Risk Management Publications

Medication administration is commonly the responsibility of medical assistants (MAs) in many California medical offices and clinic settings. While MAs play a vital role in carrying out a variety of routine tasks that keep your office running smoothly, they may also represent an underappreciated source of risk for your practice.

Notwithstanding the usual suspects that hinder electronic medical record implementation — initial costs, interoperability problems, training burdens, and altered physician-patient dynamics — there’s also the risk of a pure system malfunction. In a malpractice suit after an admitted malfunction, a physician’s actions will still be scrutinized.

You may have already read about CAPAdvantage, our suite of no-cost and discounted practice management programs. Leveraging the buying power of your 12,000 member-strong cooperative, all programs are administered by highly reputable, CAP-vetted vendors. But can these programs really save your practice time, money, and aggravation?

According to a new report on sexual harassment released by the Equal Employment Opportunity Commission, data for fiscal year 2018 shows a more than 50 percent increase in sexual harassment lawsuits filed by the agency, and a more than 12 percent increase in the number of charges it received over fiscal year 2017.

The goal of CAP’s Risk Management and Patient Safety Department is to prevent patient injury, prevent adverse events, and reduce claims by educating physicians to utilize risk strategies across the continuum of care.

CAP members face a variety of challenges in their medical practice in addition to lawsuits by patients. CAP members may also encounter Medical Board inquiries, regulatory investigations or complaints about Medicare/Medicaid fraud or abuse, and even discrimination lawsuits brought by former or current employees.

If there is a list somewhere of phrases that will spur disagreement among physicians, certainly “curbside consult” would be included. One case shows how easy access to electronic health records can affect how involved a physician will be perceived in a particular case. A young mother was on hospital premises with her son, who was being treated for Mast Cell Activation Syndrome. The mother began to experience acute illness and self-injected two doses of epinephrine, which she carried because of her own history of anaphylaxis.

According to the Medical Board of California 2017-2018 Annual Report, the Board’s Enforcement Program received 10,188 complaints against physicians, surgeons, and unlicensed individuals. This reflects an increase of 1,269 complaints (nine percent) over the prior fiscal year. The Board also referred 504 cases to the Attorney General for further action, an increase of more than 18 percent over the prior year.

What do you do when a patient comes into your office with a dog? Tell them to leave? Allow the dog no matter what? The answer is that it depends. Service dogs are governed by the Americans with Disabilities Act (ADA), the California Disabled Persons Act (CDPA), the Unruh Civil Rights Act, and the Fair Employment and Housing Act (FEHA). 

How does your office handle telephone messages from patients?  Are they recorded in a telephone log?  Added to the chart?  How are physicians notified about the call?  These are important questions because they affect patient outcomes and patient safety.