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IL LU S T R A T IO N B Y E LI Z A B E T H L A D A W ith medical malpractice insurance premiums rising sharply across the nation and at least a dozen states facing an insurance crisis, physicians and policymakers are debating vigorously how best to respond. Tort reforms that would cap awards are among the proposals and have proven effective at moderat- ing premiums in several states. [See “Understanding the Physician Liability Insurance Crisis,” FPM, October 2002, page 47.] But while physicians await legislative action or an upturn in the economy to soften the impact of insurance hikes, there is something doctors can do: better manage risk. Risk management involves more than just reading a journal article, listening to a lecture or filling out a work- book. It is a style of practice that endeavors, first and foremost, to prevent patient injuries; second, to avoid malpractice claims; and third, when a claim does occur, to reduce malpractice claim losses. First prevent patient injury A while back, I was involved in the care of a four-year-old boy who was admitted with status asthmaticus. He was very ill, requiring intubation and ventilatory support. ➤ March 2003 ■ w w w. a a f p . or g / f pm ■ F A M I L Y P R A C T I C E M A N A G E M E N T ■ 2 9 Dr. Roberts is past president of the AAFP. He served for six years on the Board of Governors of the Wisconsin Patient Compensation Fund and for the past eight years has served on the Board of Directors of the Physician Insurance Company of Wisconsin. He is a professor of family medicine at the University of Wisconsin Medical School and practices in Belleville, Wis. Conflicts of interest: Dr. Roberts discloses that he is a member of the Board of Directors of the Physicians Insurance Company of Wisconsin. Seven Reasons Family Doctors Get Sued and How to Reduce Your Risk By adopting a risk-management mind-set, physicians can avert not only malpractice claims but also patient injury. Richard G. Roberts, MD, JD, FAAFP Downloaded from the Family Practice Management Web site at www.aafp.org /fpm. Copyright © 2003 American Academy of Family Physicians. For the private, noncommercial use of one individual user of the Web site. All other rights reserved. Contact [email protected] for copyright questions and /or permission requests. 3 0 ■ F A M I L Y P R A C T I C E M A N A G E M E N T ■ w w w. a a f p . or g / f pm ■ March 2003 We were at his bedside literally breath by breath through the night. The child bounced back, fortunately, as children often do, and within three days he was home. The following week at grand rounds, the senior resident presented the case. I opened the question and answer session that followed by asking the group, “How did we fail this boy?” A long silence ensued. One of the second-year residents responded, “I don’t understand what you’re talking about. You saved this kid’s life. At every turn you made exactly the right decision.” And I said, “Y ...
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