Strategies to minimize liability risk in pediatric practice

Given the crucial role pediatricians play in the health of children and in the US healthcare system in general, it is vitally important that pediatric practices understand what the actual legal obligations and risks are for providing pediatric services.

“A better understanding of relevant legal rules and liability risks, and a thoughtful approach to risk management and legal compliance, can benefit the viability of pediatric practices and the quality of care that they provide,” according to William M McDonnell, MD, JD, FAAP, clinical service chief, Pediatric Emergency Medicine, Children’s Hospital and Medical Center, and division chief, Pediatric Emergency Medicine, University of Nebraska Medical Center, Omaha.

McDonnell spoke on risk management strategies that can help pediatric practices reduce their liability risks while also improving quality and patient satisfaction in a session titled “Top 10 medical liability myths” on Monday, October 24.

As the title suggests, the presentation included a review of commonly held incorrect beliefs (myths) that contribute to pediatricians’ liability risk. “Unfortunately, misunderstandings about legal restrictions and liability risks can sometimes interfere with the delivery of pediatric health services and can jeopardize pediatric practices,” said McDonnell.

McDonnell, along with Karen Santucci, MD, medical director and section chief, Yale Pediatric Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, engaged the audience in a case-based discussion of 10 common liability-related myths to help pediatricians first better recognize these myths and then learn how to incorporate effective risk management measures for actual legal obligations and risks into medical practice.

Among the practical risk management strategies they discussed is the need for good communication skills given that communication style and attitude are major factors in most malpractice lawsuits. Strategies to improve communication include slowing down, using plain language, showing pictures, limiting the amount of information, and encouraging patients to ask questions.

Another strategy, McDonnell said, is to keep good documentation, which, along with facilitating good medical care, can reduce the likelihood of errors and act as the best defense in a lawsuit.

Among the information important to document are notes on the decision-making process (ie, information evaluated, rationale for the diagnosis given, treatment recommended and why, consideration of alternative treatments, and rationale for any deviations from usual practice).

Along with suggesting how pediatricians could incorporate effective risk-management strategies into their individual practices, McDonnell and Santucci discussed additional changes that pediatricians could make to reduce their liability risks. 

Ms Nierengarten, a medical writer in Minneapolis, Minnesota, has over 25 years of medical writing experience, authoring articles for a number of online and print publications, including various Lancet supplements, and Medscape. She has nothing to disclose in regard to affiliations with or financial interests in any organizations that may have an interest in any part of this article.