What a physician and a medical practice’s front line staff says to a patient after an adverse result can affect that practitioner’s chances of successfully defending a liability claim.
Watch what you say — know what NOT to say. Foot-in-mouth disease can be expensive when it comes to handling patient complaints. Front-line office employees who answer phone calls, fielding questions and complaints can help or hurt. With proper training and sensitivity about what not to say, phone representatives can help avert medical professional liability claims or at least avoid stepping on verbal land-mines which may later harm the practitioner’s chances of defending a liability claim.
Here are some of the statements which your phone staff — and all employees — should be schooled NOT to say:
- “I can’t believe we’ve had another one of these.” [While empathetic, this comment may imply that you have been on notice of a prior medical problem.]
- “I told Dr. X that this was an accident waiting to happen.” [Same as above — very damning.]
- “We’ll take care of everything.” [What if you investigation ultimately exonerates you? Also, your insurance policy may require you to refrain from making any payment or promise to pay without the insurer’s consent. Be circumspect in making verbal commitments.]
Do not accept responsibility prematurely. Physicians and hospitals often will be under extreme pressure to accept liability and to pay claims. Pressure may come from irate patients or from attorneys who threaten to file suit. Ironically, pressure may even come from the insurance company or claims supervisor, who want file inventory reduced. It may even come from the hospital trustees, who are tired of dealing with a vocal critic of their facility.
The claims investigator must diplomatically but firmly resist attempts to pressure him or her into hasty decisions on medical malpractice claims. It may help to tell the patient that the fact-finding process is underway and that the investigator needs to know exactly what happened. This buys time within which an investigator can gather sufficient facts and decide whether the claim presents a case of genuine deviation from an acceptable standard of care or some alternate cause. It can also help avoid ill-advised remarks to injured persons.
Coach your medical staff on appropriate word choice. So what should medical personnel and phone representatives say? The best responses to patient complaints are questions such as:
“Did you read the pre-op and post-op instructions?”
“Did you read the informed consent form?”
“We’re sorry that you’ve had a problem with this . . .”
“Please tell us what happened.”
“We want to help you.”
“Tell us everything.”
Consider writing off bills, balances due or forgoing collection efforts to retain customer goodwill and thwart claims. Often, you can nip in the bud a nascent claim by forgoing a collection effort. Many medical malpractice claims arise as counter-attacks to bill collection actions by a physician or hospital. If you can keep a patient satisfied, you reduce the odds of him or her becoming a claimant or plaintiff. If they feel you have bent over backwards to treat them fairly, there is less chance you will face a medical liability claim. The reason is because . . .
HAPPY PATIENTS DON’T SUE!!
Sometimes what you write off in the way of an outstanding bill is worth every penny you avoid spending in defending a claim.
Avoid the topic of liability insurance in your discussions. Do not raise the issue of insurance, or mention it, even if you have insurance coverage for medical malpractice claims. This may plant the seed of a claim in the patient’s mind or raise expectations of a settlement funded by insurance. Thus, downplay the role of insurance by not mentioning it when speaking with aggrieved patients or family members.
Sheila Carmody of the Lewis & Roca law firm in Phoenix, AZ states:
Doctors should undertake NO Investigation. If he/she does and talks to any other practitioners, in later discovery it would appear as if “he/she was twisting somebody’s arm” or “covering the trail.” Healthcare practitioners should not investigate.
The above was excerpted from Quinley, KM Bulletproofing Your Medical Practice: Risk Management Techniques for Physicians that Work (SEAK 2000). Please click here to download a free complete copy of Bulletproofing Your Medical Practice: Risk Management Techniques for Physicians that Work.