Certified Nurse-Midwife and Certified Midwife Resources
Get risk management/patient safety resources and free accredited education opportunities tailored for certified nurse-midwives and certified midwives.
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Apr 14, 2025
TDC Group Announces Additions to Its Advanced Practice Clinician (APC) Advisory Board
TDC Group, the nation’s largest provider of insurance and risk management solutions owned by healthcare professionals, announced new members to its Advanced Practice Clinician (APC) Advisory Board. Nearly 84 million Americans lack adequate primary care, and APCs are crucial for maintaining and expanding patient access.
Professional Education
Prevention of Medical Errors 2024 to 2026 (National)
Few medical errors are attributed to faulty medical judgment. More commonly, they are attributed to system failures inherent in healthcare delivery. By drawing on our professional liability closed claims data, we have identified common performance and diagnostic errors. We analyzed loss prevention measures in tandem with the elements necessary to conduct a credible and thorough root cause analysis to reduce system failures, respond to sentinel events, prevent medical errors, and improve patient safety. The purpose of this program is to provide clinicians with the most current information regarding the prevention of common performance and diagnostic errors.
Professional Education
Prevention of Medical Errors 2024 to 2026 (Florida)
Few medical errors are attributed to faulty medical judgment. More commonly, they are attributed to system failures inherent in healthcare delivery. By drawing on our professional liability closed claims data, we have identified common performance and diagnostic errors. We analyzed loss prevention measures in tandem with the elements necessary to conduct a credible and thorough root cause analysis to reduce system failures, respond to sentinel events, prevent medical errors, and improve patient safety. The purpose of this program is to provide clinicians with the most current information regarding the prevention of common performance and diagnostic errors. This course includes content specifically for Florida licensed practitioners.
Professional Education
Learning from Pain Management Closed Claim Analysis for Advanced Practice Clinicians
This course reviews an analysis of lawsuits and claims filed against pain management advanced practice clinicians (APCs). Insights from the study highlight interventional approaches to treatment that mitigate the risks of unintended outcomes or harms. This study breaks down where most patient injuries occur, what those injuries are, and the lessons learned from those claims.
Mar 12, 2025
Choosing a Professional Liability Insurance Carrier: A Guide for Advanced Practice Clinicians
Choosing the right malpractice insurer is one of the most important professional decisions you’ll make. Despite facing many of the same liability and malpractice risks as physicians, advanced practice clinicians (APCs)—including nurse practitioners (NPs), physician assistants (PAs), certified registered nurse anesthetists (CRNAs), certified nurse midwives (CNMs), and certified midwives (CMs)—are often not as well insured.
Feb 03, 2025
Midwives, Are You Covered? 5 Questions to Ask About Professional Liability Insurance
Midwives face distinct, significant, and long-lasting liability risks, and providing excellent care is not enough to mitigate them. Careful consideration of liability coverage options is essential for midwives to protect their licenses, reputations, professional and geographic mobility, and long-term financial health.
Jan 31, 2025
PSQH: The Podcast Episode 122 – The Growing Role of Advanced Practice Clinicians
Laura Kline, MBA, CPCU, Senior Vice President of Business Development for The Doctors Company and TDC Group, discusses how nurse practitioners and physician assistants are taking on greater responsibility in primary care delivery. These expanded roles offer opportunities for all members of the healthcare delivery team to operate at the top of their licenses.
Jan 30, 2025
Off-Label Use: Patient Safety Implications
Once authorized, a drug product may be prescribed by a licensed healthcare practitioner for any use deemed appropriate based on the practitioner’s professional opinion. The governing standard is what other similarly trained practitioners would do—not what the manufacturer of the medication or product recommends.
Jan 15, 2025
Job Shadowing: Observers, Volunteers, and Students in Clinical Settings
Create guidelines to prevent practice risks, eliminate patient harm, and protect patient privacy.
Video Jan 08, 2025
An Introduction to Medical Professional Liability Insurance for Midwives
This presentation provides a detailed examination of medical professional liability insurance, specifically designed for midwives. Learn policy coverage and exclusions, as well as practical strategies to protect your practice, whether employed or practicing independently. This session also analyzes common causes of loss in midwifery claims, comparing outcomes with those of physicians.
Dec 20, 2024
Patient Safety Predictions for 2025, Part 2
Laura Kline, MBA, CPCU, Senior Vice President, Business Development, The Doctors Company and TDC Group, discusses how collaboration between physicians and advanced practice clinicians can lay the foundation for continuity of care, delivering significant benefits for patients and providers.
Dec 17, 2024
Reduce Patient Safety Risks With Vaccinations
Take time to assess the vaccine administration protocols in your practice.
Dec 09, 2024
Is Your Patient a Victim of Human Trafficking?
Although trafficking victims rarely find opportunities to interact with others, a visit to a physician or dental practice may provide an opportunity for a victim to receive help. Learn to recognize the signs of human trafficking and know what steps to take.
Sep 09, 2024
Shoulder Dystocia Documentation: Implementing a Protocol
Shoulder dystocia claims have traditionally been among the most problematic to defend.
Video Jul 10, 2024
Increasing APC Responsibilities Lead to New Care Models: How TDC Group Provides Support
In a time of worsening physician shortages, new approaches to primary care, home care, and elder care are essential. Thoughtful structuring of care teams can assist many specialties in maintaining or expanding access to care while containing costs, relieving burdens for physicians, and continuing to provide high-quality and attentive care. Learn more about these new care models and how TDC Group provides support from Laura Kline, Senior Vice President of Business Development for TDC Group.
Jul 02, 2024
Practitioner Refusal to Treat Vaccine-Hesitant Patients in the Office Setting
We offer expert strategies to help practitioners address patients who refuse or delay vaccines.
Professional Education
Pain Management: A Closed Claim Analysis Looking at Risks and Lessons Learned
The Doctors Company has published an analysis of lawsuits and claims filed against pain management clinicians. This study provides quantitative and qualitative information that a clinician who practices pain management, including interventional approaches to treatment, would find useful in mitigating the risks of unintended outcomes or harms. This study breaks down where most patient injuries occur, what those injuries are, and the lessons learned from those claims.
Video May 24, 2024
What Is One of the Keys to Alleviating the Physician Shortage?
The Association of American Medical Colleges (AAMC) predicts demand for medical services in the U.S. will grow much faster than physician supply, leading to an estimated physician shortage of between 54,100 and 139,000 by 2033. In primary care relief is coming for overburdened physicians, as APCs are among the fastest growing professions.
Professional Education
Healthcare AI: Peril or Paradigm?
This program provides nurses with an overview of the range of artificial intelligence models that can potentially be applied in healthcare, examples of regulatory and ethical AI guidance documents, and evidence-based discussions of risks and strategies to address the risks of using AI in healthcare.
Jan 30, 2024
Patient Safety Strategies for Surrogate Births
Surrogate pregnancies present unique challenges that require planning and clear communication.
Professional Education
Preventing Errors in Preoperative Clearance (Claims Corner)
Primary care providers (PCPs) routinely manage complex elderly patients with multiple comorbidities who require elective surgery. Errors can occur when providers are rushed, there is a lack of effective interoffice communication, and the patient has a low health literacy. Communication and care coordination issues are commonly noted among PCPs and consulting specialists. The Doctors Company has analyzed closed claims where PCPs have been held responsible for failures in surgical mismanagement, specifically preop clearance. This program will highlight the contributing factors identified in malpractice claims involving medical clearance and provide practice strategies for reducing liability risk.
Nov 28, 2023
Higher Malpractice Risk with Advanced Practice Providers? Data Say Not Really
Does the increased prevalence of non-physician patient care mean an increased risk to patient safety?
Professional Education
Shoulder Dystocia Clinician-Patient Disclosure
This enduring activity is designed to assist physicians and advanced practice clinicians (APCs) in enhancing their communication skills when disclosing a shoulder dystocia injury to patients and family members. This type of injury to the infant may, unfortunately, occur despite the best of care; however, effective physician-patient communication is an integral part of clinical practice and has been shown to positively influence outcomes by increasing patient understanding and trust.
Professional Education
Missed Medical History Leads to Adverse Outcome (Claims Corner)
The Doctors Company has identified patient assessment issues and communication failure between providers as key contributors to malpractice claims. This dental case study describes how inadequate patient history taking and poor communication can lead to an adverse patient outcome. The lessons learned in this course are applicable to all healthcare professionals.
Professional Education
Empowering Patients Through Open Clinical Notes
This course focuses on the 21st Century Cures Act mandate for interoperability to support patients’ access to their health information. To comply with the information blocking rule, healthcare providers must ensure that they are not engaging in practices that constitute information blocking, such as restricting access to patient electronic health information, imposing unreasonable fees for EHI access, or failing to respond to requests for EHI in a timely manner.
Professional Education
Patient Termination
This brief audio presentation will give healthcare providers information on how to mitigate their risk when terminating a patient relationship. The key topics covered include establishing patient expectations, what to do when expectations aren’t being met, special circumstances to consider prior to termination, and finally, the elements of the termination notice.
Aug 01, 2023
Advanced Practice Clinicians: A Preventive Action and Loss Reduction Guide
Depending on the state, an APC may be permitted to practice autonomously, as part of a collaborative agreement, or under the supervision of a physician. Regardless of an APC’s practice status or employment arrangement, however, all individuals can be held liable for their own acts of negligence. Our preventive action and loss reduction guide can help APCs in every practice environment.
Aug 01, 2023
Obstetrics and Gynecology: Frequently Asked Patient Safety Questions
Our experts answer questions about topics in obstetrics and gynecology, including cesarean delivery on maternal request and screening mammograms.
Professional Education
Risk Management 101 for Healthcare Professionals: Malpractice, Patient Relations, and Documentation
This is an introductory level course about basic risk management for practicing clinicians focusing on malpractice, patient communication, and documentation. Healthcare professionals new to practice and more experienced will learn the legal elements of a malpractice claim that must be proven for a plaintiff to prevail. We share communication strategies to enhance patient understanding, compliance, and satisfaction while reducing the risk of abandonment when ending patient relationships. We address the importance of documentation, share open notes strategies for success, and strategies to demonstrate quality of care and reduce risk. Documentation examples are provided, as are tips for electronic health record (EHR) and telehealth documentation.
Professional Education
Loss Lessons: Practicing Out of Bounds
Unlicensed staff are vital to efficient patient flow in medical practice. Healthcare organizations have many tasks that are safely and effectively carried out by skilled unlicensed support staff every day. To reach such efficiencies with safety and reliability, careful attention must be given to scope of practice and state and local statutes regarding delegation and supervision. Policies and protocols that outline the scope of practice for unlicensed staff to follow independently, and when they must consult with licensed staff, help even the most talented of your staff understand their boundaries. This case illustrates how informal verbal guidelines can blur the lines and cause well-meaning staff to cross the boundary lines of their scope leading to misdiagnosis and death.
Professional Education
You Have Been Served with a Malpractice Lawsuit or a Regulatory Action Notice: Now What?
Malpractice litigation and government regulatory and licensing oversight are inherent aspects of licensed healthcare professionals. The concern regarding malpractice litigation is well-founded, and regulatory and licensing actions can pose significant challenges. Therefore, clinicians must be prepared and knowledgeable about navigating legal notices and taking appropriate steps to ensure compliance. By participating in this program, they can effectively mitigate the impact of claims, complaints, or regulatory actions and safeguard their practice.
May 22, 2023
Laboratory and Diagnostic Test Tracking in Ambulatory Practice
Managing patient test results in ambulatory practices can pose a significant challenge. Establishing a standardized workflow to track results is a successful strategy for avoiding missed or delayed diagnosis that can lead to patient injury.
Apr 25, 2023
Nonadherent and Noncompliant Patients: Overcoming Barriers
Nonadherent or noncompliant patient conduct (whether intentional or inadvertent) can adversely affect clinical outcomes, undermine the practitioner-patient relationship, and disrupt the operation of practice.
Mar 22, 2023
Remote Patient Monitoring: Considerations for Telehealth Care
Remote patient monitoring is advancing the safety and accuracy of telehealth by filling in some gaps and increasing the types of care that can safely be provided in the home.
Oct 18, 2022
Moderate or Conscious Sedation in the Office Setting
Prevent patient injury when providing moderate sedation in the office by incorporating these patient safety and practice improvement strategies.
Professional Education
Reducing the Risk of a Malpractice Claim
This enduring program is designed to assist physicians, dentists, and advanced practice clinicians, improve patient safety by providing information on how to implement a root cause analysis (RCA2) when a near-miss, or injury has been identified. Real cases serve as examples of how sustainable change can minimize human and environmental factors while decreasing system failures and reducing the risk of a malpractice claim.
Professional Education
Test Tracking and Referrals: Strategies for Advanced Practice Clinicians
Tracking of tests and consults is critically important in preventing diagnostic errors and preventing patient harm. The risk factors triggering an alleged malpractice claim were primarily related to the breakdown in clinical systems for test result management. Failures of systems often prevent providers from making timely and accurate diagnoses. Testing failures included test performance issues, misinterpretation of studies, receipt, and transmittal problems. Follow-up failures included lack of physician follow-up with the patient, referral management, inadequate provider to provider communication and patient noncompliance.
Professional Education
Preventing Dictation Errors for Advanced Practice Clinicians
Emergency medicine providers are increasingly using voice recognition programs, such as Dragon Direct Voice Recognition Program, to document encounters. In reviewing closed malpractice claims, The Doctors Company identified dictation errors as a significant patient safety risk factor. The following case highlights the importance of timely recognition of dictation errors to ensure accuracy of the permanent electronic health record (EHR). This is particularly important when using a voice recognition program to document encounters in the busy emergency department. In this case, the voice recognition system was Dragon Direct Voice Recognition Program.
Professional Education
Medication Management: Strategies for Advanced Practice Clinicians
Medication management is by far the area providers can make the most impact within the professional practice arena. Data from closed claims shows that medication management is a risky area, most importantly the monitoring of medications. Monitoring and management begin when the patient receives the medication until the patient is no longer on the medication. An effective medication management process is essential for safe patient care. Having current patient medication information will assist with subsequent prescribing and a plan of care.
Professional Education
Delayed Diagnosis of Malignancy: Case Review for Advanced Practice Clinicians
In reviewing closed malpractice claims, The Doctors Company identified delayed diagnosis of a malignancy as a reoccurring problem. The following highlights the importance of recognizing a spinal abnormality and recommending further follow up of a lesion seen on imaging. Contributing factors include misinterpretation of radiologic studies, narrow diagnostic focus, lack of communication, and failure to establish a differential diagnosis.
Professional Education
Delayed Diagnosis of Stroke: Case Review for Advanced Practice Clinicians
In reviewing closed malpractice claims, The Doctors Company identified diagnostic failure as a reoccurring problem and one of the top three leading allegations that result in malpractice claims. This failure often leads to a delay in treatment and causes significant harm to patients. The following highlights the importance of recognizing the signs and symptoms of a stroke. Factors contributing to delay diagnosis and treatment included failure to recognize the window (“last known well time”) for tissue plasminogen activator-clot buster (tPA) failure to order a stat MRI and neurology consult, failed communication among providers regarding changes of recurring symptoms of ischemic stroke, failure to appreciate new signs and symptoms of a stroke, and poor or inconsistent documentation. The National Academy of Medicine (NAM) has identified the top three causes of serious harm from diagnostic failure. Number one is ischemic stroke.
Jul 21, 2022
Effective Obstetrical Team Communication
Effective communication requires a team effort for the exchange of concise and relevant information.
Professional Education
Managing Patient Information: Strategies for Advanced Practice Clinicians
This program covers the patient information system, specifically documentation of patient information in the medical record. Many times, insufficient documentation results in the provider not being able to find information needed to guide clinical decision-making. Adequate documentation will enhance patient care by ensuring that patients receive the care necessary and may prevent a missed or delayed diagnosis.
Professional Education
Diversity, Equity, and Inclusion in Healthcare for Advanced Practice Clinicians
Diversity, equity, and inclusion of all patients can lead to better health outcomes in the community in which we work. Creating a culture of inclusion and understanding our own biases, will help us improve patient care. It is important to understand how we are the same and how we are different in language, education, race, ethnicity, gender, gender identify, sexual orientation, age, social class, physical ability, religion, political beliefs, and morals. Providers may not be aware of how diversity, equity, and inclusion problems can hinder their care and relationships with patients. Some states are requiring all clinical professionals to have continuing education on cultural and linguistic competency and implicit bias.
Professional Education
Cervical Cancer Claims: A Review for Advanced Practice Clinicians
Cervical cancer medical negligence claims are reviewed over a 10-year period to identify the major case types in which the advanced practice clinician (APC) is the responsible party. The factors that contributed to those claims as identified by plaintiff and defense provider experts are discussed through case examples with learner questions. Risk mitigation strategies are identified to guide gynecologists in further providing the safest patient care and thereby improving their risk profile.
Professional Education
Breast Cancer Claims: A Review for Advanced Practice Clinicians
Breast cancer medical negligence claims are reviewed over a 10-year period to identify the major case types in which the gynecologist is the responsible party. The factors that contributed to those claims as identified by plaintiff and defense physician experts are discussed through case examples with learner questions. Risk mitigation strategies are identified to guide gynecologists in further providing the safest patient care and thereby improving their risk profile.
Professional Education
Hidden Liability Risks Identified by Medical Office Reviews: Risky Practices for Advanced Practice Clinicians
Office practice assessments by TDC Group's patient safety risk managers uncover hidden liability risks, often exposing areas where patients can “fall through the cracks” and leave the practice vulnerable to a malpractice claim. Our Practice Risk INSIGHT, an assessment tool customized by specialty, zeros in on problematic areas. The assessments have been completed across a range of practice environments around the country—from small offices to practices that are part of large integrated delivery systems. In this course, we analyze the results of the Practice Risk INSIGHT assessments, highlight problem-prone areas, and offer strategies to minimize liability for advanced practice clinicians (APCs).
Professional Education
The Advanced Practice Clinician–Patient Relationship: When Does it Begin and When Does it End?
This enduring program will assist the participant in understanding the principles which form the establishment of an advanced practice clinician (APC)–patient relationship, as well as the concerns which may result in the need for the APC to consider terminating the APC-patient relationship. Additionally, the concepts of providing patient-centered care will be presented for the learner’s consideration.
Professional Education
Administrative and Regulatory Actions: Protecting Your Practice
Healthcare practitioners, including physicians, dentists, and advanced practice clinicians, need to understand the roles of their professional licensing board and state and federal agencies to protect the public.
Professional Education
An Introduction to Enhancing Patient Relations and Reducing Risks for Advanced Practice Clinicians
This enduring program is designed to assist advanced practice clinicians (APCs) with improvements in patient interactions by looking at how incorporating hospitality as a focus makes a difference. It has been developed to improve multiple facets of patient interaction.
Professional Education
When Personal Relationships Interfere with the Standard of Care for Advanced Practice Clinicians
The Doctors Company rigorously analyzed 988 claims* against internal medicine physicians that closed from 2009–2018. Regardless of the outcome, all cases that closed from 2009–2018 were included in this analysis—an approach that helps better understand what motivates patients to pursue claims and gain a broader overview of the system failures and processes that result in patient harm.
May 31, 2022
The Role of the Medical Assistant in Your Office Practice
A medical assistant (MA) can be a valuable addition to an office practice, but MAs should not perform tasks outside their scope of practice.
Apr 01, 2022
Delay in Diagnosing Breast Cancer: A Case Summary and Tips to Reduce Risk
A delay in diagnosing breast cancer may result when a patient doesn’t follow through with diagnostic recommendations.
Sep 23, 2021
The Malpractice Experience of Obstetricians with Shoulder Dystocia: Preparation May Mitigate Risks With This Unpredictable Event
Shoulder dystocia (SD) is a rare complication of vaginal delivery. The purpose of this study was to better understand factors that may contribute to medical malpractice claims with SD and to offer recommendations to practicing obstetricians regarding the management of SD.
Jan 29, 2021
Pain Management Closed Claims Study
The Doctors Company reviewed medical malpractice claims that closed between 2008 and 2018 and involved pain management physicians as the primary specialty responsible in the claim. That criteria identified 273 claims and lawsuits.
Aug 25, 2020
Distracting Devices in Healthcare: Malpractice Implications
Digital distraction in healthcare is a threat to patient safety and physician well-being. Personal electronic devices can create a digital distraction so engaging that it consumes awareness, potentially preventing healthcare providers from focusing on the primary task at hand—caring for and interacting with patients.
Jun 15, 2020
Overview of Obesity-Related Malpractice Claims
The Doctors Company continues to see an increase in lawsuits involving patients with obesity.