By Kristen M. Pratt
The Art of Defense During my annual trip to the Preferred Therapy Providers (PTP) Tactical Conference in Scottsdale, Ariz, I was pleasantly greeted with the largest attendance at this private practice meeting in the past 3 years I have attended. Definitely a good sign for private practice owners; PTP aptly titled the conference Starting Up and Starting Over—Private Practice Is Bouncing Back. For an in-depth view of private practice owners’ largest concerns, see “Private Practice Keeps On Truckin’,” page 70. A particular session on protecting your practice from malpractice suits delivered by David M. Wright, JD, of McCormick, Siepler & Baker, Glendale, Calif, sparked my interest, not only because lawsuits can mean the difference between survival and failure for private practice owners, but also because I have rarely seen this issue addressed. Wright prefaced his workshop with the grim truth—as our culture becomes more litigious, the number of allied health care professionals facing malpractice lawsuits is growing. Malpractice litigation is no longer only a physician or hospital concern; therapists must be prepared to defend themselves. According to the Institute of Medicine (IOM) Committee on Quality Care in America report on patient safety, American health care is currently unsafe, with 3% to 4% of hospital patients being harmed by the care that is supposed to help them.1 The report also stated that current statistics on patient safety are limited almost exclusively to the hospital setting, with little information available on outpatient, skilled nursing, and home health care settings, but “Our committee suspects that hazards in these areas are also common.”1 Obviously, practices must address patient safety, but how can physical and occupational therapists protect themselves from the types of patients who see the typical $1 to $3 million insurance policies that most therapists carry as a possible free ride? Wright suggests starting with patient consent. Wright explained that patient consent forms will not protect therapists completely, but they do help. A written form is provided to each patient that details the treatment you are proposing so that the patient can make an informed decision. According to Wright, physical therapists are at a higher risk for malpractice than occupational therapists, because typically PTs have a shorter number of patient visits than OTs. He went on to address PTs specifically on the importance of explaining the treatment process in laymen’s terms to patients, emphasizing the fact that physical therapy can sometimes be painful. The basis of consent is that patients understand what they are in for, which is the only way they can give their informed consent to the treatment. Wright said, “Explain everything up front, basically having patients consent to ‘I understand that [the treatment] may hurt, I may not get better, and it may take a long time.’” He also suggested providing information on what will happen if patients do not complete treatment and who will be treating them, ie, a PT, physical therapy assistant, or aide, and what each title designates in terms of education and experience. So, if you do not currently have a patient consent form in place, you might want to have your attorney draw one up, because the best defense is grounded in preparation. —Kristen Pratt Machado is no longer Editor of Rehab Management. Please address any correspondence to Sarah Schmelling, Senior Editor, at cwolski@medpubs.com. Reference
