7 malpractice risks in radiology and how to mitigate them

Malpractice suits may be an unfortunate reality for radiologists, but although they are a threat, they may also present an opportunity to improve imaging protocols, according to an article published September 22 in Academic Radiology.

Reducing radiologists' vulnerability to medical malpractice litigation starts with a thorough assessment of risk, wrote a team led by Christina Sumner, DO, of Emory University in Atlanta. The group offered a list of at least seven liability risks in radiology and suggested ways to mitigate them.

"By understanding the challenges and opportunities [medical malpractice suits present], radiologists can more effectively work toward solving and lessening [the issues that result in these suits]," it noted.

The impetus for medical malpractice litigation can be complicated, impacting both radiologists and patients, the team wrote.

"[Inappropriate] imaging utilization can lead to higher radiology workload and higher health care costs," they wrote. "In addition, inappropriate imaging utilization can pose unnecessary risks to patients, such as exposure to ionizing radiation, procedural complications, and risk of further workup for incidental findings … On the other hand, a review of malpractice suits and their effects on medical practice can uncover opportunities for improvements, such as establishing evidence-based practice standards in radiology and other medical specialties, as well as closing the communication and completion loop on actionable findings."

Most suits in the U.S. against radiologists result from errors in diagnosis and failure to communicate findings or recommend additional testing, according to the researchers. They referred to a 2021 Medscape study that reported that 71% of radiologists have been named in a lawsuit, putting it ninth among the top 10 sued medical specialties.

Sumner's group outlined liability risks radiology may face and offered suggestions for avoiding them:

Liability risks in radiology and ways to reduce them
Liability risk Mitigation approach
CT and MRI protocols Include protocoling in graduate medicine education and adopt protocol algorithms for technologists
Fatigue Improve workflow and reading room environment; use AI tools
Knowledge gaps Offer continuous education, peer learning, and ways to improve search patterns; compare exams with priors
Bias Offer reflective reasoning training, double reading, and peer learning; compare exams with priors
Communicating critical results Track results reporting and feedback
Communicating noncritical but actionable findings Establish "closed loop communication," follow-up tracking; use AI tools
Incorporating outside study second reads Establish a policy for handling outside studies as either reference or as second reads

"Medicolegal liability concerns can directly affect radiologists' practice or can indirectly affect radiologists through clinicians' defensive test ordering practices," the group concluded. "As a result, patients may be harmed physically, emotionally, and financially. Several mitigation strategies exist and could be pursued to minimize such adverse outcomes for patients."

The complete article can be found here.

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