The practice of medicine and surgery has become more than the day-to-day practice of good medicine and surgery. Lawyers and regulators are hovering, waiting to pounce upon any opportunity to profit from any breakdown in the doctor-patient relationship.

“Third-party” predators can be government agencies, health insurance companies, members of the legal profession, ex-spouses, and former practice associates. So, how does a physician minimize the possibility of becoming the target of a legal action? The answer: to make it one’s mission to understand the legal system and use every available resource to defend oneself against it. The following are points extracted from a presentation I frequently give at continuing education conventions and seminars to colleagues.

“The first thing you have to do to win is to keep from losing.” So said one of the winningest coaches in college football history, Coach Paul “Bear” Bryant. The coach’s secret to success applies in the medical profession, as well. So, how does a physician/surgeon “keep from losing”? The answer is by preparing for the day they might have to defend themself in a court of law or before a panel investigating accusations of wrongdoing.

The truth is that in the 21st century, there is a good chance that doctors have been—or will be—sued at some point in their career. You do not have to do something “wrong” to find yourself as a defendant in a malpractice suit; however, if/when you find yourself in the position of a defendant, it should be viewed as an act of war. You are fighting for your reputation. Take no prisoners. You are expected to fight fairly, but enter the arena with one though in mind: to win!

Immediately notify your malpractice insurance carrier that you either have received notice of a lawsuit, or may be expecting notification.

The plaintiff (usually a former patient) will be represented by an attorney. That attorney will hire an “expert witness” (usually a doctor in the same field of medicine/surgery as you). The plaintiff’s expert’s task it is to destroy your credibility. If that expert has been hired, you can bet they are prepared to testify-under oath—that you have committed “malpractice”; otherwise, the case will not get to trial.

Leading up to that day your role is to teach your own attorney about the medicine/surgery of the case and become your own best advocate.

If you have done the things you should have done—as the president/CEO of your practice—the medical record will have been prepared for this day. From the first time the patient/plaintiff called your office to the last, every encounter, every conversation, every element of the treatment you provided will be accurately and legibly recorded in the patient’s medical record.

Upon receiving notice of a suit, you should carefully study the entire record of the patient/plaintiff. If you discover a glaring error in the record and wish to “amend” it, make the correction in the margin or underneath the entry and write the word Addendum first; then enter the correction. Initial and date the entry. Never, ever, alter the medical record. Never erase or deface a previous entry. In the eyes of a jury, doing so amounts to an admission of guilt. Juries have been known to impose massive monetary judgments against doctors who attempted to alter the record or cover up evidence.

If you have contacted your malpractice carrier, you will have been told to make a complete and accurate copy of the medical record and file the copy in a safe place, away from the usual medical record storage site or location. Identify the copy-in bold print-“IN ANTICIPATION OF LEGAL ACTION.”