Many institutions and organizations, including the
American College of Surgeons, supplement resident
education with training in the areas of finance, professional liability, insurance, and other topics relevant to
practice management. Many residency programs also
try to address these topics in day-to-day training and
provide some real-world scenarios that can help prepare
residents for the business realities of surgical practice.
Training institutions also have morbidity and
mortality (M&M) conferences, which encourage surgeons and residents to take responsibility for the role
in a negative outcome or a near-miss and provide an
opportunity for colleagues to learn from the experience. Sometimes at these M&M meetings, attending
surgeons and residents discuss the importance of documenting our actions with the same gravitas that we
discuss the actions themselves in order to emphasize
the need to record information in a patient’s chart.
Unfortunately, even with this emphasis on recording patient information, residents walk away from these
meetings without a full understanding of the importance of documentation in determining the outcome
of a medical liability lawsuit or as evidence for use in
a deposition. With that in mind, the surgical residency
program at Maricopa decided to inject a bit of the real
world—specifically the realities of medical liability—
into its resident training.
Mock deposition at Maricopa
For one of our grand rounds, we invited an attorney,
Kenneth D. Goldberg, Esq., senior counsel of the Chartwell Law Firm, LLP, New York, NY, to speak on the
topic of medical professional liability and how surgeons
can best prepare to defend themselves if they are ever
sued for liability. Mr. Goldberg, a co-author of this article, has more than 40 years of experience preparing
defendants for both depositions and trials.
In addition to Mr. Goldberg’s lecture, we presented
a mock deposition. To show our residents what it is like
to be a defendant in a medical liability case, one of our
chief residents was “served” with a summons to appear
at the grand rounds to be deposed on an actual case in
which he had participated. For the record, there was
no issue with the case itself, but it provided enough
material to serve its purpose as an educational oppor-
tunity. In essence, this experience became an amplified
public mock oral.
In all, 20 minutes of the two-hour grand rounds
were devoted to this mock deposition. We attempted to
make this vignette as realistic as possible, with obvious
limitations. Mr. Goldberg was given few details about
the case—just enough to allow him to ask pertinent
questions, which the attending staff helped to shape.
The chief resident did not get a chance to meet with
an attorney to “prepare” for the deposition, nor did he
have a chance to review the chart until the day of the
deposition. This situation would rarely occur in reality. Liability lawyers typically spend significant time
preparing a defendant for questioning. However, in
this situation, we wanted to amplify the experience
to educate the residents and emphasize the necessity
of preparation before walking into a deposition or a
medical liability trial. The audio of the entire grand
rounds program, including the mock deposition, was
recorded and archived for future teaching purposes.
The chief resident sat in the front of the room while
Mr. Goldberg questioned him. The entire department
of surgery was present, including the attending faculty, residents, medical students, advanced nurse
practitioners, physician assistants, and support staff. A
hospitalwide announcement was issued, and members
of the department of anesthesiology (anesthesiologists
and certified registered nurse anesthetists) also were
Mr. Goldberg prefaced the deposition by providing
the attendees with a background in legal concepts. He
then began this deposition by asking background questions and learning more about the witness. The chief
resident did well initially. He is a well-spoken, well-respected resident leader who has always been known
as a patient advocate and talented clinician and surgeon.
However, the chief resident got confused and started
THE ART OF THE DEPOSITION
To show our residents what it is like to be a defendant
in a medical liability case, one of our chief residents was
“served” with a summons to appear at the grand rounds to
be deposed on an actual case in which he had participated.