What Pathologists should know when Shopping for Malpractice Insurance Coverage

Pathology is generally not considered to be a high-liability specialty, yet indemnity rulings against pathologists are more severe than the physician-wide average. Premiums for pathologists seeking medical malpractice insurance vary widely based on the location of the practice.

The most common causes of malpractice lawsuits against pathologists fall into one of two categories, mistreatment and misdiagnosis. Mistreatment involves improper actions in dealing with patients, treating them discourteously or disrespectfully. Most malpractice suits in pathology involve misdiagnosis, as pathology is mostly concerned with diagnosing diseases. The most common misdiagnoses leading to lawsuits include malignant melanoma, breast cancer and prostate cancer.

When a pathologist discovers a misdiagnosis, it is a good idea not only to immediately notify the patient’s clinician, but also take a direct part in informing the patient as well. By dealing with the problem directly and honestly, informing the patient personally, doctors can minimize the risk that a patient will feel angry and personally wronged, which can often result in a lawsuit. Complete honesty with patients is the best policy. Remember that expressing concern for a patient after a misdiagnosis is in no way an admission of malpractice.

Pathology presents unique challenges in the areas of medical malpractice and risk management. Because of the nature of the specialty in the U.S., it is rare for pathologists to develop relationships with the patients whose diseases they are diagnosing in laboratories. In most specialties, some of the most effective tools to minimize the risk of being sued are effective communication and maintaining personal relationships with patients. Since pathologists are limited in this respect, they should be doubly careful to provide considerate treatment to patients whenever they do have contact with them-for example, when patients are getting blood drawn in a laboratory overseen by a pathologist. In addition to using effective communication and courteous treatment of patients, pathologists can manage their risk by maintaining thorough, fastidious documentation of all cases. It is a good idea to record the thought processes behind diagnoses, and the factors that led to the elimination of alternative diagnoses. In the event of a lawsuit, lack of proper documentation can be devastating for physicians, while clear records can be vindicating. Also, pathologists who work as part of a medical group should take advantage of the opportunity to consult with other specialists in the group on challenging cases. For solo pathologists, arrangements can be made with nearby pathologists to work together. Records of this type of consultation bolster a physician’s defense against a malpractice suit. Similarly, outside consultation with experts in the field can be a good idea in cases that present unusual difficulties.

Pathologists who are concerned about the upward trend in liability insurance premiums can get involved in efforts to enact tort reform, measures to stabilize the volatile malpractice environment. States that have enacted tort reform, like Texas, have seen a marked stabilization in their medical malpractice insurance rates. Visit this page to read the College of American Pathologists’ position statement on medical liability reform.

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Important Resources for Pathologists

Modern Pathology
The American Board of Pathology
American Society for Clinical Pathology
Digital Pathology Association
American Society for Investigative Pathology
Pathology Outlines