 |
|
 |
 |
| |
|
|
| |
| Curbside Consultations: Unraveling a Controversial Legal Conundrum |
 |
by Marcos A. Vargas, MSHA, PA-C - April 25, 2011
|
It can seem like a harmless activity; one without legal repercussions. However, nothing could be further from the truth even though we may have been led to believe otherwise about curbside consultations.
The angst is not so much performing them, but rather knowing exactly what your role is when engaging in these possibly unspecified clinical consultative activities, especially when expected or required to provide information and/or advice on incomplete or inaccurate information given by the requesting peer.
Even more troubling may be the fact that this unspecified request often times boils down to unfamiliarity of certain legal exemptions by both or either parties. Unawareness or departure from them during the process not only raises miscommunication issues, but the liability risk exposures of the consultant--you. And even though there are those who feel that this is a very benign professional activity under the eyes of the law, there are some who would disagree with that myopic view, given the fact that there have been a handful of med-mal allegations/claims involving these “informal consultative activities” in which the consultant was found liable.
Regardless, whether trivializing or forgetting or even overlooking an area of clinical practice as important as this one ,compared to any other component of your care-giving services can still bring potential allegations of negligence under the premise of “medical mismanagement” against you—the consultant.
Remember, most juries are unforgiving when they see the patient suffered damages due to these critical misunderstandings or consultation request misinterpretations from either party.
Therefore, in order to safeguard your career and patients’ safety, it behooves you to assure yourself that the following risk deterring practices, & Risk Management oriented tips, are considered, followed and implemented from the outset. Remember, generally speaking, informal consults (aka “curbside consults”) are characterized & differentiated from formal consults by these set of lawful/criteria and provisions which your requesting peer must understand & honor them:
Tip # 1 Know (precisely) your Requested Consulting Role:
It behooves both parties to be clear cut from the very outset if the requested consult is for a “formal consult” or an “informal” one since the legal repercussions can be very different from each other when either parties have adhered or departed from their respective legal duties.
Establish early, either by querying or clarifying which role would you be held responsible for if the requesting party doesn’t tell you initially or is unclear. Therefore, the unnecessary actionable liability exposure and/or claim arising from such clinical encounter predicaments can be best avoided or minimized when assurances are set forth by each other. This is best accomplished by clearly, and specifically delineating your (the consultant’s) role as mentioned earlier.
Tip # 2: You are a Nameless Consultant in the chart:
Be assured by the requesting peer that you will not be named in the chart. Otherwise a patient-provider relationship will be established and naturally at that point it’s no longer considered a curbside consult, thus creating a legal duty for you & changing the very nature of the consult informality initially sought by the peer requestor.
Tip # 3: The Patient is Unknown to You:
Clearly this means there is no physical contact with the patient. Nor should you be aware of the patient’s name, room number, etc. Preferably it should be presented to you as a hypothetical case scenario. Again, avoid establishing a patient-provider relationship. Therefore, no legal duty is imposed.
Tip # 4 Written Reports Forbidden:
If you are to be compliant under the law, then no billing nor any formal consult note or report is created by you regarding your “involvement” in the case where your input was sought. Your advice should be brief and verbal, and/or a minimal direct recommendation. But most importantly a paperless one (no e-mailing either). Again, doing otherwise & you’re courting liability in since this changes the nature and scope of the consult by leaving a “paper trail”.
Tip # 5 one time only Engagement Allowance:
Clearly advise or remind the requesting peer that that you are willing to accommodate repeat “re-consult” requests only if he or she officially requests a “formal consult”. If continued consultative services are expected from you, then you will be best served by making a “formal one,” particularly while they are obtaining referral approval from insurance carrier(s).
Again, in terms of providing your continued advisory services or follow-up(s) arrangements, is incumbent of you to tell the requesting party that it will be best for all parties involved to “formalize” the consulting relationship. Obviously by doing this you will not be breaching the law.
In sum, by being aware and compliant with the legal exemptions not only is good medicine, but your legal burden is lessened by reducing a potential hazardous activity into a harmless one.
 Marcos A. Vargas, MSHA, PA-C is a Boston born and Puerto Rican bred individual who has an extensive healthcare industry background, both industry-related as a Pharmacy Technician during his undergraduate years, and industry-specific as a dually N.C.C.P.A. certified Physician Assistant in Surgery and Primary care after graduating from the University of Alabama—Birmingham Physician/Surgeon’s Assistant Program. He has held clinical positions in Cardiothoracic, General Surgery, & Emergency Medicine over the past twenty years. He holds a Master’s in Science Administration from Central Michigan University and a Healthcare Risk Management graduate certificate. He has been retained and consulted regularly by both plaintiff & defense law firms over the past 14 years. During this time, he has served as both a consulting medical reviewer and a PA expert. Marcos has lectured on Clinical Risk Management (PA) issues throughout the years to various Michigan-based PA Training Programs. He has done the same for lay audiences, covering a wide range of “Wellness” topics. He has been a supporter and associate member of numerous professional clinical and non-clinical organizations. Currently he is employed as an orthopedic PA at HMC.
The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
RECOMMEND THIS ARTICLE
You must be logged in
to recommend articles
|
|
|
|
| |
|
|
 |
 |
|
 |
 |
 |
|
