Planning for the Worst Case Scenario

For the third time in as many weeks, today I received a phone call from a family member of one of our insureds calling to let us know that the doctor had passed away.  As always, I was saddened to learn of the passing of one of our clients but my heart really went out to the family member – in this case the doctor’s wife – who was frantically trying to provide for the doctor’s patients while struggling with her own grief.

The doctor, like most psychiatrists, was committed to protecting the privacy of his patients.  No one but the doctor had access to his computer, his appointment schedule, or his billing records.  And no one had any idea of what his passwords were.  The irony here is that in fulfilling his duty to protect patient confidentiality, the doctor may have inadvertently put his patients’ health in jeopardy.

Don’t let this happen to your family or to the patients you’ve devoted your life to caring for.  Today, while you are able, sit down and draw up a set of instructions for your staff and/or family to follow in the event of your death or sudden incapacity.  Think of it as a professional “advance directive.”  Your plan might include such things as:

• All of your contact information: cell phone number, home phone number, pager number, e-mail address, and home address.
• All contact information for your spouse, life partner, adult children, or anyone else who would likely know of your whereabouts or sudden health problems.
• A statement that staff is authorized to contact these people in the event of your unexplained absence from the practice.
• Instructions regarding how long staff should wait before implementing the emergency contact plan in the event of any unexplained absence.
• Instructions regarding who is authorized to access  patient records in the event of your sudden absence.
• Instructions on how to access the physical office and the electronic patient records in the event this becomes necessary, including passwords, etc.
• Instructions on how to access a list of active patients and your appointment schedule.
• Instructions regarding prescription refills and release of information to third parties.
• Instructions on how to notify patients and how to deal with those who become upset, either physically or emotionally, or are in crisis.
• Names, addresses, and phone numbers of psychiatrists who have agreed to act as emergency backups.
• Contact information for your malpractice carrier, your billing service, and your business attorney.
• Any other information needed to help ensure the safety and continued care of your patients.

Once drafted, the plan should be regularly updated to reflect changes in your practice and the practices of the colleagues who have agreed to assist in an emergency. The plan need not be complex, but it must be documented and readily available to anyone who may need to implement it.  Your patients, your staff, and your family will thank you for it.