Tahitian Pearls 2015 Tahiti CME Cruise March 18 28, Avoiding Malpractice in General Practice. By Dr. John Crosby.

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1 Avoiding Malpractice in General Practice By 1

2 2

3 By FRCP (C) Emergency medicine Family Practice, Cambridge Assistant Professor of Medicine, University of Toronto and Family Medicine McMaster and Queens Columnist and blogger Medical Post Expert in over 200 Malpractice cases and college reviews 3

4 What it s like being sued Subpoena Call CMPA Copy charts, store safely and never alter them Write out your recollections. Review expert s reports 4

5 Discovery each lawyer will walk you through the case Do not argue, don t guess, it can be used in a trial 5

6 Trial Judge comes in from the back and all rise Plaintiff (patient) and lawyers on left, you and your lawyers on the right Witness box on judge s left You are allowed to bring notes and charts Answer in plain English, no jargon 6

7 Trial (continued) Your lawyer goes through your CV then asks you to go through the case. The patient s lawyer cross examines you Then your lawyer gets to question you again Other witnesses and expert witnesses then go through h the same process Just answer what is asked 7

8 Avoiding Malpractice Charting is supreme Try to have typed notes Dictate for $ 100 per week EMR s for $2 per day Use Stamps or templates 8

9 Example of a template URI for days. Fever cough - sore throat earache - sputum- On Exam: neck - Temp ENT Chest is clear to inspection and auscultation Assessment - Plan: call if worse, fever advice, Rx 9

10 Types of cases Lumps Moles Skin lesions Ectopic pregnancy Rectal bleeding 10

11 Headaches New Sudden Fever Neck stiff 11

12 Epiglottitis pg Hot potato voice Sitting up Drooling 12

13 Chest pain Gastrointestinal or cardiac Lab ECG Chest xray 13

14 Lab and imaging g follow up System: initial lab slip Do daily 14

15 Cases Meningitis Fever in babies Appendicitis Testicular torsion Compartment syndromes 15

16 If you didn t write it You didn t do it! Charting is everything. 16

17 Applause/Questions? Your experience? 17

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