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Many radiology claims involve fragmented care and lack of reliable information with which to support clinical decisions, which leads to patient injury. Quality improvement programs (QIP) can increase patient safety, decrease liability risk and increase practice revenue.¹

Some (fortunately rare) patient actions, such as a patient’s threat to harm a physician, call for immediate termination with no intermediate treatment period. Other patient actions, such as non-payment of bills or noncompliance with care recommendations, are reasons for termination but do not eliminate a physician’s duty to give a patient sufficient notice to obtain alternative medical treatment. Consider the following case, in which the physician believed the patient’s initiation of legal action against his partner justified his immediate termination of the patient relationship.*

Incidental findings of lung nodules are common and frequently missed. Many of these missed nodules are clinically irrelevant.¹ However, when a patient who is diagnosed with advanced lung cancer discovers there was an unreported incidental finding during a period when the lung cancer was treatable, a negligence claim is likely. Consider how improved communication could have affected the outcome of the following radiology case study.

Misdiagnosed breast cancer is one of the most common claims against radiologists.¹ Although much of the onus for ensuring that follow-up occurs is on the referring physician, all providers involved in the patient’s care should establish and then follow policies on communication of radiologic diagnosis and testing. Had communication roles been clear, this patient’s breast cancer could have been discovered earlier and a lawsuit could have been averted.

“Practice drift” or “physician drift” are terms used to describe the phenomenon of physicians practicing outside their specialties. The drift to cosmetic procedures is a popular one, possibly in part because such procedures are performed on a patient self-pay basis. When insurance reimbursements don’t keep pace with overhead costs, cosmetic procedures can be viewed by providers as an effective way to increase practice revenue.¹ Also, there are plenty of customers for cosmetic procedures, and the number of patients and types of procedures keeps growing. According to the American Society for Aesthetic Plastic Surgery, patients spent more than 15 billion dollars on cosmetic procedures in 2016.²