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Medical Justice Blog

No Good Deed Goes Unpunished

“No good deed goes unpunished” is an aphorism attributed to more than one origin -Oscar Wilde and Clare Booth Luce. The origin may be a mystery. Its meaning to an Iowa anesthesiologist is not. An obstetrician performed a C-section on a patient who was 35 weeks pregnant. The patient had persistent vaginal bleeding, so the […]

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There’s a Fine Line Between Aggressive Questioning of a Witness and Being an A-Hole

The vast majority of doctors wake up every morning intending to do the best possible job for their patients. It’s in our DNA. If and when a patient experiences a complication, no one beats us up harder than we do ourselves. It gnaws at us. We’ll remember it. We hope never to repeat that outcome. […]

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When a Lawyer “Just Wants to Speak” to You

The office staff of Medical Justice member received an unexpected call the other day. A lawyer said he represented the estate of the practice’s recently deceased patient.  The lawyer just wanted to ask the doctor a few questions. No other context. Zip. Nada. First, a doctor cannot just speak with a lawyer who just happens […]

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Positive Change Regarding Medical License Renewals

Medical license renewals have morphed over time to be quite involved. The Board of Medicine is charged with keeping the public safe. This includes making sure that licensees have no medical or mental health conditions which, with or without treatment, could impact taking care of patients. In a prototypical renewal form, the following question was […]

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Your Patient Bolts in the Middle of a Treatment Plan. Now What?

Not all medical and dental procedures are completed in one setting. They are staged. A common example is a patient needs new teeth. Impressions are taken. Temporaries are placed. The lab fashions the new implants. They are placed down the road. Patients often pay upfront for the bundled procedures. And the work is front-loaded. The […]

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A Carrier Tells Its Insured Doctor He’s Not Covered. WTF?

The reasonable interpretation of language in an insurance policy dictates its coverage. Sometimes the definition of a word can cost a carrier or an insured millions, if not billions. When the World Trade Towers were destroyed in a terrorist attack in 2001, there were a number of insurers who covered the risk for damage to […]

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Death and Donuts

When I was a resident, we had a weekly Morbidity and Mortality Conference. That was the euphemism for what most called it, Death and Donuts. That moniker was not meant to be disrespectful. It was merely an acknowledgement that death did happen at the hospital. High risk procedures were indeed risky. And a normal part […]

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The Insanity Defense: Medical Versus Legal Issues

We continue with our series of general educational articles penned by one attorney, an MD, JD, giving you a view of the world through a malpractice plaintiff attorney’s eyes. This attorney is a seasoned veteran.  The series includes a number of pearls on how to stay out of harm’s way. While I do not necessarily […]

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The High Cost of Medications in Prison

A recent Wall Street Journal article reported that only 3% of patients with Hepatitis C in prisons are receiving the newest medications which have a cure rate over 90%. This means most are not receiving these medications. The reason is cost. Each treatment cost up to $1,000/day for a number of weeks. A commitment to […]

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Doc, What Would YOU Do?

As physicians, we learn we must inform the patient of their options. Each patient has a different tolerance for risk. Some want aggressive treatment. Some want conservative management. The patient decides what should be done. I always thought it awkward to merely present a smorgasbord of options and then stare at the patient asking – […]

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Whose Baby Was It, Anyways?

I spent some time over the weekend scanning physician responses to this ethical conundrum. An endocrinologist was caring for a man who spent years taking anabolic steroids. He developed hypogonadotropic hypogonadism with a low sperm count. He was now living clean and ready to start his family. The endocrinologist replaced the patient’s testosterone and achieved […]

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Medico-Legal Issues in Restraining Patients

  We continue with our series of general educational articles penned by one attorney, an MD, JD, giving you a view of the world through a malpractice plaintiff attorney’s eyes. This attorney is a seasoned veteran.  The series includes a number of pearls on how to stay out of harm’s way. While I do not […]

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Crazy Cases Against Doctors — and Inexplicable Settlements

Jeffrey Segal, MD, JD Published in Medscape: May 14, 2015 (reprinted with permission) How Would You Have Handled Patients Like These? Being sued for malpractice is a traumatic experience. The odds of being sued at least once over one’s career are high.[1] Doctors typically have sufficient professional liability coverage to prevent financial loss. But not all […]

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Liability in Telemedicine: “Can you sue me now?”

Notes from a Plaintiff’s Attorney: Liability Issues in Telemedicine By Dr. JD, a plaintiff’s attorney, practicing in the Northeast We continue our series of articles penned by one attorney, an MD, JD, giving you a view of the world through a malpractice plaintiff attorney’s eyes. This attorney is a seasoned veteran.  The series includes a […]

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When a Doctor Becomes a Patient

Hundreds of articles have been published on the theme of a doctor becoming a patient.  I’d like to add one more to the literature.  But only to express my gratitude. Over the years, I’ve cataloged many of the headaches faced by professionals in health care.  This includes the countless challenges doctors face each and every […]

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Avoiding Liability When Dealing with Brain Death Cases

We continue with our series of articles penned by one attorney, an MD, JD, giving you a view of the world through a malpractice plaintiff attorney’s eyes. This attorney is a seasoned veteran.  The series includes a number of pearls on how to stay out of harm’s way. While I do not necessarily agree with […]

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Dealing with Medical Marijuana

We continue with our series of general educational articles penned by one attorney, an MD, JD, giving you a view of the world through a malpractice plaintiff attorney’s eyes. This attorney is a seasoned veteran.  The series includes a number of pearls on how to stay out of harm’s way. While I do not necessarily […]

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Those Damn Jackson-Pratt Drains

As Shakespeare once posited: “To drain or not to drain. That is this the question.” Perhaps it wasn’t him. Surgeon preference typically dictates whether a drain makes sense. Keeping a hematoma from forming means avoiding one additional nidus of infection. But, a drain (even a closed drain), can also serve as a nidus of infection. […]

Posted in Healthcare Reform | 13 Comments

Plastic Surgeons as Psychiatrists.

Many years ago, a mentor taught me a surgeon spends an entire residency learning how to operate. Then the surgeon spends the rest of one’s career learning how NOT to operate. This includes when not to operate. A plastic surgeon called me recently, and described a recent patient visit. The woman, in her mid-40’s, confessed […]

Posted in Healthcare Reform | 12 Comments

Simple Procedures: An Occasional Multi-Million Dollar Lawsuit

We often worry about complications from difficult procedures. What might happen if a patient has anesthesia for 12 hours. Or, operating on a redo-redo cervical spine. And we’re right to be cautious. But, even simple things can be fraught with hazards; hazards that are easily prevented.

Posted in Healthcare Reform | 6 Comments

Credentialing and Answering Touchy Questions

I received a call from a general surgeon in California. He was re-credentialing for hospital privileges. He was re-credentialing for his in-network status with insurance companies. And, renewing his medical license was around the corner. Credentialing questions have gotten longer and more detailed.

Posted in Healthcare Reform | 3 Comments

Suture Around the Ureter. Clip on the Common Bile Duct. Complication or Malpractice?

Over the years, I have seen many lawsuits where a specific operation ended in a complication. Two come to mind. An ob-gyn performs a hysterectomy or uterine repair and a ureter is sutured. A general surgeon performs a laparoscopic cholecystectomy and the common bile duct is clipped. Some of these cases turn into lawsuits. Some […]

Posted in Healthcare Reform | 5 Comments

Doctors Strive to Avoid Being Labeled Outliers – Except When it Comes to Schedule II Drugs

Every month I receive a letter from my electric company. It shows how much power I am consuming relative to my peers – my neighbors. Studies have shown such data, when presented in a non-confrontational way – can impact behavior. In those studies, total energy consumption went down. In the letter I receive, no allowance […]

Posted in Healthcare Reform | 6 Comments

NC Medical Board Disciplines Doctor for a Lease Dispute.

I can understand why a Medical Board investigates a practice for allegations related to patient safety. I get it when the Board responds to concerns a doctor may be taking advantage of patients sexually. The main purpose of the Medical Board is to protect the public. What I don’t understand is when a Medical Board […]

Posted in Healthcare Reform | 11 Comments

HIPAA Conundrum. War of the Roses After Death.

Remember the movie War of the Roses.  Kathleen Turner and Michael Douglas play married characters. They hated each other. But, neither wanted to part with their opulent house. So, they stay put. No one moved. They continue to spew hate and back it up with hateful actions. Recently, a Medical Justice member said they cared […]

Posted in Healthcare Reform | 3 Comments

Deporting Hospital Patients

Illegal immigration is now the buzz of the political ball. Candidates are talking about building a wall, rounding up and deporting undocumented immigrants, and its economic ramifications. What happens when undocumented workers are injured and need long term medical care? What must hospitals do? What do hospitals do?

Posted in Healthcare Reform | 5 Comments

Two Counterintuitive HIPAA Scenarios

Scenario #1: Some doctors believe, incorrectly, that if a patient has already disclosed protected health information on the Internet, his doctor can “correct” the record online. In other words, if a patient slams a doctor online, and attaches his name or picture to the review, many doctors believe the toothpaste is out of the tube, […]

Posted in Healthcare Reform | 2 Comments

If You’re Not a Psychiatrist, What Do You Do if Your Patient Threatens Suicide?

A few of our members are psychiatrists. Most are not. On rare occasion a surgeon will get a call or email from a patient suggesting they are considering suicide. Or they have a detailed plan to take their life. Or they’ve posted this nugget of info on Facebook or a doctor review site and you […]

Posted in Healthcare Reform | 5 Comments

David versus Goliath. One Doctor’s Quest for Justice.

Physicians regularly renew their medical licenses. A typical question on the application reads: Since you last renewed have you become aware of any medical condition that impairs or limits, or could possibly impair or limit, your ability to practice medicine safely? (If you are an anonymous participant in the Physician Health Program and in compliance […]

Posted in Healthcare Reform | 14 Comments

Avoiding Liability When Sending Specimens

Doesn’t happen often. But, when it does, expect a potential s*%#storm. Patient is anxious about the mole on his back. A dermatologist removes the mole and sends the specimen to the lab. Rule in or rule out melanoma. The lab says it never received the specimen. The dermatologist then does full excision. Then the doctor […]

Posted in Healthcare Reform | 3 Comments

Why Not Bring The Entire Staff Into the Exam Room for My Prostate Exam?

I live in North Carolina. Each year I have a general physical exam. This includes the ritual known as the prostate exam. I don’t particularly look forward to it. But, it takes a few seconds and I’m reassured knowing that there are no lumps or bumps. My internist is male. And, in the exam room, […]

Posted in Healthcare Reform | 10 Comments

Which Workplace Bathroom to Use?

The question is not so simple anymore. According to the UCLA School of Law’s Williams Institute, there are approximately 700,000 transgender individuals in the United States. In a recent Equal Employment Opportunity Commission ruling (Lusardi v. McHugh, EEOC, No. 0120133395, 4/1/15), the US government ruled that a government employee who transitioned from male to female […]

Posted in Healthcare Reform | 1 Comment

Those Pesky Signatures

How many of us has received the dreaded notice that medical records are not complete; or worse, that records are complete but need to be signed. The absence of a “proper” signature gums up the works for getting paid. This following is what CMS considers to be a valid signed order/record. I won’t belabor the […]

Posted in Healthcare Reform | 1 Comment

A Good Samaritan Saves the Day

We’ve heard plenty of horror stories where someone tried to do the right thing – and got screwed. Everyone knows the saying, “No Good Deed Goes Unpunished.” Still, my faith in humanity was renewed on January 10th.

Posted in Healthcare Reform | 12 Comments

What Can Happen When Patient Consent Is Fuzzy? A Bizarre Odyssey…

Dr. Philip Taylor was employed by Spectrum Health Primary Care Partners. He practiced as an ob-gyn. His employment agreement with Spectrum defined how they could terminate the relationship. Summary Termination. If your employment … is terminated by its Board of Directors [the “Board”] for a serious, intentional violation of the standards of patient care (i.e., […]

Posted in Healthcare Reform | 4 Comments

Is Pimping Really Abusive?

Yesterday, I read two articles in JAMA on pimping. (Yes, I still get JAMA.) The article suggested that pimping medical students and residents may be “old school.” Used inappropriately, it may serve more as a tool off abuse and humiliation as opposed to a pedagogical art. Duh.

Posted in Healthcare Reform | 23 Comments

Easy New Year’s Resolutions for Cybersecurity.

Some say there are two types of online sites. Those that know they have been hacked. And those that have been hacked, but don’t know it. Sobering. Everyone is busy. The important question is what can be done to mitigate the downside of sites being hacked. You want two outcomes: (a) minimize the likelihood malicious […]

Posted in Healthcare Reform | 1 Comment

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Latest News

Five-star practice, one-star reputation?

October 10, 2012

Fair or not, online reviews may be the first thing a potential patient sees about a dermatologist
By John Carruthers, staff writer, Dermatology World, October 01, 2012

(more →)

Past News

April 5, 2012 HealthDay recently interviewed Medical Justice Founder and CEO, Jeff Segal, MD, JD, on the high costs of defending medical malpractice claims – win or lose

For doctors defending medical malpractice claims, costs vary widely across specialties and can run into the tens of thousands, even when a patient did not receive a payout, new research shows.

The upshot: Patients end up paying the price in the end, the researchers concluded in their letter published April 5 in the New England Journal of Medicine.… (more →)

November 10, 2011 Radio Health Journal recently interviewed Medical Justice Founder and CEO, Jeff Segal, MD, JD, FACS about the danger of “testimony for hire”.

Medical malpractice often boils down to a battle of expert witnesses. Frivolous cases are often fueled by inappropriate expert testimony.… (more →)

September 22, 2010 Preventing Frivolous Lawsuits and Frivolous Testimony

Every year, 8-10% of doctors will be sued for malpractice. Many physicians who have been sued or watched a colleague go through litigation respond with defensive medicine, which some recent studies estimate costs the healthcare system as much as $350 billion dollars a year. Most solutions to this problem would involve changes at the federal […]… (more →)