Medical Malpractice

When we headed into this recession I think we all knew that we would be facing some interesting issues with our patients when it came to out-of-pocket situations. We all can relate to the fear-factor of the economic times we are in, for some of us it is more real than others, but none the less it is real. Each day we are seeing signs of it from patients cancelling their surgeries once they find out they will have to pay a portion, to asking if they can post-date checks for copayments.

We understand that patients want value from their visit with the physician, but recently we have had more patients call wanting "phone visits" with the doctor so they do not have to pay their copayment or deductible. Many of these patients want guarantees that they will get a treatment at their visit (if they come in) that will fix their problem or they do not want to come in. We actually had a patient who had not been seen for over four years call the office and ask if she could drop off x-rays taken by another doctor who was going to do surgery on her and she want our doctor to look at the x-rays and tell her if the procedure that this doctor wanted to perform was correct for her. She did not want an appointment, just a phone call would do. It was unbelievable that she thought the doctor would do this.

One patient who was seen for plantar fasciitis was recommended that she use a night brace and was shown what one was. She was told what her benefits were for this and because of a deductible she said that she would think about it. At her next visit I asked her how she was doing she replied "much better" and I asked what she felt had helped her to improve her symptoms. She replied "I made a night brace out of a cardboard box". Without skipping a beat I said "good for you, and this is working, which is wonderful." She was very happy that I was pleased for her and then explained how she made it. I told her she was very resourceful and she said she needed to be because she had a large deductible for durable medical equipment and since the doctor believed this device would help her she made one. It is amazing what we will do when we are faced with financial situations.

The main point that I want get across is how the patient was handled. Financial issues are very personal and tough. No one should be made to feel that they are thought less of because they cannot, or do not want to spend money out-of-pocket. The question we should be asking ourselves is "how do we retain our patients though tough times?" We need to remember that patients vote with their feet (they can walk out of our offices for good just as easily as they walked in). TARP (Troubled Asset Relief Program, you can Google it) did a health care study that pointed to the importance of personal treatment in retaining patients.

According to this study patients were asked why they would change health care providers:

• 40 percent cited concerns about quality
• 40 percent cited dissatisfaction with personal treatment
• 20 percent cited concerns about time issues

When patients were asked why they did change providers a different picture emerged:

• 54 percent cited personal treatment
• 23 percent cited time issues
• 20 percent cited quality issues.

As we have all heard before patients that have negative experiences in our offices will talk about these four times more than they will talk about the positive ones. This means you need to create a positive experience for four patients out of every five you see. When problems escalate patients are more likely to bring malpractice actions against a physician if they are not satisfied with how they have been treated. When patients are satisfied with their treatment at the office they are more likely to be more compliant with treatment regimes, so they will produce better outcomes.

We need to raise our sensitivity awareness level when talking with our patients about treatment that would help to resolve their problem, but are uncovered by their insurance. In our office we used to call patients with their benefits for durable medical equipment, PT, surgery, etc., to let them know their coverage and found that many times if they did not have coverage or had a deductible they would not schedule an appointment to come back in, they would tell us they would think about it and call back, but never did. These patients felt that if the treatment the doctor wanted them to have was uncovered or out of reach financially for them, then why come back in? We have since changed how we handle this and reappoint the patient while they are in the office and let them know that we will check their benefits and discuss them at that appointment. Then if they do not have coverage or have a deductible we can discuss this face-to-face with them, which is a more personal way of communication than over the phone. We are taking the time to relate to our patients by talking and listening to them. If it is not something the patient can do at this time, that is okay, the doctor can then adjust the treatment plan accordingly with the patient and they still receive care. It is a win-win for all.

When our patients are happy the doctors and staff are happy and our office environment is pleasant, which reduces burnout, stress and dissatisfaction in our jobs. We need to strive for excellence in our offices giving value to our patients in the form of personal interactions. Problems and challenges will always come up, but it is the way that we handle them that will make the difference. These challenges are opportunities that are critical to our success with our patients and our practice.

Success is not the key to happiness. Happiness is the key to success. If you love what you are doing, you will be successful. ~ Albert Schweitzer