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December 6, 2008
Fairmont Copley Plaza Hotel, Boston, Massachusetts
Course Director: Marc B. Garnick, MD
Co-Director: Lowell Schnipper, MD
The purpose of the course is to provide an up-to-date review of two aspects of four common cancers that are encountered in primary care practicebreast, colorectal, prostate and thoraciccancers that result in a disproportionate number of medical malpractice claims against physicians and hospitals. Leading faculty from clinical medicine, risk management, insurance industry, claims specialists and fellow defense malpractice attorneys will debate critical issues. The faculty is selected predominantly from Harvard Medical School and Harvard?s Risk Management Foundation.
- The first aspect will review the current approaches to screening, diagnosis, test selection and follow-up of these cancers. We will focus on the key issues facing the primary care physician and internist when he/she considers or should consider the possibility that one of these diseases may be present. These summary presentations are directed to both our physician and non-physician audience and will focus on acceptable practice standards for considering a cancer diagnosis in the primary care setting.
- The second aspect will be a discussion of medical malpractice issues that the primary care physician faces as a result of failing to diagnose these common cancers in a timely fashion. This portion of the program will analyze critical factors in processes and procedures that may be of assistance in practices to help minimize these risks and exposures. A full discussion regarding outcomes and "loss of chance" resulting from a "failure to diagnose" or "delayed diagnoses" will be presented.
The materials will be presented in lectures. A detailed multidisciplinary discussion that highlights issues to minimize malpractice claims will include members of clinical medicine, malpractice attorneys, insurance and claims professionals and risk managers. A comprehensive syllabus will be provided.
WHO SHOULD ATTEND?
Primary Care Physicians, Attorneys with a Focus on Medical Malpractice, Insurance Company Professionals involved with Medical Malpractice, Claims Professionals, Allied Health Professionals (nurse practitioners, physician assistants), Risk Management Professionals, Insurance Payors for Screening and Diagnostic Procedures, Social Workers involved in Hospital Risk Management, medical students, law students, internal medicine and family practice residents finishing their training, especially those about to enter private practice.
YOU WILL TAKE HOME
- An understanding of the appropriate use of medical history taking, screening and diagnostic tests commonly used in primary care medicine for the common cancers
- An understanding of the limitations of screening and diagnostic tests
- An understanding of the types of clinical outcomes that can occur when a diagnosis of cancer is delayed or missed in the primary care setting
- Recommendations of processes that primary care practices can implement to minimize malpractice claims
- Recommendations for improving communications between diagnostic specialties and physicians ordering tests
COURSE PROGRAM
| SATURDAY, DECEMBER 6, 2008 | |
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| 6:45 - 7:15 | Registration and Continental Breakfast |
| 7:15 - 7:30 | Course introduction and overall agenda presentation Marc B. Garnick, MD |
| COLORECTAL CANCER MODULE (Dr. Garnick moderating) |
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| 7:30 - 8:25 | Endoscopic screening, diagnosis and follow up of colorectal cancerconsiderations for the primary care physician Deborah Nagle, MD, Chief of Colorectal Surgery, BIDMC, HMS |
| 8:25 - 8:35 | Questions and Answers |
| 8:35 - 9:20 | Case Presentations and Panel Discussion: Minimizing the risk of litigation in colorectal cancer cases Case 1: Delay in ordering a colonoscopy in a patient with rectal bleeding Case 2: Establishing appropriate follow up in a patient with known colonic polyps and other pre-neoplastic lesions Panel Moderator: Helen Shields, MD, Presentation of cases and framing of questions and issues Discussants: Deborah Nagle, MD Ann Louise Puopolo, BSN, RN Atty. Ellen Epstein Cohen, JD |
| BREAST CANCER MODULE (Dr. Schnipper moderating) |
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| 9:20 - 9:50 | Mammographic screening, diagnosis and follow up of breast cancerconsiderations for the primary care physician Sue Troyan, MD, Chief, Breast Cancer Surgery, BIDMC |
| 9:50 - 10:20 | Genetic testing for breast cancerwhen and for whom? Nadine Tung, MD, BIDMC, HMS |
| 10:20 - 10:35 | Refreshment and rejuvenation* |
| 10:35 - 11:40 | Case Presentations and Panel Discussion: Minimizing the risk of litigation in breast cancer cases
Sue Troyan, MD, Chief, Breast Cancer Surgery, BIDMC Discussants: Lowell Schnipper, MD Nadine Tung, MD Jennifer Potter, MD, Primary Care Division, BIDMC, HMS Ann Louise Puopolo, BSN, RN, RMF Atty. Ellen Cohen, JD (Closing Comments from the perspective of Risk Management) |
| 11:40 - 12:20 | Advances in Information TechnologySystems that can be implemented in your practice environment to reduce risk John D. Halamka, MD, BIDMC, HMS |
| 12:20 - 1:30 | Luncheon Break with Special Presentation Special Presentation: Experiencing a medical malpractice claimthe physician’s perspective Attys. Beth Cushing and Mark Horgan, RMF |
| PROSTATE CANCER MODULE (Dr. Schnipper presiding) |
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| 1:30 - 2:00 | Expanding the role of the Primary Care Physician in Prostate CancerGetting to the diagnosis Michael Barry, MD, MGH, HMS |
| 2:00 - 2:20 | Expanding the role of the Primary Care Physician in Prostate CancerHelping with treatment choices, including active surveillance Marc B. Garnick, MD, BIDMC, HMS |
| 2:20 - 3:00 | Case Presentation and Demonstrations: Minimizing the risk of litigation in prostate cancer cases Case 1: Delayed recognition of an elevated PSAwas there any impact in outcome? Case 2: Importance of biopsy score in determining causationreal life cases Panel Moderator: Marc B. Garnick, MD Discussants: Kevin Loughlin, MD, MBA, Professor of Surgery (Urology), BWH, HMS Michael Barry, MD, Professor of Medicine, Chief Ambulatory Services, MGH Ann Louise Puopolo, BSN, RN, RMF Demonstration 1: Web based demonstration to access up to date public policy recommendations from the Physician Information Educational Resource (PIER) program of the American College of Physicians* |
| 3:00 - 3:20 | Refreshments and rejuvenation |
| LUNG CANCER MODULE (Dr. Garnick moderating) | |
| 3:20 - 4:00 | Radiographic screening, diagnosis and follow up on thoracic (lung) cancer with emphasis on controversial recent high resolution CT screening studies Mark Huberman, MD, BIDMC, HMS |
| 4:20 - 5:00 | Case Presentation and Panel Discussion Case 1: The missed 1 cm lesion on a chest x-ray obtained for evaluation of pneumoniais there any impact on outcome? Case 2: The presence of sub-centimeter lesions found on chest CT scanning: What to do (and whose responsibility is it) about the recommendations on the report? Case 3: Failure of notification to patient: A 1 cm lesion correctly identified; patient not notified; growth to 7 cm lesion 3 years later. What are the obligations? Panel Moderator: Atty. Robert Hanscom, RMF Discussants: (will address all three cases) Mark Huberman, MD Paul Spirn, MD - The radiology perspective |
ACCREDITATION
Harvard Medical School is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Harvard Medical School designates this educational activity for a maximum of 8 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
A portion of this program has been designed to meet the criteria for 3.5 hours of risk management credit in Massachusetts.
REGISTRATION INFORMATION
Tuition Fee: $550 (USD)
Reduced Fee for Physicians and Allied Health Professionals: $395 (USD)
All foreign payments must be made by a draft on a United States Bank or by Visa or MasterCard.
If paying by CHECK, please make payable to Harvard Medical School and mail with completed registration form to Harvard Medical SchoolDepartment of Continuing Education, PO Box 825, Boston, MA 02117-0825.
If paying by credit card, please register online via the REGISTER NOW! link above.
Telephone or mail-in registration with credit card payment is not accepted.
Inquiries should be directed to the above address, made by phone: (617) 384-8600, Monday Friday, 10 AM to 4 PM (EST), or by email: hms-cme@hms.harvard.edu
Upon receipt of registration a confirmation will be mailed to the address listed on the form.
TUITION REFUND POLICY
A handling fee of $60 is deducted for cancellation. Refund requests must be received by mail one week prior to the course. No refunds will be made thereafter.
COURSE LOCATION
All sessions will be held at The Fairmont Copley Plaza Hotel, 138 St. James Avenue, Boston, MA 02116 (Telephone: 617-267-5300)
ACCOMMODATIONS
Hotel rooms in Boston and Cambridge are limited. You are urged to make your reservations early. A limited number of rooms have been reserved at the the Fairmont Copley Plaza Hotel, 138 St. James Avenue, Boston, MA 02116 (Telephone: 617-267-5300 or 1-800-795-3906) until November 6, 2008. A map of Boston listing local hotels will be sent with your confirmation of enrollment. For additional housing assistance, call Boston Reservations at (617) 332-4199.
TRAVEL
Please do not make non-refundable airline reservations until you have been confirmed into your course. You can make your airline reservation by calling: the HMS Travel Desk toll free 1-877-4HARVMD (1-877-442-7863) Monday - Friday 9 am - 8 pm (EST). From outside the U.S., Canada and Virgin Islands, please call 617-559-3764.
FACULTY
| HARVARD MEDICAL SCHOOL COURSE DIRECTORS | ||
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| MARC B. GARNICK, MD Course Director, Clinical Professor of Medicine |
LOWELL SCHNIPPER, MD Course Co-Director, Theodore and Evylyn Berenson Professor of Medicine | |
| GUEST FACULTY | ||
ATTY. ELLEN EPSTEIN COHEN, JD |
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| RISK MANAGEMENT FOUNDATION OF HARVARD MEDICAL INSTITUTIONS FACULTY | ||
| ANN LOUISE PUOPOLO, BSN, RN |
ATTY. BETH CUSHING |
ATTY. ROBERT HANSCOM |
| ATTY. MARK HORGAN |
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| HARVARD MEDICAL SCHOOL COURSE FACULTY | ||
| MICHAEL BARRY, MD |
JENNIFER POTTER, MD |
JOHN D. HALAMKA, MD |
| HELEN SHIELDS, MD |
MARK HUBERMAN, MD |
PAUL SPIRN, MD |
| KEVIN LOUGHLIN, MD, MBA |
NADINE TUNG, MD |
DEBORAH NAGLE, MD |
| SUE TROYAN, MD |
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Last Updated 07.31.08
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Offered by
Department of Medicine and
Division of Oncology