Minimizing Liability This is nothing new for healthcare professionals, however in our profession everything we do and say can be used against us. The difference between us and other professionals is that even if we don’t personally say anything it could be construed as our directions which will then have a similar effect as saying it. According to New York malpractice attorney Lee J. Johnson, Esq; “even when you shut off the lights to your practice and go home at night, you could be at risk for committing malpractice if your answering service handles after-hours call inappropriately”. Consider that anybody that answers your telephone calls is acting as your agents. You could actually apply this rule even to your reception personnel as I have see them “providing” medical advice more frequently that I would like to. The bottom-line, as Johnson stated in a video posted on Medscape is: “you are responsible for selection, training and monitoring the service.” So, for example, if a patient calls with a headache and says it is not an emergency, but later is diagnosed with cerebral aneurysm, you are responsible for the answering service’s decision not to call you, and may find yourself defending its actions (and your career) in court. To make matters worse, a trend such as transposing numbers, delaying messages and calls, not dating or timing the calls and even garbled messages may be interpreted as negligence on your part as you may have been aware of the problem but didn’t take actions to correct the same. The truth is that there is not foolproof course of action; however here are some recommendations to mitigate the risk: • Train all your agents on the basics of how to handle patients regardless of medium (e-mail, telephone, person to person); • Write a script for your reception and front staff “agents” and have them stick to it; o Policies and Procedures as it relates to these issues are strongly recommended. • Determine urgency of the call right away and if emergency or if you cannot get to the call within a “reasonable” amount of time have them go to the ER; • Have a back-up for all of your operations, including answering patient calls; • Conduct a risk analysis to identify potential problem areas. Another possible recommendation is to contact us directly to assist with risk assessment, analysis, policy development and training. The important issue at this point in time is that you need to be aware of the risks and take action to mitigate them.