Legislation and Legalities: How Not to End Up on the Nightly News
Today, 4-5 p.m.
Upper Level 8

Bad things can happen to good anesthesiologists. But bad patient outcomes don’t have to translate into bad legal and financial outcomes. Every physician anesthesiologist can take a few basic steps to protect their patients and themselves.

“Patient safety is crucial to anesthesia care, and peer review is a key step in improving care,” said Vilma Joseph, M.D., M.P.H., Associate Professor of Clinical Anesthesiology at Albert Einstein College of Medicine/Montefiore Medical Center. “The problem is that so many providers are afraid that if I say too much during peer review, I’m going to get sued. Many anesthesiologists are completely unaware that there are protections on both the federal and state levels.”

Dr. Joseph will open a Professional Issues session, “Legislation and Legalities: How Not to End Up on the Nightly News,” from 4 to 5 p.m. today in Upper Level 8. She will discuss legislative protections anesthesiologists have against malpractice claims, as well as practical steps that can protect their patients, careers and assets.

“None of us wake up in the morning wanting a patient in cardiac arrest on our operating table, but it can happen,” said Shamema Karjeker, M.B.Ch.B., J.D., a retired anesthesiologist and attorney. “You need to start thinking about a possible bad outcome and how to prepare for it prior to it happening.”

Preparing for medical malpractice is an exercise in professional and personal preventative care. On the professional side, anesthesiologists absolutely must deliver standard of care treatment to every patient. Physicians who fail to provide standard of care treatment as judged by a judge or jury face the psychological, social, professional and financial consequences of that judgement.

“One of the highest profile cases was a physician who used single-use anesthesia vials for multiple patients,” Dr. Joseph said. “Several patients contracted hepatitis C and two of them died. We all face daily pressures to do things faster and cheaper, but there are worse outcomes than spending a few extra dollars and a few extra minutes to open a new vial for every patient. We must remember to always follow safe injection practices. Patient safety means doing the right thing every time.”

And what about those times when bad things happen regardless? That’s where advance knowledge and preparation come into play. In addition to federal protections, some states have apology laws that protect providers who apologize to patients and caregivers for poor outcomes. Some states protect details revealed during peer review from discovery in medical malpractice actions. The onus is on the anesthesiologist to become familiar with laws that apply to the state or states in which they practice.

Every anesthesiologist needs medical malpractice insurance. But they don’t all need the same amount of coverage.

“If you are just out of residency and have no assets but lots of medical school debt, you can probably make do with lower coverage limits,” Dr. Karjeker said. “But if you are close to retirement and have accumulated assets, you need maximum protection, currently $1 million from most insurance companies. You need to start thinking about litigation, how the legal process works and how to prepare for it long before anything bad happens. The more you know in advance, the better you and your patients will fare.”