Philosophy of Risk Management
At Medical Assurance Company of Mississippi, we believe that protecting our insureds from litigation is just as important as the service we provide after a suit is filed. The primary focus of our physician insureds is the health and well-being of their patients, and we believe it is our responsibility to help them keep that focus, while working on issues and topics that affect the delivery of healthcare in
MACM Risk Management offers several complimentary services to our insureds. It is our hope that, by providing information on relevant topics, our insureds will be able to better cope with the ever-changing landscape of medicine. We believe that education is a major component in changing behaviors, whether it is formalized educational offerings or more informal interventions such as consultations, surveys, and providing helpful tools to better the delivery of healthcare. Our consultants provide needed assistance in the areas of clinic and office risk management systems, medical records, compliance issues, and hospital practice as it relates to the insured’s liability.
This survey is designed to evaluate the risk management systems and documentation within your practice and offer suggestions for improvement. We will interview key staff to discuss systems currently in place and evaluate documentation related to patient care and follow-up. A written report of concerns and recommendations will be provided to the clinic. We can also visit the clinic and present the results to the staff and physicians.
This survey process is focused on an area that is of concern to the clinic. Examples of these types of surveys include prescribing of controlled substances within the regulations; use of EMR; telephone documentation; proper and consistent use of informed consent forms; or the development of a new service. Call us and tell us about your concerns to see if we can tailor a survey to assist you.
If your practice is having a problem in a risk management area such as a disruptive staff member, management of difficult patients, poor use of the EMR, or future addition of services or procedures, call us and we can come to your office to evaluate the concerns and discuss risk management strategies to lessen your liability.
We can offer programs designed for administrative, clinical and physician members of your clinic. These presentations can be customized to fit your needs. See the list of presentation topics here or call us and give us a risk management topic for a presentation.
Phone & Email Consultations
Our consultants are available either by phone or e-mail to answer those risk management questions that come up in your daily clinic practice. For example: When and how do you withdraw from care? How to handle a non-compliant patient? How to manage the misuse of social media?
RISK MANAGEMENT PRACTICE
This illustration shows the mutually dependent parts of excellent risk management. Separately, each component is a significant aspect for good risk management. Working together – patient care, communication and documentation – form a risk management program that tracks systems and offers built-in safety checks. When these systems are followed by all members of the healthcare team, the result is safe patient care and complete risk management practices.
Clinically appropriate and safe patient care given by the appropriate provider based upon education, training, and experience.
Clear and appropriate verbal communication. This aspect of risk management can occur between the patient and the provider, or branch out to include the patient’s family, other providers, the clinic and hospital staff, and any other segment of the healthcare system.
Complete and individualized documentation of every aspect of the care given to the patient. Documentation includes the rationale for care and conversations with the patient, the patient’s family, and other healthcare providers. It also must include educational information and instructions provided to the patient.
This FAQ is for informational purposes only and is in no way intended to amount to a representation regarding insurance coverage. Further, it is not intended and should not be construed to be or to establish the standard of care applicable to physicians practicing in Mississippi. This information should not be regarded as legal advice. We encourage physicians to seek the advice of their own legal counsel.
When releasing the medical records of a patient, with a properly executed authorization, may we release records of other physicians or clinics which may have been sent to us?
Yes, any records, letters, laboratory or diagnostic tests from outside sources which your physicians have used in diagnosing or treating the patient, and which are a part of the patient’s record, should be released in accordance with the request form.
How long must I keep medical records?
At this time, we recommend that clinic records be retained indefinitely, because unlike hospital records, there is no applicable statute for retention of clinic records. Also, even though Mississippi does have a Statute of Limitations law, this is often loosely interpreted by the courts. For example, if a “cause of action” is discovered after the statute has expired, the case could be allowed to proceed and you would need your records if this occurred. We realize retaining records indefinitely is burdensome at best, but at this time, this is the best answer we can offer.
A physician in our practice is becoming disruptive. What is our liability? Do we have a duty to report him if we suspect substance abuse?
The disruptive physician usually directs his anger toward staff; however, there is no guarantee the anger will not be directed at a patient. By displaying this behavior, the physician is also hampering communication with the staff and the staff may be hesitant to point out potential problems (such as a mistake in a prescription) for fear of his reaction. The clinic staff is an important quality check and support system for the physician to prevent potential errors concerning medical care. If this system is hampered through poor communication, then the potential for harm to the patient increases.
If a clinic and/or its partners have knowledge of a physician’s propensity toward disruptive behavior, the clinic may be in a precarious position if a patient is harmed as the result of the physician’s behavior. If the clinic and its partners fail to take corrective action, then the clinic may be considered grossly negligent and be exposed to punitive damages.
Additionally, we suggest you consult your clinic’s attorney regarding this issue as a claim made by a clinic employee would NOT be covered by the medical professional insurance policies issued by this company as these policies only cover claims made by patients.
The Mississippi State Board of Medical Licensure will take anonymous reports of disruptive behavior and suspected substance abuse. The Board does investigate all reports.
What do I need to do in order to properly close my practice?
It is important that you give your patients adequate notice of your retirement. A letter should be sent to all active patients stating your date of retirement as well as who will be taking over your practice. A notice should also be prominently placed in your office several months prior stating the date you will retire. In addition to the patient letters, a notice in the local paper, on your website, and on your clinic’s social media platforms is recommended.
If another physician does not take over the practice, you may want to have a staff member available for approximately 30 days after you retire to assure all “loose ends” are resolved. It may be wise to utilize some type of system as a “double check” to ensure all patients are notified and that records have been sent to the new physician of the patient’s choice.
We must emphasize the necessity of having all records completed at the time of your retirement. You may want to consider assigning someone to check the records to be sure entries are complete and signed.
Many of our minor patients have divorced parents. If the parent that does not have custody of the child requests the child’s medical records, may we release them?
Both the custodial and noncustodial parent are entitled to access the medical records of a minor child as long as parental rights have not been terminated. The mere granting of physical or legal custody to one parent is not a termination of parental rights. Records may be released with a signed HIPAA authorization. If, however, in the opinion of the treating physician, the release of medical records to this person is not in the best interest of the minor or this person has subjected the child to abuse or neglect, the physician may elect not to release the records.
Who can authorize the release of medical records of a deceased patient?
If an estate has been opened, only the executor or administrator can authorize the release of medical records. If an estate has not been opened, as many as three heirs-at-law of the decedent can authorize the release of medical records; however, each must first complete an heirship affidavit pursuant to Mississippi law.
If I want to start using telemedicine in my practice, what should I do?
The very first thing you should do when starting to incorporate telemedicine into your practice is to decide on the following:
- Type of service you want to provide
- Equipment you will need
- Location of service – at both ends
- Telemedicine practice times (hours/days and days/week)
- Personnel needed – at all sites
After that, contact MACM and let us help you through the process.
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