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Adolescent autonomy and privacy are affected by a tangled web of state and federal laws that clinicians are expected to know and abide by. As a rule, adolescent patients cannot give consent for their own medical treatment before they reach the legal age of majority, which, in most states, is 18. The circumstances in which adolescent patients can consent to their own medical treatment vary by state; however, most states have consent exceptions based on an adolescent’s legal status (e.g., married, emancipated) and select medical conditions (“sensitive medical conditions”).

An adverse drug event (ADE) is defined as “harm experienced by a patient as a result of exposure to a medication.”¹ The Institute of Medicine says an ADE is “an injury resulting from a medical intervention.”² Like any adverse event, occurrence of an ADE does not necessarily indicate an error or poor quality care. However, adverse drug events account for nearly 700,000 emergency department visits and 100,000 hospitalizations annually.¹

Running a medical practice involves making business decisions that can increase the risk of adverse patient outcomes, professional liability, and regulatory violations. Yet, the skills and training that support conscientious, excellent medical care do not always facilitate skilled business decision-making.^1,2

Physicians sometimes call NORCAL Group Risk Management department for advice after a patient has posted a negative review online. Some callers want confirmation that fighting back in court or online is appropriate, but these seemingly satisfying solutions can backfire.

Issuing a refund or reimbursement to a dissatisfied patient may seem like a simple solution to a potentially complicated problem. However, there are many different issues to consider that may not be immediately apparent.