Malpractice

Abstract: List of Figures List of Tables Preface Part I: Service by Professional Police Officers 1. Two Transformations in Police Upgrading Police Work * The Transformation toward Professional Police Administration * The Transformation toward Professional Police Officers * The Pace of the Two Transformations * What Makes a Good Police Department? * Overview of the Book 2. Overcoming Inertia Resistance to Change * Critique from the Perspective of Professional Administrators * Fear of Change * The Commissioner * Overcoming the Fear of Change * Opportunities and Resources for Growth * Civil Service and Union Impediments * Leaving the Cowpath for New Roads * Authority over Police 3. Patrol Officers: General Practitioners Who Make House Calls The Diverse Work of Patrol * Skill in the Use of Discretion * Police Service as Evaluated by Recipients * Response Time as a Misused Performance Measure * Consumer Demand as a Rough Measure of Consumer Satisfaction * The Long, Hard Road to Open Exercise of Discretion 4. The Hospital Model Insights from Organization Theory * An Overview of the Hospital Model * The People Attracted to Police Work * Increasing Individual Accountability * Weak Departmental Accountability * Increasing the Skills and Status of Police Officers * Similarities between Policing and Public Health Medicine Part II: Coping with Crime 5. Arrests Legal Arrests * Proper Treatment of Prisoners * A Broad Base of Public Involvement * Arrest Performance * Organizational Changes to Facilitate Burglary Arrests * Court Outcomes of Arrest * Using the Hospital Model to Produce New Patterns of Arrest 6. Solving Crime Problems The Crime Index as a False Performance Measure * Preventing Crimes by Working with Youth * Reducing the Access of Potential Offenders * Crime Prevention through Work with Potential Victims Helping Victims 7. From Fear of Crime to Sense of Safety Wave of Fear * Throwing Manpower at Crime * A Building to Radiate Crime Prevention * Crime Problems and Fear Problems * Explaining the Sense of Safety from Criminal Attack * A Conflict over Crime News * Police Programs to Promote a Sense of Protection * Friendly Relations to Promote a Sense of Protection Part III: Police Power 8. Police Malpractice Instances of Police Malpractice * Shortcomings of Disciplinary Systems * Estimating Levels of Malpractice * Systematic Promotion of Professional Practice 9. Union Power Union Perspectives * Union Solidarity * Bread-and-Butter Issues * Protecting Members from Management * Police Associations in Various Arenas * Contractual Impediments to Enhancement of Service * Contractual Support for Professional Service * The Structural Basis of Union-Management Power Struggles 10. Political Accountability versus Political Interference Interference in Personnel Matters * Distinctions between Political Accountability and Interference * The Political Context of Directing a Police Department * Appointment of a Police Manager as a Tool for Accountability * Limited Accountability through the Budget Process * Elections: Confusion without Accountability * Interference and Accountability Exercised by the City Council * Summary of Accountability on Service * Summary on Police Power Part IV: Excellence in Police Service 11. Building Bridges between Police and Public Peaceful Use of the Streets by Everyone * Officers and Citizens Being Human Together * Common Misguided Attempts to Build Bridges * Four Fundamental Ways to Build Bridges * Police Officers and Citizens as Part of the Same Community 12. Fairness Fairness in Law Enforcement * Fairness in the Provision of Service * Learning the Courage of Commitment * Structures to Increase Fairness Appendix: Some Worthwhile Questions Bibliography General Index Author Index

Abstract: Disruptive physician behavior imperils patient safety, erodes the morale of other health care providers, and dramatically increases the risk of malpractice litigation. Increasing patient volume, decreasing physician reimbursement, malpractice litigation, elevated stress, and growing job dissatisfaction have been implicated in disruptive behavior, which has emerged as one of the major challenges in health care. Because the aging patient population relies increasingly on orthopaedic services to maintain quality of life, improving professionalism and eradicating disruptive behavior are urgent concerns in orthopaedic surgery. Although many steps have been taken by The Joint Commission to improve patient care and define disruptive behavior, there is further room for improvement by physicians. Barriers to eliminating disruptive behavior by orthopaedic surgeons include fear of retaliation, lack of awareness among the surgeon's peers, and financial factors. Surgeons have a duty to address patterns of negative peer behavior for the benefit of patient care. This manuscript addresses the causes and consequences of disruptive physician behavior as well as management strategies, especially in orthopaedic surgery.

Abstract: Radiology is among the specialties with an increasing risk of litigation Regardless of the outcome of legal proceedings, physicians who are sued usually perceive the claim as an assault on their integrity and may suffer psychological or physical effects known as “malpractice stress syndrome” Two hundred and six radiologists and 108 radiotherapists responded to a questionnaire containing specific items concerning their perception of malpractice stress and their opinions about the causes of clinical errors, as well as an assessment of work satisfaction and general health One third of physicians had been sued for malpractice Age was significantly related to the occurrence of malpractice litigation Radiological errors were purportedly related to occupational discomfort, and the latter variable was significantly associated with work dissatisfaction and a low level of psychological and physical well-being Radiologists are well acquainted with medical malpractice and its causes; however, they have limited familiarity with clinical risk management practices and often ignore procedures of informed consent A targeted educational effort is required to overcome these shortcomings

Abstract: Two decades of social science research on the outcomes of medical malpractice claims show malpractice outcomes bear a surprisingly good correlation with the quality of care provided to the patient as judged by other physicians. Physicians win 80% to 90% of the jury trials with weak evidence of medical negligence, approximately 70% of the borderline cases, and even 50% of the trials in cases with strong evidence of medical negligence. With only one exception, all of the studies of malpractice settlements also find a correlation between the odds of a settlement payment and the quality of care provided to the plaintiff. Between 80% and 90% of the claims rated as defensible are dropped or dismissed without payment. In addition, the amount paid in settlement drops as the strength of the patient’s evidence weakens.