From the monthly archives: June 2012

We are pleased to present below all posts archived in 'June 2012'. If you still can't find what you are looking for, try using the search box.

Hospitalists Liability Insurance, The Doctors Company and Patient Safety Initiatives.

The increasing presence of Hospitalists, on staff, in the hospital, training and leading Care Teams places a new, higher risk on the growing sector of healthcare.
In an article submitted by Todd Neale, from Med Page Today, he points out to us that the presence of hospitalists in medical facilities raises the importance of continuing to learn and study risk management strategies to prevent both medical malpractice claims and employment practices liability claims.     The research conducted by this author, Mr. Neale indicates that due to the rapid growth and youth in this profession,  there can be a hightened incidence of 'behavior considered  unprofessional.'

Mr. Neale reported that hospitalists in Chicago, when surveyed, reported that they had to work within the systems to push tests and referrals, to expedite care and persist with lab results.  Many Hospitalist groups are catching up with the burden of multitasking physicians by increasing training and education.  The Doctors Company, in partnership with the Society of Hospital Medicine is working on developing Webinars and online Continuing Medical Education Programs which will improve the effectiveness of physician communication.  Given the level of training and motivation of so many in this field, these physicians will rapidly improve in all of the areas of care, coordination of care and communication. For now,  some Hospitalists are reporting that they  participated in unprofessional behaviors, such as ordering a test as urgent in order to get some response from other physicians or labs. (actually, that sounds like working the system to the patients advantage.

The statistics showed that among internal medicine hospitalists at three Chicago-area academic health centers, about two-thirds (67.1%) said they had non-medical or personal conversations in patient hallways, according to Vineet Arora, MD, MAPP, of the University of Chicago, and colleagues.

And 62.3% said they had ordered a routine test as "urgent" to get the results quicker, the researchers reported online in the Journal of Hospital Medicine.  

It would hardly seem that making small talk in the hallways outside patient rooms is a serious transgression, More serious transgressions -- including falsifying patient information and poor documentation or inadequate handoffs from shift to shift -- were infrequent.

These minor errors of judgment call to action some need for institutional education.  This is exactly the kind of leadership shown by The Doctors Company Medical Malpractice Insurance Company, Patient Safety Specialists.  Working in conjunction with SHM and The National Coalition for Patient Safety, TDC is constantly introducing new information for physicians to learn and implement tools to help them practice good medicine!    If the incidence of medical malpractice is going to continue to remain low, then we want to pay attention to all behaviors, whether it is interacting with nursing, physicians or patients – even the protocol surrounding the ‘office banter’ should be outlined so that the professionalism of the institution is properly reflected.

Medical schools and residency training programs have given increased attention to professionalism, and hospitalists have taken on a greater role as resident supervisors, according to the researchers. Thus, hospitalists may have an influence on the behaviors and views of professionalism of the residents.  Suddenly, and perhaps, without preparation, these hospitalists have been thrust into the center of the stage of educating our younger physicians. If institutions are not aware of the importance of proper training, there would almost certainly result some adverse outcomes.   The Doctors’ Insurance Agency, working with The Doctors Company has developed very competitive Hospitalists Liability Insurance Programs which can protect our physician groups from the financial impact of these kinds of claims

The answer to providing quality care is almost always education and communication (the two are so closely tied, it is worth noting that most of the risk management seminars, classes and webinars have a large emphasis on internal, physician to physician communication skills and strategies as well as in-depth studies of the most effective methods to communicate with patients.  Effective patient communication leads to better physician relationships and fewer clinical errors.


Hitec Act of 2009; Physician’s Billing Errors and Omissions, What is it and why is it important for me to understand?

The Doctors’ Company offers $ 25,000 of Administrative Defense ‘Insurance’ with each medical malpractice policy to protect our physicians against the costly The Hitec Act of 2009, extends the same level of confidentiality afforded a patient in a medial practice to the electronic files stored on each physician, physician group, medical facility or business partner’s computer.

The most alarming aspect of this law is the business associate element.  Suddenly with this implemented regulation, if you are doing business with a medial entity, you have the same duty of care to contain and protect the confidentiality o the patient record as the physician.  This legislation opened up another area of liability that previously was not ‘on the radar’,

It was understood with HIPAA that patient records had to be carefully protected,  the physical PHI had to be kept confidential or else the physician group would be fined. Now, with the investment by the government into the economy (the American Recovery and Reinvestment Act), with incentives by medical practices to introduce electronic records, also cut the other side of the sword,  the penalties imposed for implementing these systems incorrectly.  Hitech stands for “Health Information Technology for Economic and Clinical Health”.. Act .  The American Recovery and Reinvestment Act contains incentives related to health care information technology  in a government push to create a national health care record system;  the Act contains incentives to accelerate the use of HER. 

As is the case with any Government incentives, the ‘there is some give and take.   Because this legislation anticipates a massive expansion in the exchange of electronic protected health information (ePHI), it also widens the burden of privacy and security protections.   

Originally, The Doctors’ Company was one of the first medical malpractice insurance companies to recognize the need to add protection to our physicians for these onerous government investigations into confidentiality breach (the physical copy of the record); when compromised results in civil fines, penalties, investigations and perhaps license sanctions.

When this act extended the responsibility of facilities and medical groups to protect the electronic record, an entire area of risk was exposed.

Hence, the added protection by The Doctors’ Company,

$ 50,000 of Cyber Liability to protect our physicians.


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