Avoid Risk Management Land Mines By Educating Yourself
Q. I am an administrator of a behavioral health care group. Our professional liability insurance for the group practice is through the Psychiatrists' Program. Several of our psychiatrists are interested in moonlighting outside of the group practice. Will they need to purchase a separate insurance policy to cover them at the outside practice?
A. No, these doctors will not need a separate insurance policy to cover work in an outside practice. With the group administrators' approval, coverage for these doctors can be extended for work outside their group employment (subject to underwriting approval).
Another important feature of the Psychiatrists' Program for group practices is that all practitioners—psychiatrists, psychologists, social workers, and other behavioral health care providers practicing in a group—can be covered under one policy, along with the group practice itself. For more information about group coverage, call (800) 245-3333, ext. 314, or visit<www.psychprogram.com/groups>.
Q. What are the most damaging claims that you see? Suicides?
A. suicide is a high-risk event that frequently results in lawsuits; however, the cases with the highest judgments or settlement values are not death cases but cases that involved significant permanent neurological or physical injuries that result in the need for lifelong care. The financial costs associated with providing lifelong care combined with the loss of potential income and, in some jurisdictions, the cost of “pain and suffering” are the reasons for awards of hundreds of thousands, sometimes even millions, of dollars.
Here are three examples of such a claim:
A patient who has developed permanent renal failure from an instance of lithium toxicity and must endure kidney dialysis and/or replacement | |||||
A patient who suffers from significant tardive dyskinesia due to a failure to detect warning signs and symptoms | |||||
A patient who suffers brain damage as a result of a failed suicide attempt | |||||
One of the primary causes of these types of injuries is the alleged mismanagement of a patient's medication regimen. For this reason, risk management advice dictates that psychiatrists prescribe carefully and monitor medication levels and appropriate physiologic functions regularly. Also, patient compliance with monitoring should be tracked.
Q. I have my malpractice insurance coverage with the Psychiatrists' Program and learned that I can earn a premium discount by attending a risk management seminar. If I am unable to attend a seminar provided by the Program, can I still earn the discount by attending a non-Program event?
A. The Program offers a 5 percent risk management premium reduction for successful completion of a least a four-hour Program-sponsored or jointly sponsored risk management seminar. (The specific education requirements and the specific premium reductions permitted are governed by state statutes and regulations and, thus, vary from state to state.)
The premium reduction can also be earned by attending a non-Program-sponsored risk management seminar if it is at least four hours and has been approved by a Program underwriter. Additionally, for Program participants unable to attend seminars, a premium reduction can be earned with the successful completion of the Program's self-Evaluation Tool (SET), a self-administered, openbook, risk management educational and evaluation tool.
Q. I am interested in learning about what risk management resources, specifically articles and publications, are available for my office staff. Does PRMS offer any materials specific to psychiatry that can be used by my office staff to help us manage our risk?
A. You can identify and manage your greatest liability risks with resources that are now available at<www.prms.com> in the PRMS online marketplace. All materials are designed for anyone in the practice of behavioral health care— psychiatrists, psychologists, nurse practitioners, social workers, and office managers.
Monographs are available on CD-ROM on a variety of topics including billing issues, informed consent, and medications. They can be purchased by Program participants at 50 percent of their regular price. Individual articles in each monograph are also accessible free on the PRMS Web site under “For Participants only.” other discounts for Program participants are available on a variety of other materials as well.
This column is provided by PRMS, manager of the Psychiatrists' Program, for the benefit of APA members. More information about the Program is available by visiting its Web site at<www.psychprogram.com>; calling (800) 245-3333, ext. 389; or sending an e-mail to [email protected].▪
