Risks in General Medicine: Contributing Factors

What’s My Risk?

Top Contributing Factors Leading to Malpractice Risks in General Medicine: How to Protect Your Patients and Yourself

When you took the Hippocratic Oath, you promised to do no harm. Yet despite your best intentions, as a general medical practitioner, you face a risk every time you interact with patients that something could go wrong.

CRICO’s national Candello Data, which captures 30 percent of all medical professional liability (MPL) cases across the country, identifies patterns in national claims data through detailed coding and deep analysis to help providers better understand their areas of vulnerability. Use the insights gleaned from our findings to put safety first. Take the necessary steps to strengthen your patient safety practices, as well as to implement necessary improvements within your department and health care system.

Understanding Your Risk

With 7,726 cases asserted over a 10-year period from 2008 to 2017, general medicine was the third most frequent specialty named in malpractice claims and suits. (Surgery has the highest rate, followed by medicine.)

General medicine includes physicians working in internal medicine and in family practice: attending physicians, residents, and fellows are all at risk of being named in a medical malpractice case. Therefore, it’s essential to understand your specific risks and to follow best practices including those associated with communication. Through proactive incorporation of available risk reduction resources, you can ensure the safest possible care environment for your patients.

Leading Contributing Factors Cited in General Medicine Malpractice Cases

As a general medicine physician, you are at risk for mistakes throughout the patient care journey, from taking a patient’s personal and family history, to ordering tests, to determining a diagnosis and assigning a treatment protocol. Within these broader processes, the Candello analytics (as shown in the table above) reveal several key contributing factors to medical error in general medicine; the top three are related to clinical judgment and communication:

1. Patient Assessment (54 percent of cases),
2. Selection and Management of Therapy (27 percent of cases), and
3. Communication among providers (22 percent of cases).

Here are some key insights you should know:

1. Patient Assessment Failures: Common errors within the assessment and diagnosis process include failure to order a diagnostic test, misinterpretation of the results, failure to establish a differential diagnosis, delay or failure to obtain a consult, and failure to rule out an abnormal finding.
2. Selection and Management of Therapy: Errors in selection and management of therapy range from failing to order the correct medication in the ambulatory or emergency department setting, to performing an inappropriate procedure or selecting an inappropriate treatment, to not administering the treatment properly.
3. Communication: The CBS findings reveal that communication failure that leads to medical errors can occur either as miscommunication with patients/families or miscommunication among providers. The rate of incidence in general medicine is split evenly between those two categories.

Learn More

By tapping into insights provided by Candello Data and patient safety resources for general medicine clinicians, you’ll be able to establish safer care practices for yourself and for your patients. Leverage our data to identify risks that resonate, and apply a process to mitigate those risks by addressing specific problems. When you begin by making small changes and allowing them to build over time, you can ensure you’re living up to your Oath, putting safety first, and providing the best quality care for your patients.

Risk Mitigation Resources

• Mitigating Diagnostic Risks in Primary Care
• A Handful of Opportunities to Reduce the Risk of Being Sued
• CRICO CME Bundles
• Malpractice Risks of Health Care Communication Failures