Study: Hospitalists face acute risk for medical malpractice

The vast majority — 78 percent — of medical malpractice lawsuits levied against hospitalists include the three most prevalent patient allegations: failed, delayed or wrong diagnosis; improper management of treatment; and medication-related error, a study by The Doctors Company found.

The study, which evaluated 464 claims against more than 2,100 hospitalists between 2007 and 2014, underscores the particularly high risks hospitalists face for malpractice lawsuits, mostly because the patients they treat have high-acuity medical conditions.

Here are three findings from the report.

1. Of the three most common patient allegations, 36 percent were diagnosis-related (failure, delay or wrong diagnosis), 31 percent were for improper management of treatment and 11 percent were over medication-related errors.

2. The research includes insights from expert physicians into the specific factors that led to patient injury. The physician reviewers determined the top factor was inadequate patient assessments, which occurred in 35 percent of cases. Other factors contributing to patient injury were failures with communication among providers (23 percent of cases), selection and management of therapy (16 percent), communication between patient or family and provider (12 percent), failure to obtain a consult or referral (12 percent) and patient factors (12 percent).

3. Based on the findings, the physician reviewers outlined three tips to lessen the risk of being sued for medical malpractice.

  • If a differential diagnosis has the potential for a serious sequelae or death, the attending hospitalist should alert and consult other specialists as early as possible.
  • Hospitalists should clearly communicate concerns for specific patients during handoffs to fellow hospitalists, including advanced warning about patients who present confusing symptoms or deteriorating conditions.
  • The hospitalist should review all documentation to ensure he or she is aware of all consultation reports, consultation orders and any subtle changes in the patient's condition that nurses recorded.

"This study brings to light the particular challenges faced by hospitalists who manage high-acuity patients, have limited access to patients' past medical histories and often receive patients with serious conditions," said David B. Troxel, MD, medical director of The Doctors Company.

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