All Other Specialty Cases

CRICO insures 16,600 physicians and surgeons in 50+ specialties. Included in the “Other Specialties” data shown in this chart are: Anesthesiology, Dentistry/Oral Surgery, Pathology, Pediatrics/Neonatology, Psychiatry, and retired teaching physicians.

Quality of care can be improved by delineating responsibilities and clarifying expectations between providers regarding communication, documentation, coverage arrangements, sharing of confidential information, and handling of emergencies. Historically, CRICO has considered these issues and, in conjunction with experts from Psychiatry and General Medicine, developed the Guidelines for Prescribing Psychiatrists in Consultative, Collaborative, or Supervisory Relationships.

Across all CRICO-insured specialties, allegations of surgery-related errors (31.4%) and diagnosis-related errors (31.0%) account for 62 percent of malpractice claims and suits.

Across all CRICO specialties, clinical judgment is a factor in a malpractice claim or suit twice as often as any other category.

Premature death and periods of diminished capacity are often considered a “loss of chance” in cases of missed or delayed diagnoses on the premise that, if the patient had known sooner, his or her medical outcome would have been less severe.

For all cases naming CRICO-insured physician defendants, 22.5 percent closed with a payment. CRICO thoroughly investigates all claims and suits, conferring with the parties involved, clinical peers, and legal counsel before determining whether to deny payment, attempt to reach a settlement, or proceed to trial on behalf of the defendants. We understand that even a case that “goes away” before going to court, or is resolved in favor of the defendant physician without a finding of negligence, is a traumatic experience. CRICO offers a variety of services, information, and videos to help you cope with the experience of being named in a malpractice case.

What Can I Do to Mitigate Risk?

• Between 2009 and 2013, 30 percent of all malpractice cases involved some form of miscommunication. Malpractice Risks in Communication Failures offers insight to mitigate those risks.
• Follow best practices for disclosure after an adverse event. CRICO offers guidelines for disclosure to assist you.
• Our 2014 CBS Benchmarking Report: Malpractice Risk in the Diagnostic Process, analyzes more than 8,400 factors from 2,685 ambulatory dx-related cases.
• The underlying principle of informed consent is that patients have the right to be told what to expect and to determine what will be done with their bodies. CRICO offers basic guidelines on ways for you to improve your delivery of informed consent with your patients.
• Listen to a top malpractice defense attorney discuss the informed consent process techniques that protect patients and their health care providers.
• Read what patients say they didn’t know about their care.
• Understand CRICO’s 12-step diagnostic process of care framework. Each step presents a focal point for more detailed analysis and opportunities for provider training and systems improvements.
• CRICO Are You Safe? case studies are designed to help all members of a multidisciplinary team reduce the risk of patient harm in the course of diagnosis and treatment.
• Detours—or shortcuts—on the diagnostic path can significantly delay the correct diagnosis and leave both patient and provider susceptible to “what ifs” related to Clinical Judgment Calls.
• Incorporate decision support into the diagnostic process.
• Realistically, a clinician is not always able to prevent a suicide in a determined patient. CRICO has worked with experts in Psychiatry, General Medicine, and Emergency Medicine on guidelines to assist primary care and mental health professionals in their decision making:
  • Guidelines for Identification, Assessment, and Treatment Planning for Suicidality
  • Decision Support Outline: Emergency/Crisis Coverage of a Suicidal Patient
  • Review real case studies that illustrate how a series of missteps can lead to tragic outcomes
• When care does not go as planned, have empathic, honest, informed communication with the patient/family.
• Good communication with patients through the continuum of care can help maintain patient expectations and potentially mitigate the decision of whether or not to assert a malpractice allegation in the aftermath of an unexpected adverse outcome.
• Document clinical information contemporaneously and objectively, with care to protect yourself, patients, and colleagues.
• Meet your defense team.