Follow these 5 documentation tips to avoid future malpractice allegations:
- Always maintain thorough and detailed records of care, patient communication, and communication with additional providers.
- Create a standardized approach to documentation, and maintain the same record standards for every patient.
- Include narrative descriptions to patient records.
- Document a detailed account of informed consent and informed refusal discussions.
- Maintain healthy working relationships with other providers.
Author(s)
Stuart J. Oberman, Esq.
Stuart J. Oberman is the founder and President of Oberman Law Firm. Mr. Oberman graduated from Urbana University and received his law degree from John Marshall Law School. Mr. Oberman has been practicing law for over 30 years, and before going into private practice, Mr. Oberman was in-house counsel for a Fortune 500 Company.
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