Knowledge Library

A Failure to Document Patient’s Refusal

This case study was made available to MIEC through our partnership with CRICO. It was written by Jennifer Vuu Sanchez, CRICO Description A 60-year-old male’s allegation of a failure to diagnose colon cancer was complicated by his undocumented refusals of recommended cancer screenings. Key Lessons Inadequate documentation of a patient’s refusal of cancer screening falls below the standard of care. A patient’s refusal of cancer screening, risks related to the refusal, and alternatives offered to the patient should always be documented in the patient’s medical record. Provide patient education on the importance of cancer screenings and document the patient’s level...

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A Discordant Provider-Patient Relationship

This case study was made available to MIEC through our partnership with CRICO. It was written by Barbara Szeidler, CRICO Description Mother’s dissatisfaction with her son’s care ultimately leads to a malpractice claim against the child’s pediatrician. Key Lessons Patient and family anxiety is a factor in how the clinical care plan is understood and followed. A patient with multiple caregivers is best served by a coordinated and focused communication process. Education using the “teach back” method where patients are asked to restate instructions or concepts in their own words is a mechanism to aid in assuring their understanding. Clinical...

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Treating Unvaccinated Patients

MIEC has been receiving increasing calls from members who are concerned about patients who have not received a COVID vaccine. Members have expressed concerns regarding the safety of unvaccinated patients, other patients in the practice, and their staff. Some members have expressed an unwillingness to continue treating patients who are either vaccine-hesitant or who have refused to get vaccinated, or they are unwilling to see these patients in their offices. To address this question more broadly, MIEC turned to ECRI, which provided the following recommendations based on a review of clinical and gray literature and ECRI resources. ECRI answers questions...

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Professional Boundaries in the Medical Practice

The doctor-patient relationship is rooted in trust. Patients often present their most vulnerable selves to their physicians with the trust that they will remain respectful and professional at all times. An important part of establishing an atmosphere of trust is maintaining clear professional boundaries with patients. If this trust is compromised it can be damaging to the patient, your reputation, your practice, and the medical community. Not all cases are clear when it comes to avoiding boundary violations. Sure, it is easy to recognize blatant violations such as having sexual relations with a patient, but what about attending a wedding...

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Smartphones and Texting with Patients

Text messaging or SMS (short message service) has become the virtual default method of direct communication in today’s society. As regular mail and even personal emails are increasingly as difficult to find as needles in virtual haystacks, and there is less and less time for telephone calls, individuals who want timely responses are using text messages to communicate- and this expectation is present in healthcare as well. Consider the following statistics: 95% of text messages are read within 3 minutes of being sent. (Forbes) 98% of text messages are read. (Physician Practice News) 91% of US adults 65+ own a...

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