A study of 45 randomly selected plaintiff’s depositions in medical malpractice cases from over 25 years ago1 is as applicable to EMS today as it was then. In this study, the researchers found that a poor relationship between the healthcare provider and the patient was a key driving force behind all medical malpractice lawsuits. Specifically, the study found the following issues arose in over 70% of all medical malpractice depositions when patients were asked: “Why did you sue the health care provider?” They said that their healthcare provider:
- Deserted the patient
- Devalued the patient’s views
- Delivered information poorly, or
- Failed to understand the patient’s perspectives
So how do we avoid these issues from arising in a case against your EMS agency?
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Don’t Leave Behind the Patient Who Needs You
Lawsuits for patient abandonment and wrongful death are rare, but when they occur, the jury awards will often be in the six figures. The key is to prevent a “medical rekindle.” You don’t want to get called back to the home of a patient who is now in cardiac arrest when you left the patient a few hours earlier after spending only a short time obtaining a “refusal.” All refusals of care must be well documented and extra care taken to clearly explain to the patient the risks of refusing treatment and transport when the patient needs it.
Be positive, be patient and be persistent. Take your time with the patient and document accurately and completely how you explained the risks of refusal, the steps you took to convince the patient to go and the patient’s response.
Pay Close Attention to the Patient’s Words
We need to listen carefully to the patient and their family members by practicing “active listening.” Show that you are truly interested in what they have to say by looking them in the eye, tilting and nodding your head appropriately, and by asking questions to clarify and elaborate on their statements.
Too often we dismiss what the patient says and thus miss key signs and symptoms of a serious problem. Patients “know their body” better than anyone else and will provide important information to guide your assessment and treatment – if you listen properly.
Be Clear in Your Communication
A key to a positive experience for the patient is to keep the patient and family informed. Let them know what you are doing. Let them know what to expect. Be sensitive to how you deliver information and communicate with them on their level.
Patients come from different backgrounds and levels of education. They often don’t understand medical terminology or why we perform the procedures we perform. Being courteous, concise and sincere in talking to the patient can help allay a lot of anxiety as well.
Appreciate Where the Patient is Coming From
This is all about empathy by putting yourself in the patient’s shoes and looking at the situation from their perspective, not yours! This requires emotional intelligence – understanding the patient’s emotions and not letting those emotions get the best of you.
It requires that we appreciate and understand that we are all different. If we can appreciate and respect those cultural, ethnic, economic and familial differences, we will be better suited to better understand the patient’s perspective and how that can help effectively guide the care that we give.
The bottom line is that patients are less likely to sue you if you are nice to them and pay attention to them as an equal human being and not judge them. Yes, even if you make a mistake – if you are kind and compassionate, patients are often forgiving.
The key is to work to develop a “positive connection” with the patient. By being nice to the patient and the patient’s family and treating them with respect and dignity – as if the patient was your own family member – you can reduce your risk of a lawsuit tremendously. And you won’t end up being questioned in a deposition or in the courtroom!
1. Beckman HB, Markakis KM, Suchman AL, Frankel RM: The Doctor-Patient Relationship and Malpractice – Lessons from Plaintiff Depositions, Arch Intern Med. 1994 Jun 27; 154(12):1365-70.
Steve Wirth is a founding partner of Page, Wolfberg & Wirth, LLC and has been involved in all facets of EMS from field provider to EMS attorney in a career that spans over 40 years. He has authored or co-authored hundreds of articles, blogs, and book chapters on a wide range of EMS leadership, reimbursement, risk management, corporate compliance and workplace law topics. He can be reached at: [email protected]
For 20 years, PWW has been the nation’s leading EMS industry law firm. PWW attorneys and consultants have decades of hands-on experience providing EMS, managing ambulance services and advising public, private and nonprofit clients across the U.S. PWW helps EMS agencies with reimbursement, compliance, HR, privacy and business issues, and provides training on documentation, liability, leadership, reimbursement and more. Visit the firm’s website at www.pwwemslaw.com.