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EFENSIVE
ME ICINE
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PHYSICIAN’S REACTION TOMALPRACTICE:
Partial or
complete
abandonment ofmedical practice
Practice of
DEFENSIVE
MEDICINE
ProfessionalLiabilityProphylaxis
MedicalMalpracticeLiabilityInsurance
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PARTIAL or COMPLETE ABANDONMENT ofPARTIAL or COMPLETE ABANDONMENT of
MEDICAL PRACTICEMEDICAL PRACTICE
After arduous years ofAfter arduous years ofmedia! eduatio"# $ismedia! eduatio"# $is
%$a"tom fear of a suit%$a"tom fear of a suitor t$e distressi"&or t$e distressi"&e'%erie"e of (ei"&e'%erie"e of (ei"&i")o!)ed i" ai")o!)ed i" a
ma!%ratie !iti&atio"ma!%ratie !iti&atio"may ma*e a %$ysiia"may ma*e a %$ysiia"forsa*e t$e )oatio" offorsa*e t$e )oatio" ofsa)i"& !i)es+sa)i"& !i)es+
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PRACTICE O,PRACTICE O,
DE,ENSI-E MEDICINEDE,ENSI-E MEDICINE
INDS!negativenegative
positivepositive
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NE.ATI-ENE.ATI-E
DE,ENSI-E MEDICINEDE,ENSI-E MEDICINE
T$e %$ysiia" a)oids%erformi"& $a/ardous
%roedures su$ as:(rai" sur&ery# o%e"0$eart#
s%i"a! sur&ery#radiatio" t$era%y#
a"er sur&ery# et1
"#est Interest $ule%
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POSITI-EPOSITI-E
DE,ENSI-E MEDICINEDE,ENSI-E MEDICINE
P$ysiia" %erformsP$ysiia" %erforms
additio"a! m&mt1additio"a! m&mt1
%roedures to%roedures to
a)oid !ia(i!ity2a)oid !ia(i!ity2
Hos%ita!i/atio" of aHos%ita!i/atio" of a
%atie"t for a%atie"t for a
%roedure 3$i$ is%roedure 3$i$ is
usua!!y do"e i" t$eusua!!y do"e i" t$e!i"is!i"is
Co"su!tatio"s toCo"su!tatio"s to
o"4rm dia&"ostio"4rm dia&"ostior t$era%eutior t$era%euti
%ro%osa!%ro%osa! Additio"a! D' testsAdditio"a! D' tests
&VE$'$E('MEN'&VE$'$E('MEN'
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&VE$'$E('MEN'!
A%%!iatio" of amedia! ma"a&eme"t
more t$a" t$at 3$i$is t$e dema"d of t$eoasio"# t$ea%%!iatio" of a
dia&"osti ortreatme"t %roedure3it$out o"ei)a(!ei"diatio"1
C&N'IN)I'* &F C($E(F'E$!
0 t$e si&"s a"d
sym%toms $a)edisa%%eared#
0 3$e" ma'imum re%aira"d re$a(i!itatio"$a)e (ee" a$ie)ed#
or0 3$e" t$e (est %ossi(!e
ure $as (ee"attai"ed1
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5INDS O, O-ERTREATMENT5INDS O, O-ERTREATMENT
▪QUALITATIVE QUALITATIVE
▪QUANTITATIVE QUANTITATIVE
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6ua!itati)e O)ertreatme"t
T$e a%%!iatio" of t$era%euti%roedure or su%%orti)e de)iesordi"ari!y %resri(ed o"!y to mu$
more serious o"ditio"s or for i"7uryor disease di8ere"t from t$e o"e3$i$ su$ treatme"t is direted1
E':%erformi"& CS to a "orma! %re&"a"ya%%!iatio" of ast 3it$ "o 7usti4atio"o"4"eme"t for a mi"or ai!me"t
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6ua"titati)e O)ertreatme"t
)n+usti,ed procedures
E':e'essi)e !a(oratory tests
more '0raysfre9ue"t )isits!o"&er treatme"ti"disrimi"ate %resri%tio"s
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E,,ECTS of O-ERTREATMENT:E,,ECTS of O-ERTREATMENT:
unnecessaryunnecessary
,nancial losses,nancial losses
to patient to patient
unnecessaryunnecessary
,nancial losses,nancial losses
to patient to patient
ris-s of physicalris-s of physical
and emotionaland emotional
harm to patientharm to patient
ris-s of physicalris-s of physical
and emotionaland emotional
harm to patientharm to patient
there may bethere may be
symptoms actuallysymptoms actuallyresultin. fromresultin. from
o/ertreatmento/ertreatment
itself itself
there may bethere may be
symptoms actuallysymptoms actually
resultin. fromresultin. from
o/ertreatmento/ertreatment
itself itself
possible in+urypossible in+ury
to patient thatto patient thatmay ser/e asmay ser/e as
catalyst to acatalyst to a
malpractice suitmalpractice suit
possible in+urypossible in+ury
to patient thatto patient thatmay ser/e asmay ser/e as
catalyst to acatalyst to a
malpractice suitmalpractice suit
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LIABILITY PROPHYLAIS:LIABILITY PROPHYLAIS:
• More ari"& a"dmore *"o3!ed&e of!e&a! duties
• A)oida"e ofdestruti)eritiisms of t$e3or*s of ot$er
%$ysiia"s• 5ee%i"& a" ;idea!<
media! reord
A)oida"e ofA)oida"e of
admitti"& t$i"&sadmitti"& t$i"&s
t$at mi&$t (et$at mi&$t (eo"strued aso"strued as
admissio" of fau!tadmissio" of fau!t
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Ad)ie %atie"t ofAd)ie %atie"t of
a"y i"te"deda"y i"te"ded
a(se"e a"da(se"e a"dreomme"d a"reomme"d a"
a)ai!a(!e a"da)ai!a(!e a"d
9ua!i4ed su(stitute9ua!i4ed su(stitute
More tat a"dMore tat a"da)oida"e ofa)oida"e of
o)ero%timistio)ero%timisti
%ro&"ostiatio"%ro&"ostiatio"
A!3ays seure a"A!3ays seure a" ;i"formed o"se"t
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Secure le.alSecure le.al
ad/ice 0henad/ice 0henso re1uiredso re1uired
No e'%erime"tatio"No e'%erime"tatio"
3it$out e'%!iit3it$out e'%!iit
o"se"to"se"t No a(a"do"me"t ofNo a(a"do"me"t of
%atie"t%atie"t A!3ays &i)e &e"era!A!3ays &i)e &e"era!
i"strutio"si"strutio"s
="dersta"di"& i" t$e="dersta"di"& i" t$ematter of feesmatter of fees
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MEDICAL MALPRACTICELIABILITY INS=RANCE
LI(#ILI'*C&N'$(C'INS)$(NCE
Indemnity orFull Coverage
Insurer can only beliable for the fullamount of coveragein the policy