Internal Medicine

Nov 15, 2024
Defensible Medical and Dental Records
Richard F. Cahill, JD, Vice President and Associate General Counsel, The Doctors Company, Part of TDC Group
Patient records, which serve a critical function in healthcare delivery and routine clinical operations, can provide key evidence in the event of a professional liability action.

Oct 21, 2024
Dispensing Sample Medications: Risk Management Strategies
Debra Kane Hill, MBA, RN, Senior Patient Safety Risk Manager, The Doctors Company, Part of TDC Group
If not carefully managed, sample medications can create issues that place patients and the practice at risk.

Aug 27, 2024
Adjusting Medications for Patients With Kidney Disease: Case Study
Melissa Nelson, RN, Senior Patient Safety Analyst, The Doctors Company
Strategies from our case examination can help practitioners ensure that patients with poor kidney function receive appropriately adjusted medication doses.
From The Doctor’s Advocate

Jul 02, 2024
Practitioner Refusal to Treat Vaccine-Hesitant Patients in the Office Setting
Patti L. Ellis, RN, CPHRM, Patient Safety Risk Manager II, The Doctors Company, Part of TDC Group
We offer expert strategies to help practitioners address patients who refuse or delay vaccines.

Professional Education
Alzheimer's 8: Dementia Update for PCPs: Disease-Modifying Medications Risks and Benefits
A panel of dementia specialists provide up-to-date information on new disease-modifying medications receiving FDA approval, but with specific candidate criteria. Practitioners will learn how these medications work, which of their patients may benefit, how to identify and address risks, and how to effectively communicate with patients and family members. [1.50 AMA PRA Category 1 Credits™, 1.50 Contact Hours (ANCC)]
1.5 credits

Dec 21, 2023
Suicide Prevention: Primary Care Is a Crucial Setting for Identifying Risk
Debra Davidson, MJ, CPPS, Senior Patient Safety Risk Manager, The Doctors Company
At any given time, some of your patients are having thoughts of suicide. Effective suicide prevention requires a comprehensive approach.

Dec 05, 2023
Telehealth From the Field: Case Study Involving Remote Monitoring Problems
Sue Boisvert, BSN, MHSA, Senior Patient Safety Risk Manager, The Doctors Company, and Chad Anguilm, MBA, Vice President, In-Practice Technology Services, Medical Advantage
Remote patient monitoring technologies offer many benefits, but they also create potential malpractice risks.

Nov 15, 2023
Alzheimer’s Disease and Dementia: What Healthcare Practitioners Need to Know
Julie Brightwell, JD, RN, Director, Healthcare Systems Patient Safety, The Doctors Company
Alzheimer’s disease, the most common cause of dementia, is the seventh-leading cause of death in the U.S. Early diagnosis provides important benefits to diagnosed individuals and their loved ones, caregivers, and society.

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.
0.5 credit

Oct 30, 2023
Off-Label Use: Patient Safety Implications
Kim Hathaway, MSN, CPHRM, Patient Safety Healthcare Quality and Risk Management Consultant, and Richard Cahill, JD, Vice President and Associate General Counsel, The Doctors Company
The standard for appropriate off-label use of medications and other products is what other similarly trained physicians would do, not what the manufacturer of the medication or product recommends.

Professional Education
Loss Lessons: Lithium Toxicity, Fine Tuning Medications Used in Behavioral Health
Lithium therapy can be used for bipolar affective disorders and in depressive disorders where other antidepressants have been unsuccessful. It is considered a “high-risk” drug due to its narrow therapeutic range and potential for overdose toxicity. This case illustrates the pitfalls that occurred resulting in litigation. It is followed by a discussion of the problems that could have been avoided by following safety guidelines for prescribing lithium.
0.2 credit

Oct 01, 2023
Suicide and Crisis Lifeline: Call or Text 988
The National Suicide Prevention Lifeline is now 988, an easy-to-remember number for 24/7 crisis care.

Aug 02, 2023
Noncompliant Patients Increase Liability Risks for Practitioners
Richard F. Cahill, JD, Vice President and Associate General Counsel, The Doctors Company
Practitioners face potential liability when patients do not follow up as instructed or refuse at-home help.

May 22, 2023
Laboratory and Diagnostic Test Tracking in Ambulatory Practice
Dana Faber, MS PSL, RN, Senior Patient Safety Risk Manager, The Doctors Company
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 26, 2023
Curbside Consultations: Patient Safety and Legal Risks
Richard Cahill, JD, Vice President and Associate General Counsel, The Doctors Company
Informal consultations are tempting to busy healthcare practitioners because they are convenient and speedy, but these situations also include inherent liability risks for the consulting practitioner.

Apr 25, 2023
Nonadherent and Noncompliant Patients: Overcoming Barriers
Richard Cahill, JD, Vice President and Associate General Counsel, The Doctors Company
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.

Apr 14, 2023
Postpartum Malpractice Claims: Understanding Preventable Harms and Socioeconomic Factors
Jacqueline Ross, RN, PhD, Coding Director, Department of Patient Safety and Risk Management, The Doctors Company, Part of TDC Group, and Shelise Valentine, RNC, MSN, Director of Clinical Education, Healthcare Risk Advisors, Part of TDC Group
Investigators reviewed 43 closed postpartum medical malpractice claims to develop clinical recommendations to decrease the risks of postpartum morbidity and mortality.

Mar 22, 2023
Remote Patient Monitoring: Considerations for Telehealth Care
Sue Boisvert, BSN, MHSA, Senior Patient Safety Risk Manager, The Doctors Company
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.

Mar 13, 2023
Patient Safety Strategies for Gastroenterologists
Lisa McCorkle, MSN, CPHRM, Senior Patient Safety Risk Manager, The Doctors Company
Gastroenterologists can reduce potential liability with strategies that include conducting a thorough preprocedure patient evaluation and matching the facility and setting to the patient.

Professional Education
Prevention of Medical Errors (2023–2025 Edition)
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.
2.0 credits

Oct 24, 2022
Why Medical Clearance Is Really a Preoperative Evaluation
Debra Davidson, MJ, CPHRM, Senior Patient Safety Risk Manager, The Doctors Company, and David L. Feldman, MD, MBA, FACS, Chief Medical Officer, The Doctors Company and TDC Group; Senior Vice President, Healthcare Risk Advisors
The goals of the preoperative evaluation are to determine the patient's level of risk and to identify opportunities to mitigate it.

Oct 20, 2022
Job Shadowing: Observers, Volunteers, and Students in Clinical Settings
Kim Hathaway, MSN, CPHRM, Patient Safety Healthcare Quality and Risk Management Consultant, The Doctors Company
Create guidelines to prevent practice risks, eliminate patient harm, and protect patient privacy.

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.
1.0 credit

Sep 16, 2022
Reduce Patient Safety Risks With Vaccinations, Including COVID-19
Debra Kane Hill, MBA, RN, Senior Patient Safety Risk Manager, The Doctors Company
Vaccine administration is usually regarded as a simple office procedure, often performed without the direct supervision of the physician or a licensed professional. Although vaccinations are a routine procedure, physicians and staff should remain vigilant about patient safety considerations. Whether you’re seeing children for COVID-19 vaccinations or adults for travel abroad or general disease prevention, take time now to assess the vaccine administration protocol in your practice.

Professional Education
Alzheimer's 7: Questions and Answers - What Physicians Ask About Diagnosing and Treating Dementia
This course focuses on the common concerns and questions expressed by clinicians about dementia and cognitive impairment. Practitioners will learn more about making the initial observation of cognitive decline and beginning a conversation with older adult patients, overcoming common barriers to making a definitive diagnosis of dementia, and managing the ongoing clinical needs of patients experiencing dementia. Experienced clinicians engage in conversation on how they handle delicate and difficult conversations with patients and their family members. Program participants will become knowledgeable of warning signs of dementia, gain proficiency in screening and evaluating adults for cognitive deficits, confidently disclose a diagnosis of dementia, and communicate next steps to patients and family caregivers, including safety issues, medications, and community resources. [1.50 AMA PRA Category 1 Credits™, 1.50 Contact Hours (ANCC)]
1.5 credits

Professional Education
Alzheimer's 6: Pharmacological Management of Behavioral and Psychological Symptoms of Dementia
Join our self-paced educational program to learn to distinguish dementia symptoms from other psychiatric issues and treat them with pharmacological interventions. Improve recognition of behavioral problems in Alzheimer's and dementia patients, use the DICE psycho-behavioral model for medication decisions, and create treatment plans with behavioral and pharmacological strategies to refine your best practices for individuals with dementia. [1.50 AMA PRA Category 1 Credits™, 1.50 Contact Hours (ANCC)]
1.5 credits

Professional Education
Alzheimer's 5 : Use of Pharmacotherapy for Patients with Major Neurocognitive Disorder
This activity includes video lectures and is the fifth in a series of courses that seek to educate clinicians on standardized screening, evaluation, and disease management of Alzheimer's disease and related dementias. This fifth course focuses on the most frequently used and FDA-approved prescription medications for Alzheimer's disease and dementias, the current research regarding its use, and guidelines for prescribing and discontinuing medication. The program will incorporate cultural values and beliefs when creating and sharing the pharmacological care plan. [1.75 AMA PRA Category 1 Credits™, 1.75 Contact Hours (ANCC)]
1.8 credits

Professional Education
Preventing Diagnostic Error in Primary Care: Strategies for Advanced Practice Clinicians
Diagnostic errors occur often in primary care settings and can impact over 12 million outpatients annually. This is a top patient safety concern and a global burden among advanced practice clinicians (APCs). Significant patient harm can occur due to treatment delay, testing, or misdiagnosis. This course is an opportunity to promote awareness and visibility by identifying where these errors occur most often in the diagnostic process of care framework. Examples of some best practices for the diagnostic process involves a timely and accurate diagnosis, patient engagement, effective system processes, active follow up, and communication. The information in this course will focus heavily on prevention strategies related to the primary care setting.
0.8 credit

May 31, 2022
The Role of the Medical Assistant in Your Office Practice
Debra Kane Hill, MBA, RN, Senior Patient Safety Risk Manager, The Doctors Company
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
Analysis of Cerebrovascular Accidents and Malpractice Claims
Shelley Rizzo, MSN, CPHRM, Senior Patient Safety Risk Manager, The Doctors Company
Because cerebrovascular accidents can happen at any time and in any location, it is imperative that all members of the healthcare team are able to recognize and respond to symptoms in a timely manner.

Professional Education
Burnout: Spotlight on System Changes
There is a national movement to address the systemic causes of clinician burnout. Read the article "Clinician Burnout: From a Crisis to a Movement" to learn ways that clinicians can create system change in their own work environments.
0.5 credit

Nov 29, 2021
The Evolving Landscape of Diagnostic Errors—Challenges and Opportunities
David E. Newman-Toker, MD, PhD, Professor of Neurology, Ophthalmology, and Otolaryngology, and Director, Armstrong Institute Center for Diagnostic Excellence, Johns Hopkins University School of Medicine
Internationally recognized healthcare leader David E. Newman-Toker, MD, PhD, presents a compelling case example and shares key insights into transforming diagnostic accuracy.
From The Doctor’s Advocate

Nov 15, 2021
To Measure and Reduce Diagnostic Error, Start With the Data You Have
David L. Feldman, MD, MBA, FACS, Chief Medical Officer, The Doctors Company and TDC Group; Senior Vice President, Healthcare Risk Advisors
Chief Medical Officer David L. Feldman, MD, MBA, FACS, recaps important recommendations by diagnostic safety expert Hardeep Singh, MD, MPH, for measuring and reducing diagnostic error.
From The Doctor’s Advocate

Sep 29, 2021
Getting Sued for Breast Cancer Malpractice
Richard E. Anderson, MD, FACP, Chairman and Chief Executive Officer, The Doctors Company and TDC Group
Our closed claims data reveal that suits involving breast cancer are the most common type of cancer-related claim. This article lists the issues that most often lead to claims.

Aug 04, 2021
Cognitive Assessments in Primary Care: Preparation and Tools May Mitigate Diagnosis Risks
Carol Murray, RHIA, CPHRM, Senior Patient Safety Risk Manager, The Doctors Company, Part of TDC Group
Recent reimbursement changes by the Centers for Medicare and Medicaid Services (CMS) allow primary care providers to meet their patients’ mental health needs and help build their practices by performing cognitive assessments.

Mar 29, 2021
Is Your Patient a Victim of Human Trafficking?
Amy Wasdin, RN, CPHRM, Patient Safety Risk Manager II, The Doctors Company
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.

Mar 08, 2021
Patient Safety Strategies for Dermatology
Susan Shepard, MSN, CPHRM, Senior Director, Patient Safety and Risk Management Education, The Doctors Company
Take steps to reduce risks in dermatology by reviewing your practices and systems and implementing these strategies.

Jan 20, 2021
Implicit Bias Against Obesity: An Opportunity to Improve Patient Safety
Jacqueline Ross, PhD, Coding Director, Department of Patient Safety and Risk Management, The Doctors Company
Many patients with obesity delay seeking medical care because of previous negative experiences with healthcare providers.

Professional Education
Prevention of Diagnostic Error in Primary Care
Diagnostic errors occur often in primary care settings and can impact over 12 million outpatients annually. This is a top patient safety concern and a global burden. Significant patient harm can occur due to treatment delay, testing, or misdiagnosis. This course is an opportunity to promote awareness and visibility by identifying where these errors occur most often in the diagnostic process of care framework.
1.0 credit

Jun 15, 2020
Overview of Obesity-Related Malpractice Claims
Paul Nagle, ARM, CPHRM, Director, Department of Patient Safety and Risk Management
The Doctors Company continues to see an increase in lawsuits involving patients with obesity.

Aug 27, 2019
Electronic Health Records Continue to Lead to Medical Malpractice Suits
Darrell Ranum, JD, Vice President of Patient Safety and Risk Management
We analyzed 216 medical malpractice claims that closed from 2010 to 2018 in which EHRs contributed to patient injury. The pace of these claims grew, from a low of seven cases in 2010 to an average of 22.5 cases per year in 2017 and 2018. As EHRs approach near-universal adoption, they may become a more prevalent source of patient safety risk.

Mar 20, 2019
Study of Malpractice Claims Involving Children
Darrell Ranum, JD, CPHRM, Vice President, Patient Safety and Risk Management
The Doctors Company analyzed 1,215 claims filed on behalf of pediatric patients that closed from 2008 through 2017. The study is based on the claims filed against physicians in 52 specialties and subspecialties and includes an overview of the most common types of claims, expert insights into the specific elements that led to patient injury, and risk mitigation strategies.

Video Feb 23, 2018
What to Expect from Litigation: Dr. Johnson's Perspective
Dr. Jeffrey D. Johnson, a family physician in Corpus Christi, describes his experience defending himself against a medical malpractice suit involving a young man who committed suicide using prescription medication.