Behavioral Science

182 Deja Review: Behavioral Science
What four elements in a malpractice
case must exist in order to find liability
with the treating physician (otherwise
referred to as the 4 D’s)?
How is a deviation from standard
of care decided upon?
What is the best way to avoid
a malpractice suit?
When can a physician become impaired?
Is it acceptable to work with an
impaired health-care provider?
How does a physician’s human
immunodeficiency virus (HIV) status
affect his or her ability to practice
medicine?
Duty: There must be an established
doctor-patient relationship.
Deviation or dereliction: Treatment
strayed from established standard of care.
Damages: Physical, psychological, or
social damage was done.
Direct cause: Damages were caused
directly by negligence or dereliction.
A jury decides if there has been a
deviation from the standard of care.
The jury makes this determination based
upon testimony of one or more expert
witnesses who testify as to the standard
of care as generally recognized by the
medical community and how the
defendant deviated from that standard
of care.
If an error is made, admit when you are
wrong and apologize to the patient.
Maintain a healthy physician-patient
relationship.
Keep current with standards of care.
When clinical judgment is affected by
the following:
• Physical illness
• Mental illness
• Substance abuse
No. It is the ethical duty of a physician
to report an impaired health-care
provider to the proper authorities.
Under the American Medical Association
(AMA) ethical guidelines, an HIV
physician should not engage in any
activity that would put a patient at risk
of contracting HIV (eg, an HIV-positive
surgeon may be precluded from
practicing surgery. Some states require
that an HIV-positive physician disclose,
as part of the informed consent process,
his or her HIV status before engaging in
an invasive procedure that would put
the patient at risk).