Issue link: https://viewer.e-digitaledition.com/i/511155
DOES NONTRADITIONAL CLAIMS MANAGEMENT PAY? FROM 2002 TO 2013, the rates of paid malpractice claims decreased by an annual average of 6.3 percent for medical doctors and 5.3 percent for doctors of osteopathic medicine, according to a study in The Journal of the American Medical Association. For the two groups combined, the annual rate of paid claims over the entire period dropped from 18.6 to 9.9 per 1,000 physicians. The researchers, headed by Michelle Mello, JD, PhD, MPhil, of Stanford Law School, suggest that alternative confl ict resolution tactics may help medical institutions save time and money. They note, for instance, that some organizations have seen reduced claim numbers after employing those tactics. AN E X A M I N AT I O N O F 10,367 completed cases revealed that the number of mal- practice claims related to chronic pain rose from merely 3 percent of all anesthesia- related claims made in the 1980s to 18 percent of those made from 2000 to 2011. The number resulting from cases of per- manent disability, including severe nerve injury and loss of life, also rose signifi cantly, from 6 percent to 28 percent and 6 percent to 20 percent, respectively — all at a time when the total number of paid malpractice payments has declined. " T h is [dat a] sug gest s that pain medicine carries greater risk than the rest of the fi eld of anesthesiology," says Kelly Pollak, MD, lead author of the study and Assistant Professor of Anesthesiology and Pain Medicine at University of Washington Medical Center and the Seattle Cancer Care Alliance. "Being aware of these fi ndings is important … as we carefully weigh the risks and benefi ts of [certain chronic pain management] treatments for our patients." Focusing the Lens Cervical injections and opioid medica- tions were disproportionately represented among pain management techniques in the closed malpractice claims cases compared with the number of procedures reported in the National Anesthesia Clinical Outcomes Registry. As a result, best practices for the use of both have come under scrutiny, and researchers hope to reduce both the rate of claims and their severity by helping guide the development of new care standards for improved patient outcomes. By Valerie Lauer "We believe there are things that people can do differently to reduce the risk [of treat- ments such as cervical spine injections]," says James Rathmell, MD, Executive Vice Chair and Chief of the Division of Pain Medicine at Massachusetts General Hospital and Professor of Anesthesiology at Harvard Medical School. "By looking at [this] small number of malpractice claims and the trends, we can make things safer going forward." Dr. Rathmell worked as part of an inter- disciplinary group with the support of the FDA Safe Use Initiative to develop updated recommendations — released in February — for the administration of injections to aid in the management of radicular pain. These guidelines included detailed clinical considerations and suggestions for improved image guidance for physicians who admin- ister cervical spine injections. The hope is that this set of standardized best practices will improve pain management throughout the industry for increased safety, better outcomes, fewer malpractice claims and reduced claim severity. ■ Closed-claims Analysis Highlights Need for Change in Chronic Pain Management DATA FROM THE ANESTHESIA CLOSED CLAIMS PROJECT SHOWS THE NUMBER OF CLAIMS RELATED TO CHRONIC PAIN MANAGEMENT HAS INCREASED AT A RATE GREATER THAN IN OTHER AREAS OF ANESTHESIOLOGY, AS HAS THE SEVERITY OF THOSE CLAIMS. +++++++++++++++++++++++++++++ + +++ + +++ +++++++++++++++++++++++++++++ BUSINESS OF MEDICINE ❯ 1 0 | San Antonio MD NEWS ■ M D N E W S . CO M