Urologists and their Liability Needs
Urology is the medical specialty focusing on the urinary tract and the male reproductive system, which is closely related to the male urinary system. Urologists diagnose and treat disorders and diseases in the kidneys, ureters, bladder, urethra, and other urinary and reproductive organs. The specialty encompasses non-surgical and surgical procedures, and urologists work closely with other specialists, particularly oncologists. Urology is a broad specialty and many urologists choose to practice in a subspecialty like endourology, laparoscopy, or pediatric urology.
Because urology includes surgical procedures, it is classified as a higher-risk specialty by medical malpractice insurers. This means that urologists who perform surgery will have to pay relatively high premiums for medical malpractice insurance. Premiums have been climbing steadily over the last several years. A study published in the Journal of Urology that surveyed members of the American Urological Association examined the effects of the malpractice environment on urology. The survey found an average malpractice insurance premium of about $30,000 among urologists, with the upper end topping $120,000. This wide range of premiums is due to the differences in the legal climates of different states. Litigious states like Florida will have the highest premiums, while physicians pay significantly less in rural states and in states that have passed tort reform measures.
The AUA survey also found that over 60% of urologists reported having faced an average of about 2 malpractice claims each in their careers. Another study found that a urologist can expect to face 1.9 to 2.36 claims in his or her career. Almost a third of lawsuits were caused by an incident involving urological oncology. Many urologists have made changes to their practices because of malpractice fears, or are considering doing so; 60% are considering restricting their practice or referring complicated cases, 25% are considering moving to a different state and about 40% are considering early retirement because of the fear of lawsuits.
Urologists can practice risk management techniques to limit their exposure to lawsuits. Good documentation is one of the most important of these techniques. Physicians should be sure to keep a thorough record of every case, including the thought processes behind a diagnosis and even details that may seem incidental. Organized and complete records can mean the difference between a large indemnity payment and a dismissed claim. Also important is communication with patients; physicians should develop a clear style of communication, making sure that patients understand each step of the treatment process and answering any questions that patients may have. For risk management in surgical procedures, it is a good idea to use a written checklist and to verify a patient’s identity directly before surgery.
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This write-up for Urologists was put together by Michael Matray, the Editor of the Medical Liability Monitor