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Year-End Physician Risk Management and Business Issues


Here are some common reoccurring issues at the end of each year your practice needs to know about and act on properly.

As 2014 comes to a close, there are various risk management and business issues physicians and medical practices should address to ensure their success in 2015.

I've addressed several seasonal risk management issues for doctors in recent columns, touching on both personal and professional exposures. Last week, we provided some specific guidance for practices that may be replacing computers and related electronic equipment and the serious risk they pose to exposing patient HIPAA and financial data. We've also covered personal financial exposures that peak at the holidays and the issues to be aware of to avoid liability at your medical practice's staff holiday party.

Today, we take a final look at some common recurring year-end issues.

Keep an Eye on Your Bills - Some of Them May be Fraudulent

We've devoted several articles to helping prevent and identify theft and embezzlement at your practice. A variety of these scams are designed to take advantage of the holiday rush and some basic and predictable behavior patterns, including the fact that many of you will be paying a higher than average number of bills due to both year-end spending on issues like equipment and in an effort to spend down profits that will otherwise be taxed. Make sure the person paying the bills at your practice is following some basic security procedures to verify that you are not the target of fraudulent invoices for things you did not actually get or order. These are often from businesses you've never actually done business with or for things you don't actually have to pay, including fake fines and penalties from fictitious organizations with official sounding names.

Unfortunately, not all the threats are from outside. Make sure management has an eye on the same bills and payments for signs of internal theft and embezzlement as well, as it often takes advantage of the same perfect storm; a business deluged in paperwork and anxious to write checks.

Act on Employment Issues

As mentioned above, the wrong employees can be a serious threat to your business, but the right ones are its most valuable asset. The end of the year is a great and logical time to take a long hard look back at the year and how effectively you managed that human capital to see what worked, what didn't, and what needs to be changed. At least 50 percent of the time, it's at least as much the fault of the manager as it is the employee. We see many variations of the following basic areas addressed around the new year; your practice's needs may be different:

1. Change policies (and job descriptions) that aren't working, implement the ones that are missing, and enforce the ones that worked right. I often suggest a consultation with an employment attorney or HR management company to practices making these changes to their employment manuals and internal procedures. They will help you make required changes legally and in an enforceable way and will often point out and include other legally required changes in a fast paced employment law environment, including compliance with evolving federal law.

2. Make staff changes, even the hard ones. If you have an employee that you've properly managed, corrected and coached who still doesn't comply with the job description and parameters you've set, or is toxic to the office in some other way, the beginning of the year is a good time to make a change and a fresh start. Again, even if the employment is legally "at-will" we often suggest consulting with an employment authority to make sure you are doing it the right way and saying and doing the right things in the eyes of the law.

Remember, this is a shocking and unpleasant thing for most employees and how you handle them both from a legal perspective and from a human perspective may have long reaching ramifications. If possible, handle an unpleasant situation like a termination in the most professional and cooperative way. Many lawsuits start when someone simply gets their feelings hurt, is embarrassed, or is put into a situation where they feel desperate enough to make up a reason to sue.

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