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Physician Liability Often Goes Beyond Treatment Delivered

Physician Liability Often Goes Beyond Treatment Delivered

Those of you who have followed the last 100 or so discussions we have had here know that the primary focus of my articles is asset protection in all its forms. Those forms include legal planning, tax planning, insurance planning, and financial planning; the four columns of wealth-preservation planning.

Given recent tragic events like the mass shootings that have dominated the media and the relentless onslaught of both plaintiff-attorney advertising and the culture of blame so prevalent in the country at the moment, physicians have more reason than ever to be concerned and act proactively to protect their businesses, assets, and families. As “deep pockets” the public and the litigation system now seek to make you liable for a wide variety of issues including child welfare, gun ownership and safety and now even what a patient may do behind the wheel of a car. These issues clearly exceed the bounds of what most of you consider to be your traditional medical malpractice “risk picture."

By now you may be aware that the psychiatrist who treated the Colorado theater shooter has been named in a lawsuit by the family of at least one victim. According to one legal analyst she had a duty to report if she felt he had a specific intent to commit an act of violence against a specific person. He had apparently told her that he had fantasies of killing mass numbers of people several weeks before the shooting. She did her duty and reported him to campus police but did not require a “72-hour hold” on him, which is at least part of the cause of action cited by the 26-year-old widow of the victim. Are psychiatrists now to be held responsible for not acting on knowledge of any and every aberrant fantasy a patient may share? If that’s the case we are certainly going to need more jails and secure mental health facilities.

In another recent case a Brooklyn doctor correctly surmised that a young woman’s white blood cell count and other conditions were symptomatic of HIV infection. As part of the course of treatment he offered to have her blood drawn for a routine blood test and discovered that she did have HIV. Now she has taken legal action against the doctor for “lack of informed consent” to be tested saying that she would rather not have known, ignoring the fact that she would have thus presented a substantial health risk to the public and her own family.

Going beyond this exposure is growing trend in the legal community to blame and sue doctors who treat elderly patients for ailments including dementia. Such is the case of Arthur Daigneault, an internist who is being sued for wrongful death by the family of a elderly gentlemen who was killed when his girlfriend, the doctor’s 85-year-old patient, wrecked her vehicle when he was a passenger, killing him. The argument against the doctor is based at least in part on the idea that California statutes require doctors to be vigilant for patients with "disorders characterized by lapses of consciousness" and creates a duty for physicians to report them to health authorities who may in turn notify the Department of Motor Vehicles. Such reportable conditions may include Alzheimer's disease and related ailments and has doctors use their clinical judgment to determine if a patient is still able to drive. This story in the Los Angeles Times has additional detail on this case and several other similar instances of death or injury caused by elderly drivers.

These are just three simple examples of the growing scope of professional liability being attributed to doctors in nearly every specialty. We could provide another dozen examples in radiology, pain management, and just about any other specialty you can imagine. The key is to understand both the scope of your professional liability and make sure you are in compliance with the required standards of care. You should also possess a good understanding of your personal exposures from an asset protection perspective. Acting today is always key, there is little effective against this exposure or any other, practice related or not, as remedial planning.

so lets all quit our jobs and find someone who is still working and sue them

Bonnie @

So if u own nothing then they are less likely to sue. Setup a trust. Put everything in kids and spouse name. I already did that. Wife is non physician. Therefore no liability issues

Shawn @

Yes, but if she divorces you, you are screwed. Also, if she gets into a car crash or any other liability not connected to medical practice.

svet @

"Are psychiatrists now to be held responsible for not acting on knowledge of any and every aberrant fantasy a patient may share?" No. Are psychiatrists required to report if they have good reason to believe a patient has a specific intent to commit an act of violence? Yes. Oh, how burdensome!

The HIV case will be dismissed on summary judgment, perhaps with monetary sanctions against the plaintiff and attorney for filing a frivolous lawsuit.

Yes, you could find dozens examples of frivolous lawsuits against doctors. But you could find hundreds of thousands of cases of injury caused by negligence where doctors do not face liability, because they have far more legal protection under the prevailing standard of care doctrine than the ordinary person, and because they are exceptionally difficult to sue, given jurors' trust of doctors and distrust of plaintiffs and lawyers, as a result of three-decade long media campaign by the insurance industry.

Tell me this. What percentage of doctors dealing with complex medical problems keep up-to-date in their areas of practice by spending as little as 1-2 hours per week looking at abstracts of medical literature reviews on PubMed? Practicing medicine without doing this is equivalent to practicing law without doing legal research, relying only on info obtained in continuing legal education courses. But that's how the vast majority of doctors practice medicine.

Please quit complaining and realize how much more insulated you are from liability than you should be.

Daniel
Medical researcher (former attorney)

Daniel @

not enough business, sir?

annette @

In response to the comment above: I don't know doctors who don't stop and research their complex cases, whether during the day or at the end of it, in addition to time spent reading journal articles, reviewing unusual disorders, attending conferences, etc. Over time, it adds up.
Healthcare does not compare well to other industries. If you want to understand it well, then go practice it, then come back and criticize everyone else's work. Doctors do not set out to be negligent and harm people as the comment implies. Their purpose is to help people. There are occasionally going to be bad outcomes even when the best care is performed. Those outside of medicine have a very difficult time understanding this, because they have never experienced the disappointment of it. There has to be some level of standard of care that everyone agrees on. And if there were not, you would complain about that.
You cannot go looking to blame the psychiatry field everytime someone loses it and goes on a killing rampage. By that logic, psychiatrists would be preventing every murder in the world if we just get these people into the clinic soon enough. That's obviously not realistic. The Colorado shooter admitted fantasies several weeks before the actual incident. An eventual hospitalization may or may not have prevented a shooting. He was reported. There was plenty going on in his apartment. Did the police not do enough?
Also, I don't believe what you say about doctors being difficult to sue.

Rick @
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