title: Nine medico-legal pitfalls in inflammatory bowel disease in the United States.
abstract: The optimal care of patients with inflammatory bowel disease depends on adherence to standards of care regarding diagnosis, informing the patient of potential risks of treatment, obtaining recommended baseline studies, and monitoring the patient for efficacy and adverse effects. In clinical research as well as practice, financial conflicts of interest must be disclosed and managed to insure that patients have sufficient information to make a decision regarding participation in a study and to insure their safety. Medical education of care-givers in training carries the obligation and liability to oversee the care of the IBD patient and insure that safe and optimal care. This review addresses medicolegal issues that can arise in the care of the patient with IBD. Clinicians who provide optimal care for patients with inflammatory bowel diseases (IBD) must employ appropriate diagnostic and therapeutic options and also adhere to standards of care and ethical principles. Ethical and medicolegal issues can arise from the failure to adhere to the standards of medical care, clinical research and education. In a report in the New England Journal of Medicine in 2011, gastroenterologists in the U.S. ranked 6th out of 26 subspecialities as the most commonly sued for malpractice, with the mean payment to the plaintiff of just under $200,000 [1]. It is noteworthy that two other specialties that involve invasive procedures ranked lower on the list than Gastroenterology. For example, Cardiology and Anesthesiology ranked 11th and 17th, respectively. In this review, nine of the pitfalls to adherence to the standards of practice for IBD are reviewed.
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, 200 1st St, S.W., Rochester, MN 55905, USA. tremaine.william@mayo.edu.
authors.forename: William J
authors.initials: WJ
authors.lastname: Tremaine
mesh_terms: D005762:Gastroenterology / Q000941:ethics* / Q000331:legislation & jurisprudence / Q000592:standards; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000628:therapy*; D008318:Malpractice; D010349:Patient Compliance; D017410:Practice Guidelines as Topic; D059039:Standard of Care / Q000941:ethics* / Q000331:legislation & jurisprudence; D014481:United States; D000078329:Workforce