Physician Liability Often Extends Beyond Self within a Practice

In the medical malpractice world, whether it is warranted or not, physicians are often left holding the bag for errors that may have been made by the larger health care team. A recent AMedNews.com article tackles this topic of physician liability in a practice setting and how to reduce one’s risk by addressing issues within the health care team appropriately and proactively.

While we have all heard about how errors in communication contribute to many malpractice claims, the article provides an interesting way to look at how many errors occur –and why the physician may be, rightly, to blame in less-than-obvious situations. A leadership expert interviewed for the article compares the physician to the quarterback of a football team. It is the physician’s job to establish the “play” for each patient and to coordinate the activities of the other team members. In order for the play to work, each member of the health care team has to understand his or her role, be able to accomplish his or her task, and then has to be able to interact accordingly with his or her teammates. So, we should not just think of the physician only in terms of his or her hands-on patient contact, we also need to add in their role as coordinator of care. And, weak links in communication should be considered as openings for liability.

Thus, failures in “team” care can result in “failure-to-supervise” claims. So, for example, while nurse practitioners and physician assistants are often authorized to prescribe, they are often expected to be supervised by a physician. And, should an error occur, the physician can be held liable. Thus, supervisory and/or Medical Director roles should be taken seriously. Physicians can also be found guilty of “administrative negligence” or “vicarious liability.”

The article goes on to discuss the importance of quality patient “hand-offs” and how these are possible minefields of liability. It should never be assumed that all relevant patient information is being transferred from one health care team member to another. The physician must layout the expectations and responsibilities of good communication and documentation for the practice. And, a good practice culture is necessary to accomplish this. While many physicians may assume that they have a practice with a “good culture” where everyone feels free to communicate openly, the article actually suggests conducting an anonymous survey of the health care team to get a true gauge of how functional the environment really is. The best health care teams have a culture of continuous learning and improvement with physicians physicians leading the charge –by following protocols and checklists, for example.

For more on the topic, the article has an excellent bonus section at the end on “How to strengthen the bonds of team-based care.”