits, and incentives; currently, all costs are incurred by physician practices, and all financial savings and benefits from prior authorization accrue to health insurance plans, leading to perverse incentives,” says Alex Shteynshlyuger, MD.
