Risk Management for the Endoscopist
Discussions of risk management may seem trivial to physicians in the day-to-day activities of practice. Most physicians recognize the benefits of being proactive in trying to minimize the risks of malpractice litigation through careful documentation, informed consent and adhering to the accepted standards of practice. Yet practitioners routinely accept many other areas of risk, often without a second thought. There may be assignment of injury to the endoscopist based upon failure of the chosen pathologist to provide an adequate diagnosis. Patients may be injured while on the property of an ambulatory surgical center, or mercury from a defective Maloney dilator may contaminate an endoscopy unit. Owners of ambulatory surgical centers are also responsible for adequate disposal of hazardous waste, such as needles and syringes from the unit. OSHA regulations may be invoked for failure to provide adequate personal protective apparel for personnel. There are exposures associated with vicarious liability, accepting duty when unnecessary, fraud and abuse, hiring and firing employees, proctoring new colleagues, sexual harassment and a variety of other suspected or unsuspected activities that may easily be overlooked. There is literally no end to the limits of potential responsibility for injury.
Unrequested interaction between practitioners of the legal and medical fields is not usually one anticipated with great pleasure by physicians. The following documents are provided for endoscopists who are interested in reviewing their practices for potentially litigious situations and optimizing their protection against a successful judgment. The key elements of this document are that reasonable safeguards be undertaken to limit (not prevent) liability, and that the patient be granted the right of self-determination. There is no absolute protection from potential litigation, but fastidious adherence to appropriate, well conceived and executed risk management programs will help to mitigate responsibility and hence, limit liability. In addition, the law is not static and each physician is responsible for understanding the standards of care, documentation and informed consent applicable at the current time in his or her area of practice.
The preceding information is intended only to provide general information and not as a definitive basis for diagnosis or treatment in any particular case. It is very important that you consult your doctor about your specific condition.