Author + information
- Daisy F. Lazarous, MD,
- Brenda L. Hindle, MS, MBA and
- William J. Oetgen, MD, MBA∗ ()
- ↵∗American College of Cardiology, 2400 N Street NW, Washington, DC, 20037
Dr. Badri makes some cogent points in his recent opinion piece, “Medical Malpractice Litigation: A Fellow’s Perspective” (1). We, too, are concerned with trainees’ lack of knowledge of medical professional liability (MPL) issues. We also agree with Hochberg et al. (2) that this is a topic that should be part of the professionalism education for all residents and fellows-in-training (FITs), and we suggest that having an understanding of MPL is part of achieving competence in systems-based practice as well.
MPL may not be a topic of significant attention in most cardiology fellowship programs, but it is recognized as a small, but real, part of the cardiology curriculum. The American Board of Internal Medicine (ABIM) lists professional liability as a topic for a proportion (<2%) of questions on its cardiovascular disease (3) and interventional cardiology certification examinations (4). Interestingly, MPL is not currently treated in the blueprints of the certifying examinations in advanced heart failure and transplant cardiology or in clinical cardiac electrophysiology.
In an effort to fill this gap in training for FITs, the American College of Cardiology (ACC) has created an opportunity for all interested FITs to learn the basics of MPL. In a voluntary educational research project, FITs may agree to participate in the testing of an online self-assessment program that has been approved by the Institutional Review Board of MedStar Health Research Institute in Washington, DC. The “Fellows-in-Training Patient Safety and Risk Management Study” may be accessed online as a self-paced program that is designed to take approximately 10 to 12 h to complete (5). Approximately 30 FITs have volunteered for the project to date. FITs who are interested in learning more may contact the authors.
Non-FIT members of the ACC may access the same MPL curriculum with the Patient Safety and Risk Management Self-Assessment Program, which provides up to 12 h of continuing medical education and continuing education credit and 10 points of ABIM medical knowledge maintenance of certification credit.
Finally, we would quibble a bit over the term medical malpractice employed by Dr. Badri. The term preferred by the Physician Insurers Association of America and the National Association of Insurance Commissioners is medical professional liability. This is because the term medical malpractice is, in itself, prejudicial and potentially deleterious to physicians who find themselves involved in a legal action. The phrase MPL has the beneficial characteristic of precision without the negative connotation of negligence on the part of the physician. Culpability should not be the presumption in these cases because no fault is found or payment made in 82% of MPL claims brought against cardiologists.
Please note: Dr. Lazarous is on the Advisory Board of Amgen. Dr. Oetgen and Ms. Hindle are employees of the American College of Cardiology.
- American College of Cardiology Foundation
- Badri M.
- ↵American Board of Internal Medicine. Cardiovascular disease certification examination blueprint. Available at: http://www.abim.org/pdf/blueprint/card_cert.pdf. Accessed October 28, 2014.
- ↵American Board of Internal Medicine. Interventional cardiology certification examination blueprint. Available at: http://www.abim.org/pdf/blueprint/icard_cert.pdf. Accessed October 28, 2014.
- ↵Oetgen WJ, Flannery FT, Fletcher B, Donnellen J. Fellows in training patient safety and risk management study. Available at: http://www.cardiosource.org/Lifelong-Learning-and-MOC/Certified-Learning/SAPs/2013/FIT_RMSAP.aspx?w_nav=Search&WT.oss=Patient%20Safety&WT.oss_r=6376&4. Accessed October 29, 2014.