Adverse events can be unavoidable in the practice of medicine. Here are some tips for you to consider should you be involved in an adverse outcome:
1. Talk to the Patient or Family (and remain accessible)
Speak with the patient and family members as soon as possible after an adverse event. Explain the situation and answer questions factually and directly. Show compassion and offer emotional support. Try not to be defensive, even if their remarks are hurtful or accusatory. Be accessible for follow-up questions or further explanations – oftentimes there are more questions after the family/patient has had time to process things. Being absent or “hard to get hold of” leads to patient frustration.
2. Don’t Play the Blame Game
It’s ok to acknowledge and apologize for the patient's emotional distress, but make sure that you do not accept blame or point the finger at anyone else. Do not speculate with the patient as to how or why the adverse outcome occurred. Speculation only leads to further issues. Review the medical records and meet with the healthcare team to discuss the situation and what needs to be done in response. Coordinate with your medical provider colleagues to ensure that communication is consistent and that patient needs are being met.
3. Contact Practice Administrator / Risk Manager
Don’t delay in contacting your practice administrator or risk manager. Be factual in explaining the situation so that you can determine the proper next steps. Contact your malpractice insurance carrier (to report the incident) or the FDA (in the event of a medical device failure), if appropriate. Proactively engaging your carrier and risk manager allows the team to “get in front of” any potential issue so that you can work together to resolve the situation as quickly as possible, to the patient’s satisfaction.
4. Ensure Proper Medical Records
Record factual statements of the events in the patient’s medical record along with notes related to follow-up care. If you disagree with another provider, do not use the medical record to document your concerns; rather, thoroughly document the basis for your treatment. Do not backdate any entries in the medical record and avoid creating entries that could appear self-serving. Remember that medical records are admissible in court. Avoid writing anything in the file that is unrelated to the care of the patient (e.g. “family is mad” or “legal team notified”).
5. Consider write-offs / no overly aggressive collections
In the event of an adverse outcome, it may be prudent to consider waiving all or part of the patient’s medical bill. Before proceeding with this option, however, be sure to discuss it with your malpractice insurance carrier and legal representative. While some patients will be satisfied with this result, others may be inclined to sue, regardless. Be considerate of collection call techniques. A slightly disgruntled patient could be further agitated with overly aggressive collection calls.