During the lecture, “Mitigating Malpractice: A Complete Guide for Optometrists,” Paul C. Ajamian, OD, discussed the 7 reasons for malpractice lawsuits and provided 9 tips on how ODs can avoid them. The presentation occurred Feb. 26, between 9 AM and 11 AM, in the Georgia World Congress Center, 305.
“Optometrists who perform complete exams and who document in detail are far less likely to get sued,” Dr. Ajamian notes of the presentation. “Making sure you explain vision that is not correctable to 20/20, dilating every patient, and carefully examining the optic nerve in stereo will ensure that you will stay out of trouble.”
Seven Reasons
Dr. Ajamian, an expert witness for the defense in 20 cases (nine of which have taken place in the last five years), cited these reasons for malpractice lawsuits:
- Failure to diagnose: 31%
- Patient suffered an abnormal injury: 31%
- Failure to treat: 12%
- Errors in medication administration: 4%
- Poor documentation of patient instruction and education: 4%
- Failure to follow safety procedures: 3%
- Improperly obtaining/lack of informed consent: 3%
Nine Tips
In recognizing the aforementioned reasons, Dr. Ajamian provided these 9 tips for preventing them, along with cases that reinforced the proper diagnosis and management of commonly seen ocular diseases, such as glaucoma.
- Explain that VA is not correctable to 20/20.
- Dilate! Dilate! Dilate!
- Review your record keeping.
- Always perform your “core” exam in the same order on every patient, every time!
- Get good at gonioscopy/don’t miss chronic open-angle glaucoma.
- Communicate with patients/family members from the start regarding all suspicious findings, etc.
- Make appointments for patients, schedule lab tests for patients, send letters on what you want, and document all of it in great detail.
- Don’t miss that glaucoma!!! Do the baseline tests necessary to protect yourself and the patient!
- Cover your own call or have a friendly colleague cover for you!
“Don't get hung up on IOP numbers and get lulled into complacency if the number is below 21,” Dr. Ajamian asserts. “Look at the nerve, perform ancillary tests early, and treat the patient aggressively. Up to 50% of patients with chronic open angle glaucoma have pressures under 20!” OM
My Atlanta Hot Spot
“There are 2 places that very few people know about that I love. One is the Gone with the Wind exhibit in Marietta, and the other is the Southeastern Railway Museum in Duluth,” says Dr. Ajamian. The latter has “actual old trains that you can board and old artifacts, and you can take the kids for a small train ride!"
