When reporting their findings, it is common to see consulting physicians recommend further testing. Absent such an explicit recommendation, a patient’s decision to bypass conservative measures can spell trouble for all.

When communicating with patients, a physician’s “custom and practice” as to what he or she advises is often an acceptable substitute for granular detail in a chart entry. But when the physician departs from his or her custom and practice, it’s easy for things to go wrong.

Physicians with patients on pain medication regimens are often attuned to signs of drug abuse. Multiple-drug interactions and simple overuse should also be a concern.

Envision a scenario in which an adult brings a minor into your office. During check-in, it is revealed that the minor does not live with their parents but “lives with” the adult accompanying them. The adult in question could be an aunt, a grandparent or a cousin. Having a minor “live” with them does not mean for an afternoon, weekend or while the parents are on vacation. It means the parent is actually “absent” perhaps living in another state, country or maybe in jail; therefore, the minor lives with this person.

There will always be noncompliant patients. Physicians treating those patients need to foster a heightened sense of danger.