Rapid Clinical Updates: Medical Liability and Hospital Medicine-Slides

Slides

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The "SHM Rapid Clinical Updates: Medical Liability and Hospital Medicine" session, moderated by Dr. Jagriti Chadha with speakers Dr. G. Randy Smith Jr. and Dr. Adam C. Schaffer, provided a comprehensive overview of malpractice risks and liability within hospital medicine. The event offered 1.0 AMA PRA Category 1 CreditTM and focused on the malpractice litigation process, liability risks unique to hospitalists, and strategies to mitigate litigation exposure.<br /><br />Key points included the typical timeline of malpractice litigation—from clinical event through filing complaint, discovery, and trial—and the strict criteria for successful tort claims: a breach of national standard of care that resulted in patient harm and tangible loss. Data presented showed that malpractice claim rates against hospitalists are increasing, with high indemnity payments and severe injury outcomes involved.<br /><br />The speakers differentiated between the “person approach” to error—focusing on punishing individual wrongdoing—and the “system approach” aiming to improve outcomes through systemic changes. They emphasized that most patients injured by errors do not pursue claims; common reasons for filing include poor communication or feeling ignored.<br /><br />Effective risk reduction strategies highlighted include open disclosure after adverse events, with institutions like the University of Michigan and Massachusetts demonstrating that early admission of fault, apologies, and compensation offers reduce claim frequency, time to resolution, and costs. Best disclosure practices involve promptly meeting the patient/family, admitting harm without assigning blame, committing to investigation and support, and clear communication.<br /><br />For clinicians facing litigation, the importance of real-time, thorough documentation reflecting clinical reasoning was underscored, as legal review relies heavily on medical records. Depositions generally involve verifying facts rather than arguing clinical decisions, which are handled by expert witnesses.<br /><br />In sum, the program stressed that hospitalists can mitigate malpractice risk through patient-centered communication, transparent disclosure, system-level safety improvements, and meticulous documentation aligned with care delivered.

Keywords

Medical liability

Hospital medicine

Malpractice litigation

Hospitalists

Risk mitigation

System approach to errors

Open disclosure

Patient-centered communication

Clinical documentation

AMA PRA Category 1 Credit