A Well-planned Patient Selection Process Is a Valuable Tool

Many medical malpractice claims occur with patients who request elective procedures and are then dissatisfied with the outcome. A well-planned patient selection process can not only be a valuable tool for loss control, but it can also help identify patients who are good surgical candidates. During the initial visit, asking the following questions may help avoid the stress and disruption of a lawsuit or an adverse outcome:

• Is this a repeat surgery or repair of another physician's work?
• Does the patient's spouse or significant other know about the procedure?
• If yes, does he or she agree with the decision for surgery? If not, why?
• Is the patient financially able to handle the costs associated with the procedure and any additional procedures?
• Is there a history of compliance with pre- and post-op instructions?
• Is the patient a smoker? If so, can he or she desist from smoking for the period of time necessary for maximum healing?
• During the past two weeks (or in the two weeks prior to surgery), has or will the patient experience periods of extended sedentary situations (e.g., long flights, bed rest, extended car rides, etc.)?

It is always beneficial to assess the patient's body language behavior. Red flags that may warrant additional assessment include, but are not limited to, the following:

• Patient appears angry and hostile and exhibits negative facial expressions.
• Patient is resentful of questions and makes defensive short or one-word responses.
• Patient has unrealistic expectations.
• Patient blames another physician for previous treatment.
• Patient appears to be engaged in "doctor shopping."

Better integration of the patient's voice in the selection process, as well as increased personal attention to each patient, may help minimize the potential risks of the surgical outcome.