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- Don't Know The Rules That Define Your Protection
In a recent malpractice course, about half of the audience raised
their hands to the question of whether they had read their policy.
Many others did not know what type of insurance they had. Policies
contain language to make risk manageable for the insurer. You
don't want to be managed out of coverage, or fall in a technical
loophole regarding your coverage. Be sure to read and understand
it, including the individual and aggregate coverage, the presence
of defense monies if the aggregate is breached, and notification
requirements. If you are not sure, get an experienced legal opinion.
- Ignore Warning Signs
If a patient expresses dissatisfaction, or staff picks up warnings,
or a worrisome result occurs, take the necesssary steps to pay
special attention to the patient. Plan the best management of
the case to estabhish a good standard of care in the chart. This
is good medical care that creates good protection.
- Keep Poor Records
This is a particularly problematic area, and there is an old tradition
to keep concise notes, and a current need to have detailed notes.
Plus there is usually not enough time. But you have to document
key events and decisions, good patient communication, your intent
and plan, your adherence to the community standard, and establish
that standard. For all practical purposes the chart is the 600
pound gorilla in the courtroom, so make it tough. And it could
keep you out of the courtroom.
- Alter Records
This is an act of suicide. You will likely lose insurance coverage,
and lose the case. Many times these have to be settled. Worse
could happen.While this seems obvious, it is emphasized at such
length by insurers, it remains an important problem. The legitimate
way to correct a note is a single strike through, then a new dated
note.
- Don't Plan Your Finances
Once a case occurs, many of the best protective strategies don't
work. The best course is to consider this issue now, not just
because of malpractice, but because it is good financial management.
- Make Your Defense a Side Issue
It is a common story. You are too busy, too short on mental energy,
to be diverted by day to day steps of protection of your practice,
much less long term strategy. They are valid reasons, but you
still aren't protected. Plus it is hard to change. But it is far
easier now, than if trouble comes.
- Be Seen As Distant, Arrogant, Or Hard To Identify With.
In many ways your best defense is that the patients, families,
colleagues and jurors identify with you, like and trust you. In
the strange pressures of modern practice this is difficult to
nourish at times, but again, it is invaluable.To a jury you are
what you see.
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