life care. TMA believes that by sharing these stories physicians make a valuable contribution that will help patients go- ing through the final decisionmaking process. To submit a story for “Final De- cisions,” click on Guest Post in the upper right portion of
www.meandmydoctor .com.
Ernest Buck, MD, a Corpus Christi pe-
diatrician and chair of the TMA Council on Health Promotion, says physicians choose differently than the average pa- tient when it comes to their own end- of-life care.
“Physicians spend a career watching patients and families live their lives and die their deaths. Most come to respect the frailty of the human condition and the strength of the human spirit. They remember particular patients who live well and die well, and they pray that they, too, can do just that,” he said. Thomas Jennings, MD, a Dallas oph- thalmologist and a member of the Coun- cil on Health Promotion, says the “Final Decisions” forum provides physicians an opportunity to show patients, by ex- ample, how to deal with severe medical problems. Ken Murray, MD, a retired Califor- nia family physician, has become an expert on end-of-life issues since the publication of his essay “How Doctors Die,” which can be read at http://bit .ly/1dSE9OZ. He says storytelling helps inform people’s understanding of death, and he has written a blog entry, titled “End of Life From 20,000 Feet,” for the “Final Decisions” forum. He encourages physicians in all specialties to contribute to “Final Decisions.”
“Physicians’ perspectives on death can
help inform patients’ end-of-life deci- sions,” Dr. Murray said. “We’re in a po- sition to know and share stories about things we’ve actually seen that the aver- age person hasn’t seen and doesn’t know. We can bring that to bear in a powerful, emotional way that can affect people’s viewpoints. Physicians need to tell their stories.” Robert M. Tenery, MD, a Dallas oph- thalmologist and former chair of the American Medical Association Council on Ethical and Judicial Affairs, says all physicians have a story to tell. He wit-
12 TEXAS MEDICINE September 2013
nessed his physician-father’s deteriora- tion and ultimate death from disease. “What I learned from our experience changed my life. I learned that once there is the realization that death is in- evitable, fear comes from two concerns,” said Dr. Tenery, a former TMA president.
“First is the fear of dying in pain, and second is the fear of dying alone. With the proper use of medications, a painful death can usually be avoided. It is some- times the second concern that can be the most difficult. For it is at that point, even when nothing else can be done, that the ‘physician’ in us never leaves our pa- tient’s bedside,” he said.
Eight medical liability myths
BY LAURA HALE BROCKAWAY Understand- ing how medicine and the law intersect is complicated. It can be tedious. Yet, a thorough understanding of medical li- ability can help you practice safe medi- cine and help keep you out of the court- room. The following is a list of some common and prevailing myths about medical liability, each dispelled by Texas Medical Liability Trust (TMLT) claim and risk management experts.
Myth 1: Because of medical liability re- form, litigation is no longer a problem for physicians.
Truth: While the rate of litigation is greatly reduced, reform did not hinder a patient’s ability to sue for legitimate injuries incurred during the course of medical treatment.
“It is also important to remember that
juries are still willing to award substan- tial damages when they feel the physi- cian failed to meet the standard of care or failed in communicating with the pa- tient,” said Sue Mills, senior vice presi- dent of claim operations and risk man- agement with TMLT. The bottom line is litigation is still a concern for physicians. “Physicians are advised to continue fol- lowing basic risk management principles to prevent lawsuits and enhance defen- sibility,” Ms. Mills said. “This includes
documenting thoroughly, making sure you track test results and patient refer- rals, and communicating openly with patients.”
Myth 2: I should contact TMLT to report a claim only after I’ve been officially “served” with a citation and petition.
Truth: Your policy requires you to notify TMLT as soon as reasonably possible af- ter becoming aware of any claim covered by your policy. TMLT claim staff may have limited time to investigate and evaluate the claim, and any delay in re- porting could compromise your defense. Notify TMLT immediately if you re- ceive any of the following:
• A demand for compensation — any written communication from or on behalf of a patient that seeks mone- tary payment or other compensation because of a perceived error in treat- ment or an unexpected outcome.
• A notice-of-claim letter — a letter that refers to Civil Practice and Rem- edies Code Section 74.052 or refers to a notice of claim. Upon receiving a 74.052 letter, a physician and his or her insurer have 60 days to inves- tigate and evaluate the claim.
• A citation (which informs you of a lawsuit) and a petition (which lists the plaintiff versus the defendant). A lawsuit also will include the allega- tions made against you. The law sets out a mandatory timeframe in which an answer must be filed on your be- half. Therefore, once you are served with a citation and petition, TMLT has a limited time to respond by re- taining a defense attorney to file an answer on your behalf.
If you receive a records request from an attorney or a request for a deposition in a case involving medical liability, con- tact TMLT for advice on how to respond.
Myth 3: A Texas Medical Board (TMB) complaint is no big deal. I can just re- spond by writing a letter.
Truth: It is not advisable to respond to a TMB complaint letter or notice without
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68