Legal theory

The jury system is ill-equipped to determine medical negligence. Jurors often have trouble understanding the highly technical testimony from academic experts on both sides of the docket. To add to the confusion, testimony pertaining to the same piece of evidence (in this case, the IVP films) is often directly contradictory.


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Many jurors often start with a presumption of innocence toward the defending physician. Dr. H’s rational approach to the patient’s problems and his personable demeanor led the jury to like him, and to appreciate him as a com-petent, compassionate, and caring physician.


Protecting yourself

Solo physicians labor under many disadvantages, including very long hours and lack of organizational depth. But in one area, they are at a distinct advantage—communication within the practice. Poor professional communication within a large group practice is a potent source of adverse outcomes and subsequent lawsuits.


The advantage of a one-physician practice is counterbalanced, however, by the greater potential for patient-physician personality conflict. In a group, such conflict can be resolved by passing the patient to another practitioner, but in a solo practice, severe conflict can only be resolved by referring the patient to another practice, which is hard for the physician to do.


Jurors are patients too, and they hunger for evidence that patients mean more to the physician than a source of revenue. Dr. H’s practice of personally reviewing IVP films to confirm radiologists’ findings was cited by the defense lawyer as evidence of his caring attitude and personal interest in his patients.


Another example of risk-management is a follow-up call the day after a procedure or hospital discharge. Such a call speaks loudly of the physician’s concern for the patient’s well-being, as well as identifying potential problems and concerns.

A follow-up call is best made by someone the patient already knows, such as the office nurse or physician assistant, and is most effective when the patient and family knows to expect it ahead of time. Such an inquiry can also avert many of the calls to the office from the patient or family seeking advice and reassurance.