The phone is your friend when used properly

May 10, 2011

For whatever reason, the author says, many physicians appear to be afraid of the phone.

Try to look at the phone as your friend, however, especially if you are on call and must be available wherever you go. If you don't want to be disturbed, put the phone's ringer on mute and answer it at your convenience. Availability and responsiveness are duties of medical practice and may be necessary to protect you from liability.

COMMUNICATION FUNDAMENTAL

In the event of a malpractice lawsuit, you will have to defend your standard of care in the timeliness and appropriateness of the advice you gave the patient. You could have potential liability if you didn't respond to a patient complaint or request in a timely or appropriate manner.

You or your patient may initiate a doctor-patient phone conversation. Your patient may relay information to you. The patient may be concerned about his or her health, possible side effects of medications, the results of a biopsy, etc. In turn, you convey information and advice. Detail the advice you provide verbally and in writing-for instance, that the patient should go to the emergency department (ED), call the office to be seen the next day, keep a regular appointment, continue taking medication, stop taking medication, etc.

DOCUMENTATION VITAL

Many malpractice lawsuits hinge on evidence of what was said in a telephone conversation. Your documentation of communication may help you win a lawsuit. For example, if a patient files a claim for failure to diagnose a brain tumor, she may claim she called and mentioned to you a history of headaches, or a patient who has a myocardial infarction may claim he told you he had chest pains.

In the event of a lawsuit, you will need to produce documentation to support your standard of care. The office record-your note in the chart explaining the nature of the complaint in the call you received and the advice you gave-is your chance to create the best piece of evidence for your defense.

All staff must document-and you must do so when in your office or on call to your practice, another practice, or a hospital. Information written in the chart usually is assumed to be true. Therefore, complete all conversations in reference to the communication with any specific patient's treatment.

If you receive a call after hours and are on call and out of the office, log on to your electronic health record system immediately, if possible, send an email message as soon as possible, or see that the record is updated at the office when you arrive the next day (depending on the charting system you use). Include information about the patient's complaint, your advice, and the date and time of the call. Doing so as soon as possible not only ensures that information in the medical record will be as complete and accurate as possible but also helps others in your practice assist the patient-for instance, if he or she calls the office the next business day before you arrive.