Rapid Clinical Updates: Medical Liability and Hospital Medicine-Handout

Handout

Pdf Summary

This summary presents key insights on medical malpractice involving hospital medicine (HM) physicians, drawn from recent literature and best practices.<br /><br />Contextually, internal medicine (IM) generally experiences fewer malpractice cases than many specialties. Hospital medicine, a subset of IM, has a comparable annual claim rate of 1.95 per 100 physician years and a 30% payment rate—similar to other IM specialists. However, malpractice claims involving HM physicians may be rising relative to other specialties.<br /><br />A major predictor of payments in malpractice claims is clinical judgment errors, with an adjusted odds ratio of 5. Communication issues account for 36.4% and documentation errors for 19.5% of HM claims, together comprising over half of such claims. Increasing supervision requirements for advanced practice providers may also contribute to this rise. To mitigate risks, clinicians are encouraged to reduce excessive note length to avoid copy-paste mistakes, enhance clarity of clinical reasoning, and honestly document uncertainty and differential diagnoses.<br /><br />Regarding disclosure of adverse events, the typical clinical quality improvement context—a "no fault" environment—contrasts with the aggrieved patient's perspective, which often expects fault attribution. Current evidence supports that truthful, transparent disclosure by a known clinician, without haste to attribute blame, reduces lawsuits and expedites compensation. A personal commitment to engage fully in associated investigations further improves outcomes.<br /><br />In summary, hospitalists face malpractice risks comparable to other IM physicians, with rising claim rates linked to communication, documentation, and supervision challenges. Best practices emphasize careful, clear documentation; embracing clinical uncertainty; and honest, empathetic disclosure of adverse events to minimize legal exposure and improve patient trust.

Keywords

medical malpractice

hospital medicine

internal medicine

malpractice claims

clinical judgment errors

communication issues

documentation errors

advanced practice providers

adverse event disclosure

patient trust