We’ve compiled a list of answers to the most frequently asked questions from our members. They are designed to give you a better understanding of our organization, our services, and other technical information.
- What should I do if I receive a Notice of Intent to file claim (NOI) letter?
It is imperative that on receipt of anything vaguely resembling claims of wrong doing, whether it is a demand letter or a Notice of Intent (NOI) that you immediately contact MPIE at 616.202.2288 and ask to speak to our claims staff or you may email firstname.lastname@example.org. You will be advised by MPIE not to discuss this case with any one else except MPIE staff or your attorney. Under the Michigan Medical Malpractice Tort Reform Act of 1994 the plaintiff must notify the defendant at least 182 days before a lawsuit can be commenced. The NOI must state:
- The factual basis for the claim
- The applicable standard of care alleged by the plaintiff
- How the standard of care has been violated
- What treatment was required by the standard of care?
- How the breach was the proximate cause of the injury claimed
- The names of all health professionals and health facilities the plaintiff is notifying with respect to the claim
- Why do patients file claims against physicians?
There are many reasons why patients sue their physician. The most important reason is anger. Patients who are angry about the outcome of treatment, rude behavior by their physician or staff, or who have been inconvenienced unnecessarily are more prone to file a claim. Therefore, it is imperative that physicians and office staff are involved in preventive risk management practices. An honest discussion about an unfavorable clinical outcome, a simple apology when you are behind schedule, and a follow up phone call to an irritated patient are some of the ways to prevent a patient from becoming angry to the point that they file a claim. Through our phone consultation services, MPIE will assist you in risk management situations. Call MPIE at 616.202.2288 or email email@example.com for assistance.
- When a patient’s attorney requests an informal meeting with the physician to discuss medical management, what should the physician do?
Physicians should decline to discuss medical management of patient care with the patient’s attorney (plaintiff attorney) either by phone or an informal meeting. If the plaintiff attorney desires information from a physician not named in a case as a defendant, MPIE will provide legal council if necessary and assist you in responding to the plaintiff attorney’s request. Giving an informal interview or phone consultation without representation by legal council could involve you as a defendant in the future. Your discussion of the case has the potential for self-incriminating testimony.
- How do I give a deposition?
The deposition in a malpractice case is a basic element of discovery in the litigation process. Generally, you will be informed by your defense counsel that the plaintiff’s attorney requested your deposition. Your defense counsel will then have a pre-deposition conference to prepare you for the deposition. MPIE has several articles that also can help you prepare for your deposition. QuantiaMD also offers an online course titled, "Preparing for a Malpractice Deposition."
At times the Office Manager as the custodian of the medical records may be deposed and asked to provide information at a trial. The Office Manager should know the office policy and procedure for handling medical records and they will generally only be asked to verify that the record is the complete and/or original medical record.
While depositions can be stressful, your defense counsel and MPIE staff will support you.
- Does your office staff know how to prevent lawsuits?
Malpractice suits often start with poor communication with patients. You should educate your staff in four key areas:
- Documentation, especially when things go wrong.
- Confidentiality, commitment to privacy and dignity.
- Phone communication, customer relations and personal courtesy apply to the physician office staff
- Handling disgruntled patients, staff needs to learn how to defuse volatile situations. Helping your staff know their responsibilities and limits could lower your exposure to litigation. MPIE provides a yearly educational seminar for office managers and office staff aimed at risk and liability reduction in the office practice. There is currently no charge to MPIE insured practice staff for this program. View our education section for information on educational programs, seminars, and webinars.
- When an attorney requests a copy of a patient's medical record, what should be released?
It all depends on who you ask. Some office practices, on the advice of their attorney or practice consultant release only the part of the medical record that was generated in their office during the past two or three years. MPIE on the other hand recommends that the complete medical record, including lab results, x-ray reports, letters, consultations, except legal communication be released. Legal documents, such as legal opinions from your attorney, letters from MPIE, peer review documents should be kept separate from the medical record. Our opinion is based on two considerations.
All of the information in the patient’s medical records is available to physicians or other health providers to help them shape their medical opinions, diagnosis and treatment options. Further more, under Michigan State Statute, attorneys acting on behalf of their client have a legal right to a complete set of medical records. While HIPAA regulations need to be followed in your medical record release policies, HIPAA regulations do not prohibit the release of the complete medical record. For some offices the complete medical records are voluminous and costly to duplicate. We suggest that office practices charge a reasonable, but adequate fee for their medical record release services.
Unfortunately, MPIE has been in several lawsuits in which the initial request by an attorney for complete set of medical records was not followed. This led plaintiff attorneys to allege cover up by the physician and incompetent medical office practices. While the final settlement of these cases may not have been altered by the medical record release procedure, cost of defense increased. Should you have any questions about medical record release to attorneys, please contact MPIE at 616.202.2288.
- When should physicians or practice managers call MPIE concerning risk management or claims issues?
MPIE staff is always willing to address any risk management question relating to your practice. We request that you call us whenever any of the following occur:
- Unexpected serious adverse outcome.
- Notice of Intent (NOI).
- Obvious negligence.
Calling MPIE does not jeopardize your premium. Please call 616.202.2288 and request to speak with Claims or Risk Management. Early identification of potential problems grants us the opportunity to help you manage your risks.
- Is there a charge for legal advice?
Legal advice will be sought on behalf of a member at no additioanl charge when legal expertise is required- as determined by MPIE claims or risk management staff. If a member desires legal advise that is not determined to be within the services of MPIE or the member's policy coverage, the member will be responsible for all legal charges.