Toward more effective risk prevention.

Reviews of medical malpractice claims against ophthalmologists have revealed a pattern of misunderstanding and improper or underutilization of several risk prevention and defense techniques. This often results in increasing the risk of litigation and weakening the defense of the claims. These techniques include the physician-attorney relationship, dealing with differences in the patient's version of the facts versus that of the physician (he said-she said), the physician-patient relationship, informed refusal, awareness of whom we are trying to convince with our arguments, vicarious liability, subpoena duces tecum, the most dangerous diagnosis, and the management of unethical plaintiff witnesses. Many of these techniques have been extensively described in the literature. This article discusses the means by which to make optimal use of them in order to achieve maximal risk prevention and the strongest possible defense in the event of litigation.