Psychiatr News October 20, 2006
Volume 41, Number 20, page 24
© 2006 American Psychiatric Association
Avoid Risk Management Land Mines By Educating Yourself
Q. I am an administrator of a behavioral health care group. Our
professional liability insurance for the group practice is through the
Psychiatrists' Program. Several of our psychiatrists are interested in
moonlighting outside of the group practice. Will they need to purchase a
separate insurance policy to cover them at the outside practice?
A. No, these doctors will not need a separate insurance policy to
cover work in an outside practice. With the group administrators' approval,
coverage for these doctors can be extended for work outside their group
employment (subject to underwriting approval).
Another important feature of the Psychiatrists' Program for group practices
is that all practitioners—psychiatrists, psychologists, social workers,
and other behavioral health care providers practicing in a group—can be
covered under one policy, along with the group practice itself. For more
information about group coverage, call (800) 245-3333, ext. 314, or visit
<www.psychprogram.com/groups>.
Q. What are the most damaging claims that you see? Suicides?
A. suicide is a high-risk event that frequently results in lawsuits;
however, the cases with the highest judgments or settlement values are not
death cases but cases that involved significant permanent neurological or
physical injuries that result in the need for lifelong care. The financial
costs associated with providing lifelong care combined with the loss of
potential income and, in some jurisdictions, the cost of "pain and
suffering" are the reasons for awards of hundreds of thousands,
sometimes even millions, of dollars.
Here are three examples of such a claim:
- A patient who has developed permanent renal failure from an instance of
lithium toxicity and must endure kidney dialysis and/or replacement
- A patient who suffers from significant tardive dyskinesia due to a failure
to detect warning signs and symptoms
- A patient who suffers brain damage as a result of a failed suicide
attempt
One of the primary causes of these types of injuries is the alleged
mismanagement of a patient's medication regimen. For this reason, risk
management advice dictates that psychiatrists prescribe carefully and monitor
medication levels and appropriate physiologic functions regularly. Also,
patient compliance with monitoring should be tracked.
Q. I have my malpractice insurance coverage with the Psychiatrists'
Program and learned that I can earn a premium discount by attending a risk
management seminar. If I am unable to attend a seminar provided by the
Program, can I still earn the discount by attending a non-Program
event?
A. The Program offers a 5 percent risk management premium reduction
for successful completion of a least a four-hour Program-sponsored or jointly
sponsored risk management seminar. (The specific education requirements and
the specific premium reductions permitted are governed by state statutes and
regulations and, thus, vary from state to state.)
The premium reduction can also be earned by attending a
non-Program-sponsored risk management seminar if it is at least four hours and
has been approved by a Program underwriter. Additionally, for Program
participants unable to attend seminars, a premium reduction can be earned with
the successful completion of the Program's self-Evaluation Tool (SET), a
self-administered, openbook, risk management educational and evaluation
tool.
Q. I am interested in learning about what risk management resources,
specifically articles and publications, are available for my office staff.
Does PRMS offer any materials specific to psychiatry that can be used by my
office staff to help us manage our risk?
A. You can identify and manage your greatest liability risks with
resources that are now available at
<www.prms.com>
in the PRMS online marketplace. All materials are designed for anyone in the
practice of behavioral health care— psychiatrists, psychologists, nurse
practitioners, social workers, and office managers.
Monographs are available on CD-ROM on a variety of topics including billing
issues, informed consent, and medications. They can be purchased by Program
participants at 50 percent of their regular price. Individual articles in each
monograph are also accessible free on the PRMS Web site under "For
Participants only." other discounts for Program participants are
available on a variety of other materials as well.
This column is provided by PRMS, manager of the Psychiatrists'
Program, for the benefit of APA members. More information about the Program is
available by visiting its Web site at
<www.psychprogram.com>;
calling (800) 245-3333, ext. 389; or sending an e-mail to
TheProgram{at}prms.com.
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American Psychiatric Association.
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