Professional Liability Pertinent to Graduate Medical Education: The Intersection of Medical Education, Patient Care, and Law.

Physicians in training, nurse practitioners, physician assistants, attending physicians, and institutions that sponsor medical education are all at risk for potential professional liability issues. The unique relationship between healthcare providers and their sponsoring institution generates complex and evolving legal issues for all participants in medical education training. The law has played a great role integrating quality care and patient safety with excellent medical education for training physicians, while providing an avenue for relief when a medical error occurs.

Liability of physicians supervising nonphysician clinicians.

Physicians confront a variety of liability issues when supervising nonphysician clinicians (NPC) including: (1) direct liability resulting from a failure to meet the state-defined standards of supervision/collaboration with NPCs; (2) vicarious liability, arising from agency law, where physicians are held accountable for NPC clinical care that does not meet the national standard of care; and (3) responsibility for medical errors when the NPC and physician are co-employees of the corporate enterprise. Physician-NPC co-employee relationships are highlighted because they are new and becoming predominant in existing healthcare models. Because of their novelty, there is a paucity of judicial decisions determining liability for NPC errors in this setting.

The challenges to transparency in reporting medical errors.

In an ideal health care environment, physicians and health care organizations would acknowledge and factually report all medical errors and "near misses" in an effort to improve future patient safety by better identifying systemic safety lapses. Truth must permeate the health care system to achieve the goal of transparency. The Institute of Medicine has estimated that 44,000 to 98,000 patients die each year as a result of medical errors.

The healthcare crisis: competition is the problem and the solution.

When judged by any responsible national or international criteria, the U.S. healthcare system has reached the point of crsis.

Changing perspectives in medical practice: disruptive innovation.

Disruptive innovation represents a business model that identifies a market location and increases consumer options. Retail clinics may represent a disruptive healthcare innovation that identifies strategies to reduce the cost of healthcare at the primary care level. The future of healthcare demands disruptive innovation that will allow for the 50 million uninsured members of our society to receive medical care.

The fundamentals of liability insurance: physician and organization perspectives.

Professional liability insurance is critical to physicians to protect their assets. Current medical practice reveals that most physicians will experience an allegation of negligence during their medical practice lifetime. Professional liability insurance is a contract between the physician and the insurance company.

Optimal medical outcomes with limited liability: risk management principles for medical practices at the intersection of medicine, law, and business.

Physicians practice at the intersection of medicine, law, and business. Each discipline creates its own challenges for the practicing physician: to practice efficient, effective medicine; to limit potential liability; and to create a positive financial outcome. Those challenges increase with escalating costs and reduced reimbursements.