You are asked to sign a chart for a patient for whom you had assisted the primary surgeon, and you see false statements in the operative dictation that obviously were written to mitigate medical malpractice liability. What would you do?

"I would not sign the chart as an assistant if there were such a thing going on. I would tell him or her to re-dictate the op note to reflect a more accurate version. I wouldn't have to pester him to do it, because without my signature, the chart is incomplete and bound to come to the attention of billing and further reveiw."

It is tempting to think that a surgeon dictating a false story that dismisses a mishap that could result in a suit would be a welcome tactic by the hospital. After all, if a doctor is sued, so will be the facility. But this is erroneous thinking. Getting caught doing something like this by opposing counsel or by a regulatory agency is a major mistake, much costlier than whatever financial damages would have been saved by sidestepping a possible suit. Even worse, most suits are only for the purpose of initiating discovery, and a complication that otherwise might have gone nowhere medicolegally may in fact gain momentum if a plaintiff's lawyer can demonstrate manipulation of evidence. Your answer should subscribe to law.

"I would not sign a chart that wasn't accurate. I would let the primary surgeon know this and the chart would be incomplete until this is done and I can sign with a good conscience."