Doctors Need to Manage Risk, Not Crisis

September 24, 2013

The difference between physicians who manage risk and those who manage crisis when it comes to legal and financial planning.

Physicians are more than familiar with the concept of preventative medicine, that is, identifying and trying to eliminate the causes of harm before the harm actually occurs. When done right, this provides the patient the greatest number of options and avoids costly treatment of varying results. In the same way, we repeatedly see the difference between those doctors who manage risk and those who manage crisis in other areas of their life and especially in legal and financial planning.

We’ve covered a variety of these issues in past articles in areas including vital insurance planning, the importance of sound employment, and HIPAA procedures, and even offered a glimpse at how your physical premises itself can generate liability. Below are some items to review now, before the risk becomes a crisis and an expense.

Review and fully implement employment policies including EPLI (employment practices liability insurance) coverage and discipline and termination policies today.

The year's end is often a catalyst for attrition due to unhappy employees, moves to new jobs, and a variety of other factors. We also see many medical practices terminate underperforming employees around the end of the year. As such this is often the season of highest employee liability exposure including wrongful termination complaints so having a well-defined procedure to document your policies and employee performance issues is vital. Keep good records and apply policies uniformly to all employees, not just those on your mental probation list.

It’s also vital for the practice manager to have a real understanding of what each employee does and to supervise the creation of a manual and job task list. This will allow you to effectively have another employee cover their position if they are out for something as routine as a prolonged illness in flu season, a vacation, or maternity leave.  It’s also a great way to help gauge who is actually doing what, how efficiently, and who may need to have their workload or supervision adjusted. In the best-organized practices this extends beyond administrative and clinical staff to the physicians and executives themselves. If certain key employees are responsible for a significant portion of practice revenue, considering contingency plans for the loss of that employee is also vital; there are few greater risks to your medical practice than significant and sustained cash-flow loss.

Create a legal 2013-2014 compliance checklist and ask your advisors to send you a written schedule of any changes or issues and the dates by which you must comply.

Issues of concern should include, but are not limited to:

Affordable Care Act employee coverage option notices you have a mandatory duty to provide all employees. The Department of Labor provides a great summary of these issues including sample notices on its website.

Any new EHR and PQRS compliance required including updates of billing codes and other issues.

Any additional or required continued compliance issues including those related to your third-party payer contracts including any employee credentialing requirements. Even if you use a third-party biller the liability is yours, so ask them to send you an update on what they are doing to comply with regulatory changes and for updated instructions for your staff.

The continuance and upgrade of your practice’s data-security policy, including HIPAA data, patient financial data, and website security. Back up that review with a cyber-liability policy that also covers your website and any employee-managed social media, and have a proactive plan to safely dispose of any electronic or computer equipment you’ll be upgrading at year end.

A sample list like this will vary widely from practice to practice in its details. These are just a few of the commonly recurring exposures we see affect practices in widely different ways based on the level of preparation and preventative planning implemented. Use this list as a spark to outline your own financial wellness plan including goals and a timeframe.