Haunted By Fears of Legal Nightmares?
Simple precautions can help prevent legal snafus in your clinic.
Most veterinary practices are small businesses, and statistics reveal that small businesses can expect to face a major lawsuit during the first five years of business.1 The more successful the business, the more lawsuits it is likely to face. Legal experts believe that practice managers can be instrumental in preventing some legal actions by introducing and implementing actions to reduce and prevent legal nightmares. Douglas Jack, B.A., LL.B., recently reviewed actions that a veterinary manager can introduce to reduce the risk of lawsuits.
Jack operates a law practice in Fergus, Ontario, Canada, dedicated to the law as it relates to veterinary medicine. He is a member of VHMA, a charter and founding member of the American Veterinary Medical Law Association, and a member of the Ontario Veterinary Medical Association and the American Animal Hospital Association. According to Jack, by improving communication and record-keeping, veterinary managers can made strides toward reducing the risk of lawsuits.
Communicate, Communicate, Communicate!
Professional risk management studies suggest that many lawsuits can be attributed to communication issues.2 In business, especially when dealing with staff and clients, good communication is essential. By communicating effectively with staffers and listening and responding appropriately and providing them with opportunities to be heard, the office environment promotes respect among staff and patients. In an environment characterized by respect, the office functions more effectively, staff is more productive, and patients and clients are more satisfied. This is a foundation for an office that promotes a better staff/patient relationship.
The patient/client-friendly approach can set the groundwork for better relationships. Communication is about nurturing the staff/patient relationship, and not just presenting a veneer of concern to avoid lawsuits. When discussing communication issues with practice staff, these are the basic expectations for all staff:
•Make sure the patient/client voice is heard as clearly as yours.
•Encourage raising questions, fears and expectations that are discussed openly and freely between staff and clients. •Ensure that the staff is devoting adequate time to questions and concerns raised by clients about their pets.
•Refine staff skills through training programs and provide feedback to ensure the staff is equipped with the skills and tools to effectively nurture relationships with clients.
The goal of enhancing the staff/patient relationship and fostering strong bonds between caregivers and clients is to create an atmosphere in which clients can resolve simmering issues amicably with the practice rather than use the legal system as the first line of attack in contentious situations.
Sir William Osler, called the most influential physician in history, offered this insight: “Patients don’t care how much you know until they know how much you care.” A breakdown in communication between staff and clients may occur when a client becomes angry, feeling the staff doesn’t care. By promoting enhanced communication skills and improved interpersonal skills among the staff, practice managers can minimize flare-ups that may result in litigation.
When providing the staff with feedback and organizing training to improve communication, the top ten patient satisfaction elements are concern, friendliness, patience, sincerity, consideration, availability, technical quality of care, outcome, cost, and practice environment. Almost all the factors can be conveyed more effectively to clients through good communication skills.
Although good communication skills cannot prevent all lawsuits, improving communication will most certainly nurture a more satisfied client base. Satisfied clients are happy clients and less likely to sue.
For the Record
The American Veterinary Medical Association’s Principles of Veterinary Medical Ethics state that a veterinarian must maintain records if a veterinarian/patient relationship has been formed. Conscientious practices are committed to ensuring that records accurately reflect treatments, procedures and conversations, yet must balance record-keeping responsibilities with caring for patients. The importance of keeping thorough and clear records cannot be understated. The better the records, the better the practice can make its case in the event of legal challenges. To ensure that records are complete and maintained in a timely manner, the key is to implement practices to improve record-keeping.
Practice managers find that the suggestions outlined below can effectively streamline the record-keeping process and ensure complete, up-to-date files:
•Use commercial or customized stamps, stick-on exam labels and preprinted medical record forms to minimize the repetitive part of record-keeping.
•Use customized or standard medical abbreviations. Common and recognized abbreviations can cut down on the text in the records. Create a list of abbreviations that will be used in the practice. Add the list to the employee manual and be sure that the entire staff is familiar with and proficient in identifying the abbreviations.
•Make record-keeping the responsibility of each and every staff member and ensure that notating charts becomes standard operating procedure. All staff members should receive training in the practice’s record-keeping protocol. From veterinarian to technicians, every encounter with a patient should be recorded by the staff member and each entry initialized in the treatment notes.
•Preprinted or computerized forms can make record-keeping less time-consuming.
Although maintaining excellent medical records can be a great resource in the event of a lawsuit, the real value is to provide patients with the best care. While your staffers are committed to performing at their optimum levels, memory may be affected by stress, fatigue and other pressures. Well-maintained records offer a constant reminder of a patient’s issues and treatment. They are also helpful should the patient/client transfer practices.
Implications for Practice
Like it or not, litigation is the cost of doing business. With a commitment to improving communication and documenting all patient/client interactions, practices can improve their relationships with clients and reduce their liability exposure.
Christine Shupe is the Executive Director of the Veterinary Hospital Managers Association. The association is dedicated to enhancing and serving professionals in veterinary management through superior education, certification and networking. For more information, visit www.vhma.org.
1www.lectlaw.com, “Thoughts of A Major Lawsuit Keeping You up at Night?”, G. Edward Arledge, Esq. San Diego