Practice Management Q&As

Can you refuse to transfer patient records?

If a patient we're dismissing from our practice has an outstanding balance, can we withhold his records until the account is settled?

No, it's unethical to refuse to respond promptly to a valid request for a records transfer. You're within your rights to dismiss him, but you can't get in the way of his obtaining the care he needs. Moreover, if the patient comes to harm because of your delay, you could be held liable.

A legal time bomb

I've heard stories about physicians being falsely accused of sexual improprieties by patients. I practice alone with no clinical or clerical assistants who can act as a chaperone when I examine a female patient. How can I protect myself?

You can't. There's simply no good way to protect yourself from false accusations as long as you're alone with a patient. Any time a patient must disrobe could be problematic. Even listening to heart sounds could be misconstrued.

You have to change your practice setting so you're working with other doctors or hire a low-cost assistant who can be present when you see patients. And if there's only one staffer around, keep the exam room door partially open at all times, but make sure that other patients or visitors won't be able to peek in or hear the conversation.

If you're in a rural environment or some unusual circumstances where you have no other alternative, call an experienced health-care attorney for advice.

Improving your survey response rate

Very few of our patients returned our last patient satisfaction survey. Do you have any tips for boosting the response rate?

Send a second mailing to all patients-two or three weeks after the first. Thank those who've already responded and remind the rest to return their surveys as soon as possible. Explain that your goal is to give your patients the best care possible, and that you need their help to point out the trouble spots or let you know what's working well. If they believe their input will make a difference, they'll be more likely to get back to you.

In this issue, the answers to our readers' questions were provided by: Alice G. Gosfield, JD, Alice G. Gosfield and Associates, Philadelphia, PA; David E. Hunt, CHBC, Parrish, Moody & Fikes, Waco, TX; Steve Kern, JD, Kern Augustine Conroy & Schoppmann, Bridgewater, NJ, and Lake Success, NY; Mary Jean Sage, The Sage Associates, Pismo Beach, CA.

Do you have a practice management question that may be stumping other doctors, too? Write: PMQA Editor, Medical Economics, 123 Tice Blvd., Suite 300, Woodcliff Lake, NJ 07677-7664, or send an e-mail to mepractice@advanstar.com (please include your regular postal address). Sorry, but we're not able to answer readers individually.