Not many radiologists are occupied with thoughts of malpractice risk during their day, but the concern hangs in the depths of many physician’s minds.
One radiologist, Jonathan L. Mezrich, MD, Yale University School of Medicine’s Department of Radiology and Biomedical Imaging in New Haven, Conn., took this concern to heart, sharing some tips on how to minimize malpractice risk in a new piece published in the American Journal of Roentgenology.
“The risk of malpractice within the specialty is real, and in some respect, inevitable for most of us,” Mezrich wrote. “This article provides an overview of the elements of a malpractice claim, discusses the key ingredients for avoiding malpractice liability (which I refer to as the five Cs), touches on several topics interconnected with mitigating malpractice risks (hedging, apologies, pace), and provides a series of tips a radiologist might consider in practice to decrease liability risk.”
The five Cs, as Mezrich mentioned, are based on three previously established ingredients for avoiding malpractice suits—coined as the three Cs. Below are the full five tips from Mezrich:
“Compassion involves showing empathy and respectful approach both to patients and, if need be, in front of a jury,” he wrote.
This may be hard to do in radiology due to a lack of patient contact, Mezrich noted, but prior research has concluded physicians with good patient relationships may be sued less often.
These issues are likely greater for radiologists in the emergency department and those working night-shifts where a physician may be alone and forced to read outside of their comfort zone.
Mezrich offered a few tips here. For example, reading within one’s limits and avoiding studies and modalities you aren’t trained on can greatly minimize competency issues.
Requesting a second opinion and keeping up with the latest technology can also help avoid potential problems.
“Recommending appropriate follow-up imaging or consultation in one's reports can be protective, putting the onus back on the referring clinician,” Mezrich noted.
“In the setting of radiology, the next C, care, is largely accomplished by proofreading one's radiology reports.”
If a report is incomplete or contains mistakes, a jury is increasingly likely to see that as evidence of unreliable care, Mezrich wrote. Wording is also important.
For example, “’there is no evidence of acute intracranial hemorrhage’ is very different from ‘there is evidence of acute intracranial hemorrhage.’”
A rare primary factor in lawsuits, good communication is a simple spot for radiologists to limit his or her risk of malpractice.
“Communication needs to be timely, appropriate, and, most importantly, documented,” according to Mezrich. “If a finding is significant, a jury will expect the radiologist to have taken the time to pick up the telephone.”
“A truism in the law that is sometimes perplexing to laypersons is that clinical negligence cases are won on the evidence, not the facts,” Mezrich explained. “In other words, a verdict will be based not on what happened but rather on what can be proved.”
A radiology report is a reader’s chance to clearly document what was seen, their thought process at that time, who was consulted and discussions that were had. Essentially it is a chance to put down the other four Cs, Mezrich wrote.