Tag Archives: United States

Doctors prevent patient injury and avoid lawsuits: six tips and best practices

"To identify the most overlooked risks to physicians, Medical Economics asked several thought leaders to share their insight into strategies for protecting office-based practices."

“To identify the most overlooked risks to physicians, Medical Economics asked several thought leaders to share their insight into strategies for protecting office-based practices.”

A friend recently shared a sad story about a young student who went to the hospital complaining of general pain and discomfort who recently died after being in a coma, and the family believes the specialist and administration failed them. The student of veterinary science’s professor visited during treatment before the student slipped into a coma. As family members and friends, who knew a little something about medicine, made suggestions, they were quickly dismissed. The specialist was certain that the student had a textbook case of her illness, and the administration was not about to question the specialist. Are non-physicians reading too much into what they read online? Are the specialists really at fault? What happens when families are fed up and file malpractice and wrongful death suits for patient injury and death?

A recent article offered several tips for physicians who want to prevent patient injury and avoid lawsuits[i].

  1. Informed Consent. Do you ever listen to the list of side effects on commercials for pharmaceuticals? If you slowed down and spent some time considering all the actual and apparent risks involved you might not take as many medications. When discussing various treatment options with patients and their loved ones, the full disclosure to promote a clear understanding of risks them make more informed decisions. Knowing for example, that surgery could lead to paralysis or death, is important to patients who should be an active player during the course of their treatment. Physicians should document informed consent practices so they can improve on these tasks and skills sets. Also, mitigating allegations by patients can be easier with well documented practices.
  2. Communication Failures. Physicians have a very small window of time to tell patients and their families about outcomes, both positive and negative. Patients certainly want to be kept in the loop and adequately informed about their progress and when things might be okay. The level of detail and explanation can get lost in communication. To put it simply, something that might be normal in the course of diagnosis, treatment and response to a physician, could seem very alarming to a patient or family under unusually high stress and pressure. On a case by case basis a smart physician should prioritize full and honest disclosure and communication with the patient and family. Preserving the sense of trust and diligence may allow people to be more forgiving in response to errors or bad news.
  3. Standards and Training. The current standards of practice should be studied by physicians in their areas of practice. Standards are frequently updated as more is learned about best practices in disease management for acute and chronic conditions. New advances in technology and recently published research results are imperative to physicians who are constantly learning and evolving in their practice of allopathic medicine. When doctors fail to keep up with current standards and medical training they are offering outdated medical services to understandably upset patients and families when things don’t go as well as possible.
  4. Diagnostic Test and Specialist Referral Follow-up. Patients often feel that every ordered test, x-ray and lab result is a piece of the puzzle and can solve the medical problem at hand. Sometimes those test results do not make it back to the treating physician in time or are dispensed with before the physician could properly review them and the findings are not communicated to the patient. Extra attention paid to tracking results can help prevent costly errors that upset patients and families and could cause harm. Referrals to specialists are also very important in the course of treatment because one medical professional should know what the other involved doctors are doing and what they have to say about treatment.
  5. Policy and Procedure Variation. Hospital administrations and policy and procedure directions can make any professional’s job seem like a nightmare. What compounds the problem of a volume of information that can be tough to manage is the shifting set of standards from administration to administration and from doctor to doctor. This makes the process of giving medical care and treatment very difficult if the medical professionals must constantly second guess whether what they are doing is appropriate and pursuant to the correct policy.
  6. Avoidance Behavior. With new advances and new technologies there is a counterweighing level of risk. Bad outcomes should be communicated directly and physicians should not avoid being the bearer of bad news. Managing expectations also can mean managing patient and family hope that a good outcome can occur when least expected. Many people suffering from despair and the agony of bad medical outcomes need the support of the treating physicians who did the best they could which sometimes just is not enough. Avoiding and hiding from people and unpleasant situations can look like a guilty behavior. It is better to confront people directly than let them wonder and come to their own possibly incorrect conclusions on their own.

Michael V. Favia & Associates are available to assist physicians with professional licensing matters and lawsuits for medical negligence and patient death. With offices conveniently located in the Chicago Loop, Northwest side and suburban meeting locations, you can schedule a discrete meeting with an attorney at your convenience and discretion. For more about Michael V. Favia & Associates’ professional licensing work, please visit www.IL-Licensing.com and feel free to “Like” the firm on Facebook and “Follow” the firm on Twitter.


[i] Medical Economics. Six ways physicians can prevent patient injury and avoid lawsuits. By Susan Kreimer. Dec. 10, 2013.

Advertisements

11,000 tablets of Oxycodone: Illinois physician’s license is on the line

Gregory M Bulava MD

Gregory M Bulava MD

This week the medical disciplinary board of the Illinois Department of Financial and Professional Regulation (“IDFPR”) was scheduled to hold a hearing on the status of Dr. Gregory M. Bulava, MD’s license to practice medicine in Illinois. The IDFPR temporarily suspended Bulava’s license upon accusations he prescribed over 11,000 Oxycodone painkiller pills to an individual patient. The IDFPR can suspend a professional license, on a temporary basis, when there is a report of wrongdoing. In this case the report suggested Bulava lied to the US DEA when they investigated him. According to the complaint, Bulava, “Told them that the people whose names were on the prescriptions were patients of his who were hurt on the job or were involved in vehicle accidents.[i]

Be aware that private professional listing sites are not primary sources of information about a professional’s license status.

Dr. Bulava can be found on several healthcare industry ratings websites as a board certified family practitioner, in many cases with positive ratings[ii]. Note that as of the 26th of November 2013, the date of this entry, Dr. Bulava appears on websites to be a practitioner in good standing despite the fact that the state has temporarily suspended his license. This is important to highlight for consumer shopping for physicians. State licensing boards such as the IDFPR are primary sources of licensing and inquiries as to the professional’s license history. Private websites, while often containing patient reviews, are not the primary source for determining is the physician is actively licensed to practice.

There are many published articles identifying the abuse of painkillers, specifically oxycodone (often known by brand-named OxyContin). An article on the popular and consumer-friendly WebMD site, Dr. Drew Pinsky (famous of the Loveline radio show) is quoted as stating, “What makes OxyContin dangerous is not only that it’s addictive, it can also be lethal…It makes you feel you can tolerate more, but it can precipitate respiratory failure, especially when used with other drugs like alcohol or benzodiazepenes.[iii]

Instructions on looking up a professional’s license status with the IDFPR:

"The Department of Financial and Professional Regulation said Friday that Gregory M. Bulava provided the person with prescriptions in the names of people who were never the doctor's patients."

AP: “The Department of Financial and Professional Regulation said Friday that Gregory M. Bulava provided the person with prescriptions in the names of people who were never the doctor’s patients.”

To search for a professional and reports of misconduct you can visit www.idfpr.com then use the “License Look Up” link that appears under the “Agency Quick Links” section in the upper left column of the IDFPR home page. When you click on “License Look Up” you will be directed select the profession in the drop down list, in this case, select Physician. Next, enter the last name, Bulava, and click/tap the “Search” button. The results showing as of the date of this article, the licensee’s name, Gregory M. Bulava MD has multiple licenses and their status is suspended. There is a button on the right of the search result grid for Dr. Bulava with a “Y” on the icon reading “Ever Disciplined?” When you click on that yes icon, you are directed to the page identifying “Temporary Suspension – 11/22/2013 – License temporarily suspended for non-therapeutic prescribing of controlled substances.”

If the IDFPR continues the suspension and takes further disciplinary actions, that information may be included in IDFPR monthly disciplinary reports that contain information that is more specific. By way of example, click/tap here to view the IDFPR monthly disciplinary report for October 2013. When the IDFPR makes its disciplinary report, if any, in this case, further information will be listed on the website and this blog will be updated at that time.

Conducting due diligence on current or new professionals with whom you wish to hire or associate can help prevent surprises down the road. Knowing that third party website hosts do not inherently know the status of a professional’s license is important and creating diligence habits can make us all safer when we work with professionals required to be licensed to practice their craft.

Michael V. Favia & Associates assist professionals with analysis and representation on IDFPR matters ranging from professionals new to Illinois and currently licensed Illinois professionals facing potential discipline. With offices conveniently located in the Chicago Loop, Northwest side and suburban meeting locations, you can schedule a discrete meeting with an attorney at your convenience and discretion. For more about Michael V. Favia & Associates’ professional licensing work, please visit www.IL-Licensing.com and feel free to “Like” the firm on Facebook and “Follow” the firm on Twitter.


[ii] Website listing, Healthgrades.com: Dr. Gregory M. Bulava, MD (cache link: click here)

[iii] WebMD: OxyContin: Pain Relief vs. Abuse.