Oncology (General Cancer)/Risk Management


Dear Dr Higby,

Thank you very much for volunteering on this site!

I have a few simple questions for you:  

What is the role of the Risk Manager in a hospital?   Who would normally be the next person in line above the Risk Manager?  What sort of experience and/or training should a Risk Manager have?  What role do they play in preventing unintended surgical outcomes?

Thank you very much!


Pablo Durissimo

A risk manager reviews current cases and looks for evidence of errors, and reviews cases where a relative or a patient raise complaints.  IN a small hospital they report to the CEO, but in larger ones, they might report to a vice president.  A risk manager reviews the case, identifies the problem, and if it requires remedial training, recommends that; if it requires a change in procedure, that is recommended.  Sometimes the event that is identified is not remediable -- a death from cancer chemotherapy where everything was done right but the patient got infected and died.  Risk managers generally have a fair amount of medical training -- they may be nurses or paramedics or physicians assistants.
As for preventing unintended surgical outcomes, they don't really do this.  A bad outcome might lead to an investigation that suggests the surgeon be given some training, or that new policies be instituted, and then it is assumed that future situations won't occur.  Hope this helps.  

Oncology (General Cancer)

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Donald Higby, M.D.


I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.


I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.

American Society of Clinical Oncology

New England Journal of Medicine American Journal of Medicine Journal of the American Society of Clinical Oncology Hematology Transfusion Medicine

MD, Stanford University Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY

Awards and Honors
America's Best Physicians, last 14 years

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