As 2017 comes to a close, we all make personal resolutions. But what about professional resolutions designed to ensure a prosperous, productive and stress-free new year? For solo and small practice physicians, specific resolutions could lay the groundwork for a year of unparalleled success. But choosing not to prepare for the inevitable pitfalls all practices face could result in a year of financial and legal headaches. The truth is that it’s not a matter of “if” a physician will face a professional crisis, it’s when. The good news is that physicians can follow simple steps to avoid unwanted drama.
First, let’s understand the reality. For solo practitioners and those in small practices, the sphere of risk is greater than for colleagues who operate in large health care systems. For the latter, in-house attorneys and sweeping professional liability coverage may provide a cushion of security. But big systems are not a perfect fit for everyone. Some physicians prefer autonomy, providing highly personalized services, and reaping the rewards of their own businesses. Furthermore, the need for rural practitioners attracts physicians who want to make a positive difference in underserved communities. Whatever reasons physicians have for going small, they all deserve the same protection as their colleagues.
The common denominator with physicians in solo or small practices, and those who work in large systems, is this: every physician needs to protect their reputation and assets! The difference is that large players are prepared for the inevitabilities of working in health care. They statistically expect complaints, technology breaches, lawsuits and bad reviews. They employ in-house attorneys to prepare for and navigate every possible scenario their physicians might face. Small groups, however, tend to stay put until a crisis emerges. For them, medical malpractice, compromised medical records, employee disputes, patient complaints, and more are obstacles to be dealt with as needed. Why? It’s simple psychology. Bad things happen to other people, right? Wrong. Even the most beloved and competent physicians in the world treat hundreds or thousands of patients every year, employ dozens of people, and have their professional information posted on the internet. We live in an age when dealing with one person equals dealing with personal networks of countless others. Waiting for a crisis is simply not sustainable.
Once a year, physicians purchase professional liability coverage from an insurance carrier. But in most cases, insureds don’t realize that the legal claims against them are being handled by claims adjusters, not attorneys! According to Capson Physicians Insurance President & Founder Maury Magids, “We have attorneys on staff who serve in the same capacity as attorneys at large health systems. Also, our select defense panel includes senior partners from leading medical malpractice law firms. This creates a peer-to-peer relationship between our attorneys and the patient’s attorneys, reducing the time and expense of closing claims. With this model, non-meritorious claims close 83% faster than the industry standard. Not only does that obviously save time and money, we give physicians back peace of mind, so they can focus on their patients.”
Beyond professional liability claims, risk takes many shapes and does not rest in isolated incidents. According to Dr. Jeff Segal, founder and CEO of Medical Justice and eMerit, physicians need to be more proactive in preventing scenarios that may compromise their practices.
“Risk is an ecosystem of potential threats that can derail or destroy an entire practice or career,” Dr. Segal explains. “It can feel overwhelming when balanced with the greatest responsibility of all… caring for patients. However, physicians do have a lot of control in how they prioritize managing their reputations and taking solid steps in protecting their practices. They have options.” Dr. Segal believes that a holistic approach to mitigating potential threats to physicians’ reputations is critical to preventing problems before they escalate.
For example, some solo or small practice physicians may not understand that having an attorney working on their behalf within their professional liability carrier is critical to the outcome of their cases. Medical malpractice claims can be very stressful, but most are settled before trial in mediation. So, what’s the key to developing strong patient relationships?
“We know definitively that most patients absolutely love and trust their physicians. Still, it’s impossible to please everyone. But, there’s more. Physicians also have to contend with employees, the Board of Medicine, colleagues and business partners, among other stakeholders. So I always encourage fellow physicians not to wait for a professional crisis to happen. Be prepared. Ask questions. Physicians instinctively know that providing great care to patients is not only a calling, it’s a calling card,” Dr. Segal continued. “We need to make it easier for physicians to get the specialized attention they need. A failure to plan is a plan for failure.”
There are additional options to implementing a dynamic patient relationship initiative in your own practice. Companies like Press Ganey enable smaller physician practices to leverage methodology, benchmarking and improvement tools to capture the voice of the patient and improve the patient experience. Press Ganey uses scientifically rigorous surveys and rich reporting tools to provide insights and guidance to help create and implement sustainable action plans and initiatives for patient-centered care.
To mitigate concerns and create a practice culture that is proactive and stable, here are three ways small practice and solo physicians can make 2018 a year of change:
Know Your Risks
Physicians spend a lot of time learning about medical advances and breakthroughs. It’s their job. But for small practice physicians, education about professional liability and other financial and legal issues is just as critical.
Negative patient online reviews
Physicians Practice reported a study conducted by Software Advice which paints a sobering picture:
- Nearly 84 percent of patients use online reviews to evaluate medical practitioners
- Almost 80 percent of patients conduct extensive online research before booking appointments
- 47 percent of patients would go out-of-network for a physician who has more positive reviews
Some physicians believe they can legally respond to bad reviews or other negative content directed towards them. According to Dr. Segal, “It’s extremely important to understand that there is essentially no legal recourse to online complaints. That said, praise can be just as impactful. Instituting a comprehensive patient feedback program can go a long way to improving relationships and strengthening trust.”
According to Dr. Segal, it’s extremely important to understand that there is essentially no practical, cost-effective legal recourse to online complaints. Suing a patient for defamation will be time consuming and expensive.
“A defamation suit based on a review buried deep online will become a page one Google story. A patient may successfully defend by arguing the post was either truthful or just their opinion,” Dr. Segal said. “And, adding insult to injury, in some states a physician on the losing end of a defamation case may have to reimburse the patient for his legal fees. Fortunately, online reviews are a two sided coin. The solution to pollution is dilution. Instituting a comprehensive patient feedback program can go a long way to improving relationships, strengthening trust, and promoting a more representational picture of your practice.”
The McAfee Labs Threat Report (Sep. 2017) states, “While overall healthcare data breaches are most likely the result of accidental disclosures and human error, cyberattacks on the sector continue to rise.”
Cyber Liability coverage offers protection for network security & privacy related exposures faced by physicians. Make sure your medical malpractice coverage includes:
- Patient notification & credit monitoring costs
- Network security and privacy insurance
- Regulatory coverage
- Data recovery costs
With tort reform changes in states like Wisconsin, Florida and Oklahoma, physicians are increasingly concerned about the ability of patients to file medical malpractice claims. “Doctors may be getting nervous in a handful of states where they've lost their tort reform, and where there have been some high profile Supreme Court cases where longstanding reforms are now rendered unconstitutional,” Dr. Segal said. “Although medical claims may not be frequent, they are high impact incidents for physicians and can wreak havoc in a small practice.” Prioritizing patient feedback and compliance programs within your organizations can help prevent complaints.
According to Medical Economics, there are several risks that physicians can proactively avoid including:
- Faulty communication
- Lack of informed consent
- Failure to stay up-to-date on standards and training
- Inadequate follow-up of diagnostic tests and specialist referrals
- Variations in policies and procedures
- Avoidance behavior
Depend on Experts
Physicians are experts in caring for patients. So it only makes sense that physicians leverage the expertise of legal professionals to understand how to manage risks and professional liability concerns. In other words, don’t Google it.
“Make certain that your medical liability carrier has in-house attorneys, not just claims adjustors, handling complaints from the moment one is filed,” Magids says. “Up to five months can go by before any significant action may be taken on a claim. Claims adjustors will typically work with local defense to resolve issues, if possible, and non-meritorious claims can cost around $40,000 and three years to resolve.”
The American Medical Association (AMA) reports that six out of every ten physicians 55 years of age and older have been sued at some point in their career and 22.4% are sued twice or more. Physicians will spend an average of 11% of their career dealing with unresolved medical malpractice liability claims. Using a medical malpractice carrier with expert attorneys on staff will give you back time that would have been wasted in stress and worry over a pending claim.
In closing, the 2018 professional new year resolution for a solo or small practice physician should include the understanding that the landscape of risk and threats to your hard-earned reputation is and will continue to be in a constant state change and increasing severity. Aligning yourself with a physician’s insurance carrier that provides in-house attorneys and sweeping professional liability coverage affords you a proactive stance towards protecting your brand and business. Again, it’s not a matter of “if” a physician will face a professional crisis, it’s when. Knowing that the person you call for legal protection is actually an attorney and not just a claims adjuster matters.