|
A
Statistical Approach to Effective Risk Management
No medical specialty or practice environment is immune
from the spiraling chances of being sued for malpractice.
Actuarial studies indicate that those chances are currently
one in five if you practice in the state of Florida:
more than twice the national average. Ironically, these
factors, which commonly determine risk exposure, often
have little, if anything, to do with a physician's competency
or level of care provided. Consequently, if a strategic
approach to loss prevention is to be taken, determining
actual risk exposure is essential. Drawing on national
statistics and the Florida Department Insurance, professional
liability closed claim data have been compiled, categorized
and analyzed as a means of identifying specific malpractice
risk exposure and the basis upon which effective risk
management must be targeted.
At
the conclusion of this presentation, the participant
will be able to:
| |
Recognize
the primary allegations made in
medical malpractice claims; |
| |
Identify
high-risk exposures encountered in the
practice of medicine; and |
| |
Describe
risk management measures designed to reduce the
frequency and severity of claims. |
Claim
Prevention Through Medical Record Documentation
Inadequate or inappropriate documentation
not only fuels non-meritorious claims, but often necessitates
settlement of an otherwise medically defensible case.
A well-documented chart remains one of the best mechanisms
of claim avoidance and the most important piece of evidence
in a physician's defense. Loss statistics and actual case
studies depicting actual charting deficiencies serve as
the predicate for this presentation. Current statutes,
codes and regulations pertaining to medical record content,
ownership, confidentiality will be described in order
to ensure compliance and basis of effective claim prevention
through medical record documentation.
At
the conclusion of this presentation, the participant
will be able to:
| |
Recite
applicable requirements set forth by Florida law
and Board of Medicine administrative Codes; |
| |
Identify
prevalent documentation deficiencies and methods
of prevention; |
| |
Recognize
the legal instruments necessary for disclosure and
production; and |
| |
Describe
risk management measures designed to reduce the
frequency and severity of malpractice claims. |
Comprehensive
Risk Management for the Medical Administrator
The spiraling increase in the frequency
and severity of malpractice claims attributed to factors
other than medical negligence necessitates that Medical
Office Administrators and Support Staff implement effective
risk management practices. Common allegations and factors
which prompt most lawsuits are enumerated in the context
of the outpatient setting. A two-pronged approach acquaints
non-physician support staff in clinical and medical office
settings with comprehensive loss prevention measures necessary
to deter lawsuits before they are pursued and preserve
defenses necessary to defeat the unavoidable claim. Actual
case studies delineate risk management principles entailing
office environment, practices and procedures, patient
relations, communication, managed care issues and medical
record documentation.
At
the conclusion of this presentation, the participant
will be able to:
| |
Recognize
the primary allegations made in
medical malpractice claims; |
| |
Identify
high-risk exposures encountered in the medical
office setting; and |
| |
Describe
risk management strategies for reducing the
frequency and severity of claims. |
Comprehensive
Risk Management for the Medical Office Practice
The spiraling increase in the frequency and severity of
malpractice claims arising from the medical office setting
and attributed to factors other than medical negligence
necessitates physicians and their staff implement effective
risk management practices. Common allegations and factors,
which prompt most lawsuits are enumerated in the context
of the outpatient setting. A two-pronged approach acquaints
physicians in clinical and medical office settings with
comprehensive loss prevention measures necessary to deter
lawsuits before they are pursued and preserve defenses
necessary to defeat the unavoidable claim. Risk management
principles entailing office environment, practices and
procedures, patient relations, communications and documentation
are delineated, in the context of current loss trends
and malpractice risk exposure.
At
the conclusion of this presentation, he participant
will be able to:
| |
Recognize
the primary allegations made in medical malpractice
claims; |
| |
Identify
high-risk exposures encountered in the medical
office setting; and |
| |
Describe
risk management strategies for reducing the
frequency and severity of claims. |
Comprehensive
Risk Management for the Medical Office Staff
The spiraling increase in the frequency and severity of
malpractice claims attributed to factors other than medical
negligence necessitates that Medical Office Administrators
and Support Staff implement effective risk management
practices. Common allegations and factors which prompt
most lawsuits are enumerated in the context of the outpatient
setting. A two-pronged approach acquaints non-physician
support staff in clinical and medical office settings
with comprehensive loss prevention measures necessary
to deter lawsuits before they are pursued and preserve
defenses necessary to defeat the unavoidable claim. Risk
management principles entailing office environment, practices
and procedures, patient relations and communications and
documentation are delineated.
At
the conclusion of this presentation, the participant
will be able to:
| |
Recognize
the primary allegations made in medical malpractice
claims; |
| |
Identify
high-risk exposures encountered in the medical office
setting; and |
| |
Describe
risk management strategies for reducing the frequency
and severity of claims. |
Current
Loss Trends in Malpractice: A Statistical Analysis
A strategic approach to loss prevention begins with determining
actual risk exposure. Actuarial studies indicate that
the chances of being sued for malpractice are currently
one in five if you practice in the state of Florida: more
than twice the national average. National statistics and
the Florida Department Insurance, professional liability
closed claim data have been compiled, categorized and
analyzed as a means of identifying current loss trends.
Utilizing a statistical analysis, specific malpractice
risk exposure is examined and serves as the basis upon
which effective risk management is targeted.
At
the conclusion of this presentation, the participant
will be able to:
| |
Recognize
the primary allegations made in
medical malpractice claims; |
| |
Identify
current loss trends and the high-risk exposures
encountered in the practice of medicine; and |
| |
Describe
risk management measures designed to reduce
frequency and severity of claims. |
Effective Loss
Prevention: Distinguishing Formal from Informed Consent
It is not uncommon to confuse the concept of formal consent
with informed consent. Failing to appreciate the distinction
between these two legal doctrines unknowingly exposes
physicians to increased liability exposure. Formal consent
is best described as an act, while informed consent is
a process and the basis upon which the majority of malpractice
claims alleging lack of consent are predicated. Both legal
doctrines will be clearly delineated, as will the differing
standards of disclosure. Requirements set forth by current
federal and state medical consent law will be discussed
in the context of what a physician must tell the patient
regarding proposed medical care and treatment for purposes
of compliance and loss avoidance.
At
the conclusion of this presentation, the participant
will be able to:
| |
Recognize
the legal implications and differentiate between
"formal" and "informed" consent; |
| |
Identify
the distinction between express consent, implied
consent, extension of consent and informed refusal;
|
| |
Recite
the elements necessary to obtain informed consent;
and |
| |
Describe
risk management measures designed to reduce the
frequency and severity of claims. |
Effective
Loss Prevention: Medical Record Documentation
Although a small percentage of malpractice claims are
meritorious, the majority requires settlement. Lack of
defensibility is often directly attributed to inadequate
or inappropriate medical record documentation. Lawyers
begin the process of determining whether or not to file
suit by reviewing the medical record. Cases with good
documentation, that explain why a less than sterling result
was achieved and support the medical rationale involved,
are generally not pursued. Specific statutory provisions,
regulations and administrative codes pertaining to medical
record content, documentation and disclosure will be enumerated
and discussed for purposes of compliance, patient safety
and loss prevention.
At
the conclusion of this presentation, the participant
will be able to:
| |
Recite
applicable requirements set forth by Florida law
and Board of Medicine administrative Codes; |
| |
Identify
prevalent documentation deficiencies; |
| |
Recognize
the legal instruments necessary for disclosure and
production; and |
| |
Describe
risk management measures designed to reduce the
frequency and severity of malpractice claims |
Effective
Physician-Patient Communication
Communication is both a science and art. It is also a
significant motivating factor upon which malpractice claims
are pursued and avoided. Inadequate, inappropriate or
ineffective communication increases the chances of diagnostic
error, non-compliance, poor medical outcome and the likelihood
of being sued. Conversely, effective communication improves
diagnostic accuracy, enhances patient decision-making
and increases the likelihood of adherence to therapeutic
regimens. Essential for physician-patient rapport, good
communication prevents erosion in the physician-patient
relationship, a significant challenge since the advent
of managed care. By establishing realistic expectations,
non-meritorious claims can be avoided and patient satisfaction
levels raised notwithstanding the constraints imposed
by today's healthcare delivery system.
At
the conclusion of this presentation, the participant
will be able to:
| |
Recognize
common communication errors in the clinical setting; |
| |
Identify
techniques necessary to enhance physician-patient
communication; and |
| |
Describe
risk management strategies designed to reduce the
frequency and severity of malpractice claims
|
Effective Risk
Management: Developing an OIG Compliance Program
The Office of Inspector General and Department of
Justice are under pressure to uncover fraudulent practice.
Consequently, physician's practices are being audited
with increasing frequency. Voluntary corporate compliance
is recommended to prevent and detect potentially criminal
and unethical conduct and to reduce the exposure to penalties
and sanctions. This program is designed to provide a fundamental
understanding of healthcare fraud and to present the components
of a voluntary compliance program.
At
the conclusion of this presentation, the participant
will be able to:
| |
Recognize
the benefits of a compliance program; |
| |
Describe
the essential components of a compliance plan; |
| |
Recite
risk management measures designed to reduce the
frequency and severity of claims entailing fraud
and abuse; and |
| |
Describe
methods of demonstrating the effectiveness of your
compliance program. |
Effective
Risk Management: Reducing Exposure to Claims Entailing
Stroke
Stroke remains a leading cause of death and malpractice
claims against physicians. Few medical specialties are
immune. The average indemnity payment for claims related
to strokes is more than 60% higher than the average indemnity
payment for all claims. Often, these malpractice claims
have little to do with the competency of the physician
but rather faulty monitoring and system failures. Frequently,
the physician's indefensibility is attributed directly
to inadequate management of anticoagulation therapy. This
presentation examines comprehensive loss data and national
statistics pertaining to the treatment of atrial fibrillation
and stroke prevention. Case studies entailing recent settlements
are examined in conjunction with specific risk management
strategies focusing on actual and alleged diagnostic and
performance errors commonly encountered in defending claims.
At
the conclusion of this presentation, the participant
will be able to:
| |
Recognize
the liability exposure inherent to managing atrial
fibrillation and stroke prevention; |
| |
Identify
quality improvement pathways to improve anticoagulation
management regimens; and |
| |
Describe
risk management techniques to reduce the frequency
and severity of claims. |
Effective
Risk Management: Reducing Exposure to Fraud and Abuse
The unscrupulous practices of a few have defrauded billions
of dollars from federal healthcare programs. The Office
of Inspector General and Department of Justice are under
increased pressure to uncover fraudulent practices. Consequently,
physician's practices are being audited with increasing
frequency. Unfortunately, a mere coding oversight or billing
error can result in civil damages, penalties, and/or criminal
sanctions. Voluntary corporate compliance is recommended
to prevent and detect potentially criminal and unethical
conduct and to reduce exposure to penalties and sanctions.
This program is designed to provide a fundamental understanding
of healthcare fraud and to present components of a voluntary
compliance program.
At
the conclusion of this presentation, the participant
will be able to:
| |
Identify
common allegations related to medical fraud; |
| |
Describe
the essential components of a compliance plan; |
| |
Understand
the process entailed in fraud and abuse investigations;
and |
| |
Recite
measures designed to reduce the frequency and severity
of claims. |
Fraud
and Abuse 101
This presentation is designed to provide a fundamental
understanding of healthcare fraud and abuse in tandem
with the components of a voluntary compliance program
as an effective loss prevention measure in response to
the increased chance of an audit by the Office of Inspector
General and the Department of Justice. Mere coding oversight
or billing error can result in civil damages, penalties
and/or criminal sanctions. Voluntary compliance is recommended
to prevent and detect potentially criminal and unethical
conduct and to reduce exposure to penalties and sanctions.
At
the conclusion of this presentation, the participant
will be able to:
| |
Identify
common allegations related to medical fraud;| |
| |
Describe
the essential components of a compliance plan; |
| |
Understand
the process entailed in fraud
and abuse investigations; and |
| |
Recite
measures designed to reduce the frequency
and severity of claims. |
Knowing
What It Takes to Prevail in a Medical Malpractice Action
Practicing to the standard of care does not fully
insulate a Physician from the increasing chances of being
sued for malpractice. At some point, every practitioner
will encounter a patient outcome that will become the
basis of a lawsuit regardless of merit. This presentation
will focus on the nuances of Florida's malpractice tort
system from pre-suit to trial. Legal terms and civil procedures
will be defined and demystified. Effective measures necessary
to increase the odds of prevailing in a professional liability
action will be imparted as will the way in which Physicians
must fulfill their new role as a defendant. Physicians
will gain an understanding of what it takes to utilize
the tort system to their advantage, eliminate intimidation
by the legal system and increase their odds of defeating
non-meritorious claims and suites.
At
the conclusion of this presentation, the participant
will be able to:
| |
Identify
the procedural steps of Florida's medical
malpractice tort system; |
| |
Describe
the key elements necessary to prepare
for a successful defense; |
| |
Understand
how to testify in a deposition; and |
| |
Recite
measures designed to enhance the
defendant's role during trial. |
Medical Record
Law and Risk Management Guidelines for the Medical Office
Staff
Fundamental to implementing effective risk management
guidelines in a medical practice setting is knowledge
of requirements set forth by statutes and codes pertaining
to patient records. Inadequate or inappropriate medical
record documentation, maintenance and disclosure not only
facilitates malpractice claims, but often necessitates
settlement of non-meritorious cases. (As well as legal
sanctions, fines, penalties, government audits, allegations
of fraud and abuse, and managed care issues.) Applicable
risk management principles and methods of documentation
serve as a reference for implementing policy and procedure
appropriate for the private practice setting. Actual case
studies depicting medical record charting deficiencies
serve as a predicate for this presentation, which is specifically
designed for the medical office administrator, manager
and non-physician staff.
At
the conclusion of this presentation, the participant will
be able to:
| |
Recite
applicable requirements set forth by Florida law
and Board of Medicine administrative Codes; |
| |
Identify
prevalent documentation deficiencies and methods
of prevention; |
| |
Recognize
the legal instruments necessary for disclosure and
production; and |
| |
Describe
risk management measures designed to reduce the
frequency and severity of malpractice claims |
Prevention
of Medical Errors
Few medical errors are attributed to faulty medical
judgment, but rather system failures inherent to healthcare
delivery. Drawing on professional liability closed claim
data complied by the Physician Insurers Association of
America (PIAA), common performance and diagnostic errors
entailing wrong site surgery, failure to diagnose myocardial
infarction and medication errors serves as the focal point
of this risk management presentation. Loss prevention
measures are analyzed in tandem with the elements necessary
to conduct a credible and thorough root cause analysis
in order to reduce system failures, respond to sentinel
events, prevent medical errors and improve patient safety.
At
the conclusion of this presentation, the participant
will be able to:
| |
Recognize
common performance and diagnostic errors; |
| |
Describe
the elements of a root cause analysis; and |
| |
Identify
risk management measures designed
to prevent medical errors. |
Recognize
and Reduce your Exposure to Medical Malpractice Claims
Allegations involving diagnostic error continue to remain
a leading cause of lawsuits against physicians and among
the most difficult of claims to defend. Yet, it is often
factors such as the type of medical condition or modality
of treatment that determine loss exposure. Ironically,
those factors often have little, if anything to do with
physician competency or level of care rendered. Consequently,
if a strategic approach to loss prevention is to be taken,
determining actual risk exposure is essential. Drawing
on national statistics and the Florida Department Insurance,
professional liability closed claim data have been compiled,
categorized and analyzed as a means of identifying specific
malpractice risk exposure and the basis upon which effective
risk management must be targeted.
At
the conclusion of this presentation, the participant
will be able to:
| |
Recognize
the primary allegations made in medical malpractice
claims; |
| |
Identify
high-risk exposures encountered in the practice
of medicine; and |
| |
Describe
risk management measures designed to reduce the
frequency and severity of claims. |
Risk
& Liability Issues Associated with Electronic Physician-Patient
Communication
Although written and verbal communications have traditionally
been the primary method of communicating healthcare information,
the Internet opens new avenues for providing such information
and communicating with patients. In tandem with the potential
benefits of electronic communications are sobering legal
concerns and emerging, increased liability exposure to
the public through Web site capacity. This presentation
will address the key issues in developing office policies
and procedures for Internet-based communication entailing
patient privacy, confidentiality of patient information,
security and encryption, informed consent, use of disclaimers,
opportunities for patient education and the implications
of Web site linkage. The ramifications of marketing and
advertising electronically will be discussed in conjuncture
with applicable, albeit evolving, legal parameters. Risk
Management recommendations and guidelines will be offered
to reduce liability and potential loss exposure.
At
the conclusion of this presentation, the participant
will be able to:
| |
Identify
applicable, evolving legal parameters; |
| |
Understand
the risks associated with electronic healthcare
communications; and |
| |
Describe
specific risk management measures designed to reduce
the frequency and severity of claims arising from
electronic communication. |
Specialty
Specific: Loss Prevention in Anesthesiology
As a medical specialty, anesthesiology continues to remain
at the higher-end of the spectrum in terms of medical
malpractice exposure. Recent loss data confirms that both
the frequency and severity factor of anesthesiology claims
have increased significantly. This presentation examines
comprehensive demographic information with respect to
malpractice claims encountered in anesthesiology. Professional
liability closed claim data has been compiled, analyzed
and categorized, serving as a benchmark for loss experience
and risk exposure. Case studies entailing recent settlements
are examined in conjunction with risk management caveats
focusing upon both actual and alleged errors commonly
encountered in defending anesthesiology claims.
At
the conclusion of this presentation, the participant will
be able to:
| |
Describe
major allegations currently made in malpractice
claims against physicians who practice anesthesiology; |
| |
Recognize
high-risk clinical encounters; and |
| |
Implement
risk management strategies designed to reduce the
frequency and
severity of claims. |
The
Impact of Ketchup vs. Howard upon Formal vs. Informed
Consent"
The Georgia Court of Appeals ruling in Ketchup vs. Howard
greatly expands Georgia's informed consent requirements.
It is not uncommon to confuse the concept of formal consent
with informed consent. Failing to appreciate the distinction
between these two legal doctrines unknowingly exposes
physicians to increased liability exposure. Formal consent
is best described as an act, while informed consent is
a process and the basis upon which the majority of malpractice
claims alleging lack of consent are predicted. Both legal
doctrines will be clearly delineated in conjunction with
the disclosure requirements in the state of Georgia set
forth by Ketchup, as will the differing standards of disclosure.
Requirements set forth by current federal and state medical
consent law will be discussed in the context of the new
law and what a physician must tell the patient regarding
proposed medical care and treatment for purposes of compliance
and loss avoidance.
At
the conclusion of this presentation, the participant
will be able to:
| |
Recognize
the legal implications and differentiate between
"formal" and "informed" consent;
|
| |
Recite
the statutory requirements set forth by Ketchup
vs. Howard; |
| |
Identify
the distinction between express consent, implied
consent, extension of consent and informed refusal;
and |
| |
Describe
risk management measures designed to reduce the
frequency and severity of claims. |
The
Perfect Storm: Practicing Medicine in the State of Florida
Currently, the odds of being sued for malpractice are
1:12. For those who practice in the state of Florida,
those odds are 1:5. The nuances of Florida's present tort
system, in combination with the influence managed care
continues to have on an already litigious society, are
precipitating factors for what could be described as the
"perfect storm". Consequently, if a strategic
approach to loss prevention is to be taken, determining
actual risk exposure is essential. Drawing on national
statistics and the Florida Department Insurance, professional
liability closed claim data have been compiled, categorized
and analyzed as a means of identifying specific malpractice
risk exposure and the basis upon which effective risk
management must be targeted.
At
the conclusion of this presentation, the participant
will be able to:
| |
Recognize
the primary allegations made in
medical malpractice claims; |
| |
Identify
high-risk exposures encountered in the
practice of medicine; and |
| |
Describe
risk management measures designed to
reduce the frequency and severity of claims. |
Understanding
Dental Malpractice Litigation
Practicing the standard of care does not fully insulate
a dentist from the increasing chances of being sued for
malpractice. At some point, every practitioner will encounter
a patient outcome that will become the basis of a lawsuit.
This presentation will focus on the nuances of the malpractice
tort system from pre-suit to trial. Legal terms and civil
procedures will be defined and demystified. Measures to
increase the odds of prevailing in a professional liability
action will be imparted as will the way in which dentists
must fulfill their new role as a defendant. Dentists will
gain an understanding of how to utilize the tort system
to their advantage, eliminate intimidation by the legal
system and increase their odds of defeating non-meritorious
claims and suits.
At
the conclusion of this risk management seminar, the
participant will be able to:
| |
Identify
the procedural steps in the dental malpractice
tort system; |
| |
Describe the key elements necessary to prepare
for a successful defense; |
| |
Understand
how to testify in a deposition; and |
| |
Recite
measures designed to enhance the
defendant's role during trial. |
Understanding
the Defendant's Role in Dental Malpractice
Practicing the standard of care does not fully insulate
a dentist from the increasing chances of being sued for
malpractice. At some point, every practitioner will encounter
a patient outcome that will become the basis of a lawsuit.
This presentation will focus on the nuances of the malpractice
tort system from pre-suit to trial. Legal terms and civil
procedures will be defined and demystified. Measures to
increase the odds of prevailing in a professional liability
action will be imparted as will the way in which dentists
must fulfill their new role as a defendant. Dentists will
gain an understanding of how to utilize the tort system
to their advantage, eliminate intimidation by the legal
system and increase their odds of defeating non-meritorious
claims and suits.
At
the conclusion of this risk management seminar, the
participant will be able to:
| |
Identify
the procedural steps in the dental malpractice
tort system; |
| |
Describe
the key elements necessary to prepare for
a successful defense; |
| |
Understand
how to testify in a deposition; and |
| |
Recite
measures designed to enhance the defendant's
role during trial. |
Understanding
the Defendant's Role in Medical Malpractice
Practicing the standard of care does not fully insulate
a physician from the increasing chances of being sued
for malpractice. At some point, every practitioner will
encounter a patient outcome that will become the basis
of a lawsuit. This presentation will focus on the nuances
of the malpractice tort system from pre-suit to trial.
Legal terms and civil procedures will be defined and demystified.
Measures to increase the odds of prevailing in a professional
liability action will be imparted as will the way in which
doctors must fulfill their new role as a defendant. Physicians
will gain an understanding of how to utilize the tort
system to their advantage, eliminate intimidation by the
legal system and increase their odds of defeating non-meritorious
claims and suits.
At
the conclusion of this risk management seminar, the
participant will be able to:
| |
Identify
the procedural steps in the medical malpractice
tort system; |
| |
Describe
the key elements necessary to prepare
for a successful defense; |
| |
Understand
how to testify in a deposition; and |
| |
Recite
measures designed to enhance the defendant's
role during trial. |
Using
Florida's Pre-Suit Statutes to Your Advantage
Under current Florida statutes, a physician must first
be given notice of the patient's intent to sue before
a civil action may be filed. While these pre-suit statutes
may be viewed as a precursor to litigation, the process
can be used successfully to defeat non-meritorious claims
before a lawsuit is filed and significantly increase the
chance of prevailing should litigation ensue. However,
compliance with the "informal discovery" provisions
of pre-suit as a means to preserve affirmative defenses
and support denial of allegations is essential. This presentation
will focus on Florida Statute 766 and the procedural nuances
of the pre-suit process. Physicians will gain an understanding
of how to utilize the pre-suit process to their advantage
and eliminate intimidation by the legal system.
At
the conclusion of this presentation, the participant
will be able to:
| |
Describe
the legal requirements set forth by Florida's
pre-suit statute FS 766; |
| |
Understand
how to participate in the informal discovery phase
of the pre-suit process; and |
| |
Recite
key measures necessary to reject claims prior to
litigation and prepare a malpractice defense. |
HIPAA
CME/Risk Management Programs
Federal requirements set forth by the Health Insurance
Portability and Accountability Act (HIPAA) effect virtually
all levels of healthcare delivery. This presentation is
designed to distinguish the myths of the HIPAA privacy
rule from less burdensome reality. While modest, albeit
mandatory, modifications to ensure compliance must be
made; the fact of the matter is that most applicable federal
privacy regulations are preempted by current Florida statutes.
This presentation takes a practical, risk management approach
towards HIPAA compliance. Florida physicians will gain
an understanding of HIPAA nomenclature and privacy provisions.
The elements necessary to develop and maintain a simplified,
but effective compliance plan will be described.
At
the conclusion of this presentation, the participant
will be able to:
| |
Identify
entities and types of information covered by HIPAA’s
Privacy Rule; |
| |
Recognize
those federal requirements that are preempted by
Florida statute; and |
| |
Describe
the modifications necessary to establish and maintain
a HIPAA compliance plan. |
Additional
CME
Florida
Medical Association
Online
CME programs
Prevention
of Medical Errors
BACK
TO CME/CE PROGRAMS
|