L. Medicolegal Aspects

In the current climate of increasing medical litigation, it behooves every physician to be prudent in order to prevent legal action. The shift in responsibility for the management of more and more patients with COPD from pulmonary specialists to primary care physicians brings with it certain litigious pitfalls all should know. These are listed in Table 12. It should be emphasized that the corrective actions proposed are not self-serving, but actually improve the quality of patient care.

Perhaps the most frequent cause of medicolegal dispute –one that concerns all patients, not just those with COPD–is failure to adequately document all contact with and advice given to patients. Particular problems in this regard that do involve patients with COPD concern poor compliance with the treatment regimen, including failure to quit smoking, and side effects of drugs, especially long-term corticosteroids. Failure to hospitalize, failure to refer for consultation, and failure to recognize non-COPD pulmonary diseases or COPD-associated complications are other potential causes of litigation that are dealt with elsewhere in this monograph.