Admit mistakes, keep good records to protect against malpractice suits

BOSTON — Keeping detailed patient charts, documenting informed consent and accepting responsibility for errors when they occur can help refractive surgeons avoid costly malpractice suits, according to two attorneys speaking here.

"Patients lose trust with their doctor if their doctor minimizes or ignores their problems. Physicians should be aware of this, because if patients lose trust, they will look for other doctors or find their way to a plaintiff lawyer," said Greg K. Zeuthen, a plaintiff attorney.

Mr. Zeuthen and Kevin E. Oliver, a defense attorney, discussed the current medicolegal climate in refractive surgery in two keynote lectures at American Society of Cataract and Refractive Surgery Summer Refractive Congress. They outlined LASIK cases they have handled in court and possible approaches surgeons could employ to avoid litigation.

Mr. Oliver said he tells doctors to imagine a hypothetical situation in which all their charts have court exhibit stickers on them. He then asks them to carefully consider whether those charts are well-documented and adequately clear to be used in a defense or a prosecution.

"You need to chart everything," Mr. Oliver said.

Mr. Zeuthen noted that draconian documentation is the key to minimizing the risk of legal action. Should a case go to trial, it is also important for mounting a defense.

"Paranoia is not bad at all," Mr. Zeuthen said. "It's just a higher state of awareness. If you practice medicine with a higher state of awareness, you're going to avoid more lawsuits."

Both lawyers noted that surgeons should be honest when dealing with refractive surgery mistakes or errors. Most refractive surgery patients are highly educated individuals who understand the legal system and will sue if not treated appropriately, they said.

"It's how a bad outcome is dealt with in your office that determines whether a patient will go to another doctor of to a plaintiff's lawyer," Mr. Zeuthen said.