Claims defense

EmPRO understands that defending our physicians is our number one priority. If you are ever involved in a malpractice suit, you can rest assured knowing that our claims team will work tirelessly to investigate and strategize on your behalf. At EmPRO, we will put together a team of top legal, claims, insurance, and medical experts, including leading experts in urology, to bring forth the strongest defense possible on your behalf. EmPRO’s Medical Directors will work with our attorneys in the initial phase of the claims process to ensure that your claim receives the optimal defense strategy.

EmPRO understands that the practice of medicine carries inherent risks to the patient and that an adverse event does not necessarily imply negligence. It is therefore important for urologists to select a malpractice carrier who understands that urology has inherent risks and that a case should not be settled merely because of a poor outcome.

• Where other malpractice companies settle for business reasons, EmPRO will fight on your behalf.
• EmPRO uses data-analytics to drive strategic planning of claims defense.
• EmPRO’s claims team has a proven track record of success. To learn more, click here.
• EmPRO has a captive medical malpractice law firm, providing in-house legal expertise.

Comprehensive risk management services

EmPRO’s risk management and legal team have decades of experience supporting and advising our physicians on how to best mitigate risk in their practice. EmPRO provides consultation services for both small and large practices.

Access to award-winning education

Our award winning CME and MOC education programs combine the very best risk management and patient safety content into easy to learn, memorable online courses. Our courses are approved by the Medical Society of the State of New York and the New York State Department of Financial Services for the New York State medical malpractice insurance premium discount and excess malpractice insurance program.

Also:

• Stay informed with EmPRO’s legal briefs
• Find specialty-specific risk management content with EmPRO’s original articles, videos, and posts.
• Stay current by following EmPRO’s social media feeds for the latest news, information, and original articles.
• Keep up to date with the latest malpractice trends by attending EmPRO’s webinars.

Physician peer support

No urologist wants to have an adverse event or become involved in a malpractice lawsuit. Unfortunately, it is impossible to eliminate the risk of litigation, no matter how competent a physician may be. At EmPRO, we have trained, knowledgeable, experienced physicians to provide support to you if the need arises. Our physician peer-supporters are available to have a confidential call to discuss an adverse event, litigation, or any frustrations or challenges related to practicing medicine today.

EmPRO offers:

• One-to-one support
• Virtual group peer support
• In-person group peers support

In Focus – Urology Malpractice Claims

In a review of PIAA malpractice claims, urology ranks 12th of 28 specialties reviewed in the number of claims reported and monies paid over the 23 year period of review. On average general, urologists will be sued once every 11 years. Of the urologists who had paid indemnity 78.1% had previous claims which was 3% higher for urologists than physicians on average. While urologists have higher frequency of claims, total indemnity was lower for urologists than the average for all physicians.

The top 3 medical misadventures were improper performance (36%), errors in diagnosis (15%) and failure to supervise or monitor a case (5.6%). Although diagnostic error accounted for 15% of claims, errors in diagnosis accounted for 28.6% of the total indemnity paid by urologists. This is consistent with other specialties in that diagnostic error tends to result in higher indemnity than other claim types. Procedures involving the kidney (29% of closed claims) and prostate (29% of closed claims) are most frequently implicated in claims of improper performance of a surgical technique. A survey found that urologists who had been sued were likely to consider referring out difficult cases and changing the scope of their practice.

As in other surgical disciplines, urology has seen a wellspring of innovation. Endeavors such as robotics, complex laparoscopy, and single port/natural orifice surgery have developed. To reduce risk, urologists should consider both technical and non-technical risk reduction methods. In technical risk reduction the urologists ensure that they are familiar with all of the specifications and safety features of the equipment being used. Simulation training is performed to ensure that the urologist and the supporting professionals are fully skilled in the use of the equipment and procedures. Scenario training should also include managing foreseeable complications.

Nontechnical risk reduction includes patient safety strategies such as proper informed consent and patient education, appropriate follow-up, and referrals to urologic subspecialists when the need arises. It is difficult to overestimate the importance of good communication in managing risk for urologists, whether with the patient or other members of the healthcare team.

Documentation is another area that is fundamental to reducing risk. EMR’s continuously improve, but many physicians still find them cumbersome and frustrating. Work with your IT department or EMR vendor to ensure that your product is configured in a way that maximizes appropriateness to urology and leverages safety checks that help to waterproof your practice. A good practice is to periodically print out a patient record and review it to ensure that it properly documents the encounter. It should omit any important elements that were addressed and it should also not contain any elements that were not addressed (as can sometimes happen when EMRs prepopulate information). Documentation is the cornerstone of good risk management.

References

1. Sherer BA, Et al. Urological Malpractice: Claim Trend Analysis and Severity of Injury. Urology Practice. November 2016Volume 3, Issue 6, Pages 443–448
2. Kahan SE. Urological medical malpractice. J Urol. 2001 May;165(5):1638-42.
3. Benson JS, Coogan, CL. Urological Malpractice: Analysis of Indemnity and Claim Data From 1985 to 2007. The Journal of Urology. Volume 184(3), September 2010, p 1086–1090

Helpful Urology resources

• American Urological Association http://www.auanet.org/
• American Board of Urology http://www.abu.org/
• The Journal of Urology https://www.jurology.com/
• The Journal of Urological Surgery http://jurolsurgery.org/
• European Urology https://www.europeanurology.com/