2019 January Bulletin: Cataract Surgery
January 2019 Risk Management Bulletin
Cataract Surgery Risk Reduction
Cataract surgery is the second most frequently performed ophthalmic procedure in the United States, and remains the source of the majority of the medical malpractice claims reported to OMIC. Patient expectations about the outcome of cataract surgery are heavily influenced by advertising that promises to reduce or completely eliminate dependence upon glasses and contact lens. Many patients undergoing cataract surgery thus have very high visual goals, especially if they invest their own money to upgrade to specialty IOLs. When the outcome does not match these heightened expectations, patients are more apt to complain not only to their ophthalmologist, but to acquaintances, insurance companies, regulatory agencies, and malpractice attorneys.
Our risk management recommendations and sample consent forms can help you reduce your liability exposure.
RESOURCES
2018 December Bulletin: Service Animals
December 2018 Risk Management Bulletin
Service Animals
Do you have a Service Animal Policy?
Do you know the two questions you are allowed to ask about the service animal?**
Do you know what the ADA requirements are regarding posting a sign in your office stating, “Service Animals Welcome”?
Facts:
A patient showed up for a scheduled medical appointment at an OMIC insured retina practice with a dog. The patient did not call ahead to let the practice know that he was bringing a service animal with him to the appointment. When the doctor told the patient that the animal was not allowed into the sterile treatment room, words were exchanged, and the patient left the office prior to the exam. The patient filed a claim with the U.S. Department of Justice and the State Medical Board alleging discrimination and a violation of the ADA requirements regarding service animals.
The medical office was required by the U.S. Department of Justice to draft and submit for approval their service animal policy. They were also required to post a sign informing patients that SERVICE ANIMALS ARE WELCOME. The sign had to be in a font of 26 or larger, on a contrasting white background.
The insured was required to pay the patient a $1000 fine.
**The two questions you are allowed to ask about the service animal are:
- Is this animal required because of a disability?
What tasks has the animal been trained to perform?
RESOURCES
ADA Requirements Overview: Overview and Miniature Horse Addendum
FAQ about Service Animals and the ADA: ADA Regulations
Understanding How to Accommodate Service Animals in Healthcare Facilities: HHS Document
OMIC Sample Policy: Policy
OMIC Example of Sign for Office: Service Animal Flyer and Court Document Service Animals
2019 April Bulletin: Duty of Care
April 2019 Risk Management Bulletin
When is a Physician’s Legal Duty of Care Established?
Physicians often ask at what point the physician-patient relationship begins Does a scheduled appointment for a new patient create a legal duty? What about a curbside consult? Does treatment in the ED establish a duty for follow up care? As with many medico-legal issues, it depends. OMIC has created resources to answer such questions. Click on the links at right to learn more about how to reduce your liability in these situations.
RESOURCES
2019 May Bulletin: Older Patients
May 2019 Risk Management Bulletin
Older Patients and Surrogates
The U.S. Census Bureau confirmed that by 2030, all baby boomers will be older than age 65. That means that 1 in every 5 residents will be retirement age.
Older patients make up a significant portion of the patient population of most ophthalmologists. Many older patients suffer from co-morbities like diabetes, dementia, and heart disease. Some patients lose their ability to make the informed consent decision before surgery due to poor management of medications or signs of dementia.
How should you protect yourself in the event that you do not believe that your patient understands the risks, benefits, and alternatives to surgery? If a patient lacks decision- making capability, a surrogate decision maker must be found to make the informed consent decision before surgery is allowed to proceed. States recognize that some patients may temporarily or permanently lose their ability to make decisions on their own behalf and have developed mechanisms for determining who may decide in the patient’s stead. A relative or guardian with power of attorney (POA) status is ultimately what you hope to have in place for older patients who require assistance with medical decisions. Check state law regarding who may act as a surrogate and the limitations of the types of decisions the surrogate is empowered to make.
RESOURCES
