Notwithstanding the usual suspects that hinder electronic medical record implementation — initial costs, interoperability problems, training burdens, and altered physician-patient dynamics — there’s also the risk of a pure system malfunction. In a malpractice suit after an admitted malfunction, a physician’s actions will still be scrutinized.

The Court of Appeal has found a substantial basis for a physician’s second-degree murder convictions arising out of the doctor’s drug prescriptions to three patients. By articulating the “implied malice” required for the convictions, the appellate court explained how circumstantial evidence of the physician’s state of mind could be accepted by a jury to convict the physician of murder.

If there is a list somewhere of phrases that will spur disagreement among physicians, certainly “curbside consult” would be included. One case shows how easy access to electronic health records can affect how involved a physician will be perceived in a particular case. A young mother was on hospital premises with her son, who was being treated for Mast Cell Activation Syndrome. The mother began to experience acute illness and self-injected two doses of epinephrine, which she carried because of her own history of anaphylaxis.

When the medical approach to a particular situation differs among healthcare providers within a practice, such conflict may surface later – in litigation. A 50-year-old teacher visited the medical group of his family care physician because of chest pain and a cold. With his regular physician out of the office that afternoon, the gentleman was seen by a physician assistant.

The California Supreme Court has wrested back into the workers’ compensation system a claim of medical malpractice by a worker who alleged injury from a utilization review decision. The case overrules a lower court decision handed down in 2016.