What I’ve Learned as a Physician on Copic's Risk Management Team—Alan Lembitz, MD, Senior Medical Director
“Patients have no idea all the things you’re doing for them when you’re not in the exam room.”
Dr. Alan Lembitz’s early years of practice in the ’80s and ’90s included community‑based emergency medicine and urgent care. During his medical training, he connected with Rich Quinn, MD, who was part of Copic’s initial risk management team. This relationship led to Dr. Lembitz becoming a part‑time consultant to Copic in 1999. In 2002, he joined Copic full‑time and since then, he has interacted with insureds and the medical community in numerous ways—participating in medical resident programs, answering Copic’s 24/7 risk management hotline, giving countless presentations, and working with nationally recognized medical organizations. In a conversation, Dr. Lembitz shared some key insights about what he has learned over the years.
The vast majority of patients appreciate your efforts on their behalf and present a low risk. It’s more about a few patients who can present enormous risk. Low frequency, high severity events are what drive medical malpractice claims. Most of the chronic care and scheduled visits have almost no risk. It’s the acute visits where there is a narrow window of opportunity to recognize a diagnosis that a patient is deteriorating from, and intervene.
One of the best things you can do is know the high‑risk scenarios for your medical specialty. A lot of the education Copic develops focuses on the issues related to a specific specialty and setting. We look at the complexity and elements of risk not just at the individual provider level, but also at the medical team, system, and organizational level.
The level of risk is driven by what types of cases plaintiff attorneys are pursuing. Experienced plaintiff attorneys turn away the majority of patients who come to them and focus on selecting the key cases that are most likely to get them a settlement or jury award.
What is rare for most physicians is common for Copic. We see the really difficult, the really interesting, and the really rare cases. These cases often have similar patterns and issues, and we take this insight to develop meaningful resources and programs.
I think the biggest misconception is that people think lawsuits are about training, experience, or knowledge. It is rare that we see a physician who has an incident because of inadequate training, experience, or knowledge. Instead, the issues tend to involve information, relationships, or communication.
For cognitive, non‑procedural physicians (e.g., internal medicine, hospitalists, emergency medicine), it’s often about a lack of information. They have gaps in critical information. It can be about not communicating or listening. You need to make sure you have good communication. Make sure you’re getting all the information and review what you have. And do the appropriate workup or referral, and ensure that the patient understands what you’re doing and why.
For procedural physicians (e.g., surgeons, cardiologists, radiologists), another misconception is that it’s all about how well you do the procedure. Instead, there are three areas to focus on:
- The consent process—discussing the risks and benefits through a shared decision‑making process with patients where they understand and share those risks;
- Setting expectations that are aligned with actual outcomes;
- Recognizing any complications and responding in a timely manner to rescue the patient.
We teach closed loop communication and a great tool is to ask “can you repeat back to me what you heard?” It’s really valuable because it’s surprising how often what you think you said was not what got through to the patient. From a patient’s perspective, they’re stressed, they’re concerned, and they may not be in the best cognitive state.
My advice to young physicians would be to spend less time in front of the computer screen and more time in front of the patient. Relationships matter. Reviewing information allows you to have a discussion and helps the patient feel you are being comprehensive and paying attention. It also allows you to clarify details, which is critical. Narrate your thought processes and document them, because we can defend reasonable care even when outcomes might be adverse.
The information provided herein does not, and is not intended to constitute legal, medical, or other professional advice; instead, this information is for general informational purposes only. The specifics of each state’s laws and the specifics of each circumstance may impact its accuracy and applicability, therefore, the information should not be relied upon for medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation.
Article originally published in Copic’s Copiscope 1Q26 newsletter.
