8 What outcomes are associated with the nondisclosure of medical error to patients? Nondisclosure is associated with (1) an increased likelihood of the patient seeking to change physicians, (2) a reduced satisfaction and trust of the physician, (3) an increased likelihood of the patient seeking legal advice, and (4) more negative emotional responses from the patient.1,2 What two simple things should a physician do when medical error has occurred under his or her care? A physician should always (1) explain the error, and (2) acknowledge responsibility. What outcomes are associated with full disclosure of medical error to patients? Full disclosure is more likely to have a positive effect or no effect on how patients respond to medical errors and the patient-physician relationship.1,2 In comparison to leading causes of death (i.e., heart disease, cancer), how common is medical error as a cause of death? Medical error is the eighth most common cause of death. Approximately how many patients die annually due to preventable medical error in the U.S.? In the U.S. an estimated 44,000 to 98,000 patients die annually from preventable medical errors. What is meant by “authority gradient?” In medicine, there are many situations when a house staff member may have had concerns with some aspect of therapy, but because the order or suggestion comes from a senior faculty physician, they lack confidence to question it. What is the most feared complication caused by an “authority gradient?” Medical error. How does the denial of stress in medicine affect patient outcome? The denial of stress and its effects on performance, although allowing one to adapt to medical school and residency, increases the likelihood of medical error and decreases the likelihood that officials may confront the issues and use threat and error management strategies to resolve the situation. What is Medicare? Medicare is a U.S. government–administered insurance program that provides health insurance coverage to those U.S. citizens aged 65 and older or those under 65 who meet other specified conditions.3,4 How is Medicare structured? Since this program was first signed into law in 1965, the original two-part benefit plan has been expanded to include parts A, B, C, and D, describing different areas of coverage.3,4 What are the criteria necessary for one to receive federal aid through Medicare? General criteria for eligibility for federal aid through Medicare includes: 1. U.S. citizenship or legal residency in the U.S. for 5 consecutive years 2. Age of 65 years or greater or i. Disability qualifying the patient under 65 years of age for either Social Security benefits or Railroad Retirement Board disability benefits for 24 months or greater or ii. A need for dialysis or kidney transplantation to treat complications of renal failure in a patient under 65, or finally, 3. A diagnosis of amyotrophic lateral sclerosis (ALS) in a patient under 65 What is the function of Medicare Part A? Coverage for hospital stays, including care received from skilled nursing facilities or while under home health care or hospice care. What are the four conditions placed on the eligibility of coverage by Medicare Part A?
Medicolegal Aspects
8.1 Error Disclosure
8.2 Patient Insurance (Medicare/Medicaid/HMOs/PPOs)
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