We are going to see lots of malpractice suits arise from this COVID-19 pandemic. Patients will sue for any damage suffered after intubation and they will sue for missed COVID cases. Malpractice risk exists even if these patients are seen through telemedicine.
Medical boards will investigate physicians who prescribed or didn’t prescribe certain medications. Many doctors will be held accountable for self-prescribing anti-malarial drugs, etc.
If you’re doing telemedicine, here are some great resources for you in order to decrease your malpractice risk when doing telemedicine.
#1. Document Well
Proper documentation is the cornerstone of telemedicine – you should be documenting the shit out of your visit in order to decrease your malpractice risk. And this doesn’t have to be long because you’re usually seeing the patient for a single issue.
In my current clinic where I’m seeing the patient for a rash in their crotch, hypertension, diabetes, headaches, knee pain, disability paperwork, and pain medication refill, I have to spend 1.5 years documenting everything.
For telemedicine, use voice dictation on Google Documents (which is free) and you’ll save yourself a lot of time.
But be thorough and address all proper aspects of a SOAP note. Its takes seconds to dictate it, why shortcut it? It’s the only thing you’ll have to protect you.
#2. Refer to Established Guidelines
There are lots of established guidelines which are considered “community standards of care”. If you refer to these and you give the same exact recommendations, it’s impossible for you to lose a malpractice suit and most lawyers won’t bother.
If you’re NOT supposed to give hydroxychloroquine or azithromycin or other med-de-jour in the outpatient setting, then don’t. Don’t cover someone with antibiotics for potential “pneumonia” without getting a chest xray – that’s not acceptable.
Referring to established guidelines is a great way to decrease your telemedicine malpractice risk.
Medici – which is a telemedicine software company – has provided a great resource for clinicians and patients. Review these, and refer patient to them.
AND, document that you treated the patient based on those guidelines:
“patient managed based on current CDC or WHO guidelines” – done.
If you’re a cut-and-paster, use keep.googl.com and add your blurbs in different keep notes. You can then cut and paste into your note.
#3. Document Consent
If you’re doing telemedicine be sure to know if your state requires consent for telemedicine. Many do. So, if your telemedicine company doesn’t automatically add that into the chart, add a quick note:
“patient consents to a virtual visit with me as their provider”
I know this part might seem trivial but it’s the same as getting consent before a procedure. Do it, and put your mind at ease that you’ve taken an extra step to decrease your malpractice risk.
#4. Offer Return Precautions
You must always mention and offer return precautions. As in, who should the patient contact or where should they go if they are getting worse.
“Patient understands that they should go to the ER for any worsening symptoms or can contact us on here for further questions.”
#5. Offer Testing
Many municipalities offer state-sponsored drive-through testing for patients. Offer this to the patient. They can decide what to do with that information.
Of course, not every patient needs this. But if you find it’s necessary, offer it to them and document it.
It’s not that testing is necessary but you must offer the patient the kind of information that’s expected of you. Which means, whatever state you’re practicing in, or whatever state medical license you have, you must stay up to date on whatever the medical board releases on their website.
Being informed means that you’ll further decrease your malpractice risk. It’s these little things that some attorneys will latch on to. Close that gap, any way possible.
#6. Recommend Self-Isolation
If a patient is suspected to have COVID-19, you should offer them advice to isolate at home and minimize contact with other in order to prevent spread of the disease.
Again, this is the part that obvious because it’s public information. But it’s good to document that you’ve made that recommendation to the patient. Or simply that you referred the patient to the current guidelines.
#7. Be Nice
One of the best ways to avoid a complaint when doing telemedicine or a malpractice suit is to just be nice to the patient.
Don’t kiss their ass, not at all. Be firm, be concise, but be kind. Verbalize your smile and empathy because the patient doesn’t know that you genuinely care about their payme…. I mean, health, so use the right words.
“I can imagine how scary this is for you. I’m so glad you reached out and thank you for going through all of your symptoms with me. Let me tell you everything you can do to hopefully get through this safely.”
“Remember, we’re here for you, if anything changes contact us back right away. During these uncertain times it’s better to ask us for guidance instead of causing yourself unnecessary concern.”