Knowledge Library

Informed Consent Revisited: What is Expected of Providers

Informed consent has generated many articles, legal opinions and court decisions, yet it is still a misunderstood topic. Failure to obtain informed consent is a common allegation in medical malpractice cases involving surgery, invasive diagnostic studies and even medications. In some cases, defendants are absolved of negligence, but are held liable for not adequately disclosing the material risks of treatment which prevented the patient from giving an informed consent. Many physicians think informed consent is something they give to patients (“I consented the patient.”). In fact, doctors provide information, but obtain consent from their patients by having a full discussion...

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Hawaii Informed Consent Supplement

This supplement to our "Informed Consent Revisited" article contains excerpts from Hawaii laws related to informed consent, consent by minors and special consents. Hawaii physicians who have questions about a specific patient or who require legal advice may call MIEC’s Claims Office in Honolulu at 808-545-7231 or in Oakland, CA at 800-227-4527. For general liability questions, physicians and their staff can call MIEC’s Patient Safety & Risk Management Department in Oakland, CA at 800-227-4527. Informed Consent In the state of Hawaii, physicians must obtain informed consent from a patient prior to proposed medical or surgical treatments and diagnostic or therapeutic...

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Using Email to Communicate with Patients

Email is increasingly used as an efficient communication tool in all industries, and healthcare is no exception. With the constant presence of the internet, smart mobile devices, and social media, patients are increasingly expecting to be able to communicate electronically with their medical providers. While healthcare providers were initially slower to embrace electronic communication, they are now also becoming increasingly dependent on the efficiency that electronic communication provides, both for communication between providers and with patients. Email certainly can be a valuable and time-saving communication tool to augment face-to-face interactions, if used properly, but it may create liability problems for...

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How to Discharge a Patient from Your Medical Practice

Patients can “fire” any physician they employ, and can do so for any reason and without advance notice. As physicians do not employ patients, they cannot “fire” them. But physicians can discharge patients from their medical practice for any legitimate and non-discriminatory reason, and thus terminate the doctor-patient relationship. Whether the end of the doctor-patient relationship is initiated by a patient or the physician, some safeguards should be taken to ensure that the separation is legally proper and does not endanger the patient. Physicians or their staff who have general questions about discharging patients can contact our Patient Safety &...

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How to Manage Non-Adherent Patients

Patients who are non-adherent (formerly referred to as “difficult” or “non-compliant”) with their physician’s recommendations or medical advice risk injury to themselves and pose a liability threat for their physician. Non-adherent patients typically are those who do not follow post-treatment instructions; don’t keep appointments; don’t report information about worsening symptoms; fail to follow through on referrals to a specialist; don’t get recommended diagnostic tests; or don’t take their medications properly. Reasons for non-adherence Non-adherence is not always a deliberate act. Among the reasons some patients may not follow the doctor’s advice: They didn’t understand instructions; They forgot the doctor’s oral...

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