By Ike Devji, J.D.
You spend time worrying about “technical” issues that create liability like practice procedures, HIPPA and billing compliance and other patient related procedures, all with good reason.
Sometimes however, other more basic liabilities are innocently created or overlooked by even the most informed practice managers and doctors. Here are two simple issues to examine as a starting point:
Is our facility ADA compliant? This goes beyond the obvious like having handicapped parking and restrooms and includes very specific legal requirements for the construction of public spaces like entrances, thresholds, pathways, elevators, counters, even your signage! There have been countless lawsuits on this issue with businesses nationwide, often generated by people who are not even your patients when a “scout” spots an opportunity for a lawsuit. There are specialists in ADA compliance review available in nearly every jurisdiction that will inspect your facility and supply a list of violations and the required corrective actions. What “fully abled” people take for granted and easily overlook will surprise you and the small investment required in a compliance review will almost certainly be less than the cost of responding to an ADA complaint or lawsuit. Still not convinced? Consider that in some states, plaintiffs filing ADA lawsuits are allowed to seek punitive damages, attorney’s fees and extra monetary sums, plus you’ll still have to make the changes legally required.
Have we created dangerous conditions in our office or do we allow others, including our employees and patients, to create them?
I recently read a request from an elderly person looking for a referral to a personal injury attorney after being injured at their doctor’s office. How? By the expensive bicycles of two patients who did not want to leave them outside and asked the receptionist for permission to bring them in. The elderly patient entered the waiting room, tripped over the bikes, severely injured his knee and had his cheek pierced by a section of the bike’s break cable that nearly took out his eye. The liability here is most certainly going to be attributed to the practice, and frankly they are likely a much more attractive defendant as a “deep pocketed” corporation than another patient. We have seen similar issues faced by practices all over the country, including accidents between patients in the parking lot. In more than one case the liability has been attributed to the practice by the plaintiffs for the same reason; it makes more financial sense to (as one real example) sue a doctor’s office for not having enough speed bumps in their parking lot than it does to sue the widow on a fixed income who hit a child in the parking lot.
This same logic extends to a variety of issues like cleaning crew schedules (should you EVER have wet floors during business hours?), waiting room construction and furniture selection, access to electricity or electronics, including medical devices that can cause harm, and in one case, how a flat screen TV a dentist put in his beautiful high end office was accidentally pulled over by a toddler, falling on top of him and injuring him severely. Again, there are low-cost safety inspectors that can walk your facility from the parking lot to the exam room and look for similar issues. One simple way to start today? Walk through your entire facility like you are preparing for the arrival of BOTH a puppy and a toddler that has just learned to walk and look for anything that could hurt them, including access to dangerous substances like cleaning products that may be stored in a bathroom cabinet or other publicly accessible space and consider outlet covers and other child proofing devices you might commonly find in a home, while making sure they wouldn’t limit access by a handicapped person. See how this might get complicated quickly?
These examples and questions can’t possibly provide you with a complete overview, but this should create awareness and a starting point from which to examine these issues in your own practice. Finally, make sure your general liability insurance is an adequate first line of defense and covers employee actions and omissions.
This article was originally written for and published by www.PhysiciansPractice.Com, The Nation’s Leading Practice Mgmt. Resource, where Mr. Devji is also a regular contributor.