Contents Legal system Malpractice Avoiding malpractice Physician-patient Truth and duty Privacy & confidentiality Office of Risk Management FAQs Medical record Patients' rights QUIZ

Frequently asked questions (FAQ) Q. Is an apology after an adverse event an admission of negligence. A. No. In fact, an apology after an adverse outcome can often influence a litigious patient not to pursue a malpractice claim. The nature of the apology, however, should probably not be 'sorry that negligence on my part led to an injury (which otherwise could have been avoided) on your part'. Q. With whom is it OK to share information about a particular patient's HIV status? A. No one except other health care providers who need that information in the course of caring for the patient. Third party payers cannot be told without the patients consent. Q. Is it OK to tell the sexual partner of HIV+ patient about the patient's infection? A. Under the Ryan White Care Act of 1996 it is REQUIRED to notify the partners (sexual OR needle sharing partners) of HIV infected persons whom the physician believes are at risk of infection and whom are not notified by the infected person. If both individuals are patients of the physician, the physician can notify the partner(s). If the partner(s) is not a patient of the physician, the case must be referred to the staff of the Connecticut Department of Health. When the Department of Health notifies a person, it cannot reveal the name of the infected person. Q. Do Clinical Guidelines or Critical Paths increase or decrease the risk of a malpractice suit? A. The effect of paths or guidelines on lawsuits is still relatively unknown. If care deviated from path or guideline without a clear indication, then they could be harmful in a legal sense. They could be beneficial (in a legal sense) if they are followed, however, in that they most likely represent the standard of care in that location for that time period. Q. How can I find out if I have a claim in the National Practitioners Data Bank (NPDB)? A. By either contacting the hospital medical staff office, the state licensing agency, or by calling the NPDB directly at 1-800-767-6732 Q. How can I protect myself from a lawsuit when a patient is non-compliant and does not follow up as recommended? A. The standard to meet here is to make a 'reasonable effort' to contact the patient and remind them to follow-up. The Òreasonable effortÓ may vary with the importance of the follow up. For example, a patient who continually misses appointments which are to follow up on an abnormal mammogram (suspicious for malignancy) may need a registered letter sent to her house, while a less critical issue could be dealt with by sending a regular letter via US mail. Q. What is the best way to terminate a relationship with a patient who is difficult, non-compliant, or incompatible? A. 1) Discuss your decision and the reasons for your decision to terminate the relationship with the patient. Document the discussion and the reasons in the medical record. Then send a certified letter to the patient citing your decision and the reasons. Also in the letter include: an offer to continue treatment for thirty days until the patient finds another physician and include a specific date when you will consider the relationship terminated; an offer to assist the patient in finding a new physician (perhaps sent the patient a list of physicians); and finally, include an offer to provide the patient's new physician with a copy of the patient's medical record.