Ask Me MD: Medical School for the real world

Mary Gonzales - Malpractice in the time of COVID-19

August 06, 2020 D.J. Verret, MD, FACS Season 1 Episode 1
Ask Me MD: Medical School for the real world
Mary Gonzales - Malpractice in the time of COVID-19
Chapters
Ask Me MD: Medical School for the real world
Mary Gonzales - Malpractice in the time of COVID-19
Aug 06, 2020 Season 1 Episode 1
D.J. Verret, MD, FACS

Mary Gonzales of the Texas Medical Liability Trust joins Dr. Verret to discuss malpractice issues and practice liability in the time of COVID-19.

If you have questions or ideas for a show, send us an email at questions@askmemdpodcast.com. Hear the latest podcast at http://askmemdpodcast.com or through your favorite podcast directory.

Show Notes Transcript

Mary Gonzales of the Texas Medical Liability Trust joins Dr. Verret to discuss malpractice issues and practice liability in the time of COVID-19.

If you have questions or ideas for a show, send us an email at questions@askmemdpodcast.com. Hear the latest podcast at http://askmemdpodcast.com or through your favorite podcast directory.

Announcer :

Ask Me MD, medical school for the real world with the MD Dr. D.J. Verret.

D.J. Verret, MD, FACS :

Thank you for joining us for Ask Me MD, medical school for the real world. I'm Dr. D.J. Verret. Today we're going to be joined by Mary Gonzales with the Texas medical liability trust. Mary will be talking with us about liability issues during the time of COVID. We'll be right back after this short break. Today we have the pleasure of being joined by Mary Gonzalez with the Texas medical liability trust. Mary, thanks for joining us today. I know it's the time of COVID. We're meeting via zoom. And and I think it's timely that we talk about how malpractice and COVID are intersecting. So thanks for joining us.

Mary Gonzales :

You're welcome. Thank you so much for having me.

D.J. Verret, MD, FACS :

So I know you guys have been getting fielding a lot of questions from your insurance and practice administrators, and we were talking about it before the show. And yes, just to start off with probably one of the biggest questions is, what happens if a physician or a staff member actually test positive for COVID-19? What What do we need to worry about in terms of our malpractice and in our interactions with patients there?

Mary Gonzales :

Well, in in terms of malpractice, you know, when it comes to a patient comes in, and you know, they're saying that they have have, you know, there's where they got the covid 19 and and they're gonna sue the doctor? Well, that's not really a medical malpractice claim. But that definitely is a big Texas Medical Board issue right now. So you know, you want to make sure that your staff is definitely taking precautions, your staff, they're all wearing the PP equipment, you know, that you're keeping them protected, that you're keeping your patients protected. And so many ways right now, our doctors are doing their best in order not to keep their their waiting rooms full, you know, to capacity. And so some of the things that that that, you know, are being done right now, definitely, you know, getting a lot of calls on COVID at TMLT.

D.J. Verret, MD, FACS :

You mentioned Texas Medical Board complaints and and I found that to be an area I hadn't thought about. But I know you were mentioning you you guys have been getting some of your insurance having complaints filed against them, saying that patients may have gotten covid at the physician office or the physician office wasn't handling things appropriately. Maybe if you could touch on some of the some of the medical board rules or where physicians can find the medical board rules that that are governing right now. And how TMLT and other malpractice carriers could potentially help with those kinds of complaints.

Mary Gonzales :

Sure, um, you know, right now, the the resources that our physicians have for for any type of, of COVID issue is with the Texas Medical Board, we've gone over that many times. There, they also have another resources at Texas Medical Association. You know, they have definitely lots of resources there for, for their patient for I'm sorry, for the the administrator, you know, when you've got an office administrator is trying to keep everyone healthy in your in your office employees, the physicians, the patient's, you know, there's a lot to look at. And, and as we know, this is changing on a daily on a weekly basis, you know, what the requirements are? even, you know, when we're even looking at governmental actions, you know, with our Texas Governor, you know, for a while there that was changing on a daily basis. So even team lt was having to constantly go to the Texas Medical Association to go to the Texas Medical Board, and, you know, to have answers for physicians on what they should and shouldn't be doing. So, you know, definitely look at those resources. A lot of legislative advocacy going on right now. On baseless COVID claims. I know that that we are working with the Texas Medical Association to come up with some legislation on that type of issue, because it's already starting, you know, so we're going to we're trying to get in front of this issue. Um, hopefully.

D.J. Verret, MD, FACS :

And I know we talked about medical defense coverage within malpractice, maybe you can speak to that a little bit more and how that can help physicians facing these these problems.

Mary Gonzales :

Sure. So what we how your men defense coverage is going to come into play is whenever you know you get you get a complaint and you've got a patient that says you know, their physician didn't work. mask while I was in the, you know, while I was in the physician office, so I got the exposure there, he didn't, he didn't wear the PP equipment that was required. So you definitely want to make sure this is where your med defense coverage would come into place. Any, any type of disciplinary proceedings, you know, from the Texas Medical Board, there's what that would come into. Again, I said government actions, you know, that's going to be a big right now, I think HIPAA will pretty soon get involved, and some of this requirement and you don't want it but to come and audit you, you know, then they bring the OCR the Office of Civil Rights in and you know, they want to audit your records, they want to audit everything that's going on in your in your office. So that's something that you definitely don't want to happen, but your med defense coverage, you know, will will help you in that area.

D.J. Verret, MD, FACS :

I've seen a lot of discussion in in physician discussion boards about bringing in locum physicians and practices when the physician is out for an extended period for various reasons around the COVID pandemic. What are some of the malpractice considerations that that we should think about if we're considering to bring in locums?

Mary Gonzales :

So right now, your malpractice considerations definitely should be you know, that, you know, the history of the physician that that is, is going to replace you. And just remember that that it is a replacement a locum tenens is exactly for that it's to replace you in the event that either you contracted COVID is what we've seen the doctors contracted COVID, or the doctor is on a leave of absence. Right now, carriers are allowing leave of absence, discounts that, you know, they're allowing some of our physicians who had to close their doors when they were not allowed to, you know, to perform these surgical procedures that were non essential, you know, their hours were reduced drastically. So, carriers were allowing heavy discounts, you know, to try to help our physicians out financially in that area. So, you know, a lot of response from your carriers as far as that goes.

D.J. Verret, MD, FACS :

Now, on the flip side, you mentioned shutting down practices, but what about what deficient do what do you think physicians need to consider when they're opening their practices back up, to make sure it's done correctly and their and their liability is taken care of as best we can.

Mary Gonzales :

You want to definitely make sure that you've got enough PP equipment, you want to make sure that your employees are wearing it, you want to make sure that your physicians are all wearing their PP equipment, make sure that you've got sanitizer, you know, there's go to the Texas Medical Board, there's a checklist there and what you should shouldn't be doing, you definitely should be posting your disclosures. You want to make sure that that happens. And you know, basically wear a mask, Texas Medical Board has very, very distinct rules and definitely assure you that that's where you need to go, um, you know, in order to help you in that area,

D.J. Verret, MD, FACS :

I know a lot of my friends and unfortunately have shut down their offices, but but fortunately I've started doing telemedicine and sometimes the The rules are different when you're doing telemedicine versus in person visits. Do you guys have some resources or suggestions for physicians who are looking at telemedicine options?

Mary Gonzales :

We do have resources for telemedicine options right now. I know that the before COVID-19, telemedicine was a big topic, you know, with physicians on how they were getting paid for telemedicine and things like that. So obviously, you know, now that that, you know that we're dealing with COVID, that has definitely been an excused. No, our I would say that's an allowed payment now. And so our doctors are opening up that telemedicine window, you know, allowing their patients to get a little more comfortable with it. I've even asked several administrators that I you know, have had renewal meetings with how are your patients, you know, doing with the telemedicine are they actually preferring this? Are they preferring that face to face and actually they're saying they can't wait to do face to face, you know, they, telemedicine is going to be a very temporary thing once this is over. So I tend to believe that it's going to be the norm. So who knows.

D.J. Verret, MD, FACS :

But from a liability perspective, though, do you? And I think every carrier is a little bit different. But do physicians need to notify the carriers? If they're doing telemedicine on top of our as a new addition to their practice?

Mary Gonzales :

Yes, they definitely need to notify their carrier their carrier most likely we'll cover it TLT does cover telemedicine, but you definitely want to let them know that this is what you're doing now. And and so they most likely they'll want to know what the percentages you know telemedicine is at 50% of your practice is a 10% of your practice. Right now, it tends to be, you know, a pretty big part of it. So definitely let them know that you're, you know, that you are doing.

D.J. Verret, MD, FACS :

I've also seen a fair number of places where physicians have traveled to other states to volunteer to help in the COVID crisis. And and I know the state of Texas, the Texas Medical Association, Texas Medical Board, have been soliciting volunteers. Can we talk a little bit about malpractice considerations if you're volunteering to help with covid?

Mary Gonzales :

Sure, what I've seen is on the and I know that we've had a couple there at DMlt, as we've had physicians, who are volunteering, want to come to Texas to help out the physicians and they're actually fast tracking, the Texas Medical Board is fast tracking their licenses, we've seen them these days as fast as two weeks. That is unheard of. Yet, so that's unheard of. And so we see that that's happening right now. And I know that that tml T, you know, if you're a retired physician, and you want to come back to your group practice, or you want to come back and help at the telemedicine, your insurance coverage is free. So you might want to make sure your your medical malpractice is free. So you might want to make sure you know that you're you know that you're aware of this ask your carrier if you're thinking about doing because they most likely will expand.

D.J. Verret, MD, FACS :

Now what if, as a licensed physician in Texas, I want to go help in Arizona or California I get licensed there. Is my malpractice gonna follow me there? Or is there something else I need to be doing?

Mary Gonzales :

There is something else that you need to be doing. Tlt is a Texas carrier. And so we would only carry you in Texas, there are national carriers that you know, that have that exposure. And we actually have a risk retention group that anytime one of our physicians, you know, has any exposure outside of the state of Texas, we have a risk retention group that actually will help in that, you know, with that exposure. So you want to make sure that your carrier has that for you. Otherwise, you can definitely go to independent brokers, you know, things like that to get that type of coverage. But generally, your coverage doesn't extend from state to state unless you have, you know,a license in every single state.

D.J. Verret, MD, FACS :

What about if I decide to volunteer within the state of Texas, if I decide to go to Houston from Dallas? Is Is there a consideration there with my malpractice insurance?

Mary Gonzales :

Your malpractice policy should carry you with? With us? It does it does follow you wherever you go provided that you don't have an employment exclusion. So you know, it is definitely available for you.

D.J. Verret, MD, FACS :

Fantastic. Well, Mary, I appreciate the the information. Is there anything else that you guys have been seeing during this that you think our physicians would be interested in hearing about?

Mary Gonzales :

Well, I think that just know, you know, know that you have resources with your carrier. Most of our physicians were all of our physicians, our Texas Medical Association members, you actually get access to us, through them and then within all of the medical societies in Texas, but use them they have they have great resources for you. You're never alone. Please don't think that you're alone in this crisis. You know, there are so many resources there for you. So definitely reach out.

D.J. Verret, MD, FACS :

We've been talking with Mary Gonzalez of the Texas medical liability trust about some of the special considerations during this time of COVID you're listening to Ask Me MD I'm Dr. DJ Verret. Thanks for listening. Make it an awesome week.