Managing Risk in the ED
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Key Chapter Points
ED physicians ranked 5th in frequency of malpractice claims. ED headache is not a diagnosis commonly associated with litigation. The “difficult patient” encounter usually occurs because of a combination of patient, healthcare provider, and situational factors. Be the BOSS when dealing with patients making unreasonable demands bysetting Boundaries, utilizing multiple treatment Options, Scripting responses to common patient concerns, and treating patients with Sincere concern and respect. Most errors in diagnosis in the ED stem from errors in thought processes during decision making rather than lack of knowledge. Physicians must understand the laws of their state and make sure that their diagnostic approach and approach to informed consent complies with state laws.
KeywordsAnalgesic overuse headache Context errors Drug seeking Informed consent Litigation Malpractice Metacognition
- 1.Kane CK. Medical liability claim frequency: a 2007–2008 snapshot of physicians. AMA Center for Economics and Health Policy Research, Aug 2010. http://www.ama-assn.org/ama1/pub/upload/mm/363/prp-201001-claim-freq.pdf. Accessed Nov 2010.
- 6.Hull SK, Broquet K. How to manage difficult patient encounters. Fam Pract Manage. 2007;14:30–4.Google Scholar
- 9.US Department of Health and Human Services SAMHSA website http://www.oas.samhsa.gov/. Accessed October 2010.
- 15.Chan L, Winegard B. Attributes and behaviors associated with opioid seeking in the emergency department. J Opioid Manage. 2007;3:244–8.Google Scholar
- 16.Pope D, Fernandes CB, Bouthillette F, Etherington J. Frequent users of the emergency department: a program to improve care and reduce visits. Can Med Assoc J. 2000;162:1017–20.Google Scholar
- 30.Rapoport AM, Weeks RE, Sheftell FD, Baskin SM, Verdi J. The “analgesic washout period”: a critical variable in the evaluation of treatment efficacy. Neurology. 1986;36 Suppl 1:100–1.Google Scholar