RISK MANAGEMENT FOR DENTISTS - Downloadable

George Washington�s dentures were built of hippopotamus tusk, gold, elephant ivory, and human teeth, by John Greenwood. Though he was never pleased, George never sued John.

Alas, that was 200 years ago. Today, 98% of the American public suffers from dental disease and 6,000,000 teeth are removed annually. Lots and lots of lawsuits just waiting to be filed!

If Dr. N.L. Schafler can sell a $325, three-volume set of books (1040 pages in total) telling attorneys how to prepare dental malpractice cases, you deserve at least a shorter, definitive, step-by-step $49 book called RISK MANAGEMENT FOR DENTISTS that tells you (1) how to avoid being sued and (2) what to do if you are!

Who better to write it than Jack Mumme, whose company over a 23-year period specialized in claim and risk management, handling 17,250+ medical and dental malpractice claims and representing 200 hospitals nationwide, plus 1100 emergency room physicians and 550 cosmetic surgeons and dentists, all self-insured.

Please let us save you 900 pages of reading and $276 to keep in compliance with the law. Please buy RISK MANAGEMENT FOR DENTISTS and stop taking chances.

Discussed in this book:

dental malpractice
insurance coverage
dental records
management responsibilities
risk guidelines for dentists
safety program standards
anesthesia
sexual harassment
battery
workers compensation
damages
10 case studies
disciplinary proceedings
employment responsibilities
informed consent

1.� Figure out what dental and personal assets you have to protect.
2.� Determine what you must do now, what you must get others to do, and what your staff must do (and when) to get that protection in place.
3.� Get the right kind of insurance.
4.� Define whether those working for and with you are employees or independent contractors, then relate to each appropriately.
5.� Become familiar with the basic dental tort laws.
6.� Document, in writing, all aspects of your care and treatment.
7.� Obtain informed consent from your patient.
8.� Always discuss complications that may occur with your patient.
9.� Develop and follow an effective and comprehensive safety program.
10. Make sure your staff is well trained and interacts well and properly with your patients.

From the Introduction to Risk Management for Dentists by Jack Mumme, whose company handled 17,250+ dental and medical malpractice claims for both dentists and insurance firms.
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�Jack Mumme was the founder of Akros Enterprises, Inc., a risk management/claim management company in 1971.� During his 23 years as president, Akros handled over 20,000 medical, dental, and product liability claims.� The company represented 200 hospitals nationwide, and several thousand physicians and dentists.

He was a member of Toastmasters International and made 300+ presentations and workshops for the American Hospital Association, Veterans Administration, International College of Surgeons, American Management Association, and numerous other organizations.

Jack appeared twice before the California Legislature on behalf of health care providers and has attended many settlement conferences, arbitrations, and mediations, as well as monitored numerous trials throughout the United States.

He produced nine video educational programs for physicians and hospitals, has written numerous articles on malpractice for magazines and newsletters, and appeared on Los Angeles television discussing the �Right to Die.� Jack is a member of the National Writers Association and International Television and Video Association.

Mumme obtained a teaching credential through the University of California, Irvine, and taught insurance in two southern California community colleges for three years.� He was chairman of the Education Committee for the Los Angeles Claims Managers Forum for three years.

He presently testifies as an expert on malpractice and insurance and acts as a consultant to law firms on malpractice and insurance.� Jack presently resides with his wife in Coronado, California.

��� It seems to me there are five kinds of information that every dentist needs readily at hand: (1) a standard operating procedures manual, (2) an OSHA manual, (3) a personnel manual, (4) a standard marketing procedures manual, and (5) some basic risk management guidelines.

��� Our publishing firm, Dental Communication Unlimited, has the lead book in (1): either Standard Operating Procedures for Dentists or Standard Operating Procedures for Pediatric Dentists, both by Marsha Freeman.
��� I just wrote and published (4), Standard Marketing Procedures for Dentists, and we plan to have both a basic manual and state adaptations for (2) in print well within a year.
��� Number 5 intrigued me, as much by its absence for dentists in book form as by the difficulty of finding a person sufficiently well versed to write such an important text so the entire staff could easily understand and apply it, written in straightforward and doable layman's language.

��� My answer came out of the blue. I keynoted a writing conference in Anaheim about a year back, and up from the audience when the talk ended came a stately, no-nonsense gentleman, clearly a veteran of something. A question led to a question, and in ten minutes I'd found Jack Mumme, who is the man that lawyers, insurance companies, or dentists most wanted in their corner when it came to almost all forms of risk litigation. I made some verifying phone calls a few days later, and I had found the real thing. This book is the result.

��� Dentists are extremely busy and want facts fast, accurate and immediately applicable. They are experts in the mouth; business stuff comes second, and anything with the word "risk" attached to it (meaning lawsuits, insurance, safety, and a long string of other, dangerous sounding words) would, in a perfect world, always be moved to the bottom of the pile, never read or applied.
���� Alas, "the world ain't perfect," as somebody important must have said. And dentists know three things very well: (1) That an ounce of prevention, say in insurance, might save their hide, tools, and home on any future day, (2) that it isn't whether a lawsuit will pop up in some server's hand, but when, and (3) that a patient injured in the chair or falling face-first on the top step can lead to many sleepless nights and long, litigious days.

��� So my directions to Jack were just as straightforward:

(1)� Tell dentists the essence of what they must know about risk management.
(2)� Do it in words that every person in their office can grasp.
(3)� Where you must use legal or technical terms, explain them at the time and in a glossary.
(4)� Capture the key points again in an easy-to-apply chart or graph.
(5)� Cite legal cases when necessary, but no more.
(6)� Give us a quick reader that tells the how risk management as it applies to their practice.
(7)� Don't lose us in the details. Point the dentist to the respective expert when they need help, like finding a specific insurance agent who can create the best combination of policies applicable to their local needs.

��� The only real difficulty we had with this book was deciding what should be discussed in which order. Everything with risk implications was important, and almost everything in a business where one party is physically handling another (not to mention the emotional and psychological ramifications) has risk implications. Even the employee farthest from the chair, even the parking lot, all had to be included. It was gathering gilded leaves from the ground and making a tree from them.
��� So we opted to ask first what risk management is, and why it is worth all this time and effort. Just whose assets are you trying to preserve? And in today's tort-twisted environment, is that even possible?
��� Then precisely how you do protect yourself. Like insurance for you and comp for the employees--and where that didn't work. "Who was an employee?" we asked, and just what rights did a dentist have anyway? What were the rules and guidelines; where were you safe?
���� That led to a much more specific chapter, "Risk Guidelines for the Dentist," where the need for accurate, current documentation and the proper selection of patients was highlighted.� That's right: it's your choice who gets to use your service.
��� Managed care is a huge concern among dentists, so I asked Jack to share his thoughts on how one can protect their assets, more in a legal than financial sense, in this still-evolving field.
��� What would risk management be without a safety program and a process for defining and responding to those accidents you couldn't prevent?
���� We saved the most dreaded part for last: lawsuits. What to do, from the suspicion to the reality. Jack tells us first what not to do: don't cry and don't take it personal. What you say and what you don't say, what happens at each stage, how you are involved, and how experts can help follow.
����� There are other ways to resolve disputes, so a short explanation of arbitration and mediation provides a possible alternative plan that may be far faster and less costly.
����� Does litigation seem so far off that you'll worry about it when it arrives? We hope that day never does. In the meantime, Jack shares ten actual dental cases, selected to represent a wide variety of situations, and he asks you to zero in on what happened in each, and why, to sharpen your sense of why patients take their dentist to court.
���� The book concludes with some sample letters you may wish to use to keep out of those courts, the glossary, and an index that will let you return to a specific point if needed later.

������ Jack provides a partial summary of the wider risk management concept for dentists in Chapter 3, but let me broaden it here to some plain statements that, if tended to, will mightily lessen your risk. (The book tells how.)

1.� Figure out what assets you have to protect and why you need risk management in your practice.
2.� Determine what you must do now, what you must get others to do, and what your staff must do--and when.
3.� Get the right kind of insurance.
4.� Define whether those working for and with you are employees or independent contractors, and react to each appropriately.
5.� Become familiar with the basic tort laws.
6.� Document, in writing, all aspects of care and treatment.
7.� Obtain informed consent.
8.� Discuss complications which may occur with your patient.
9.� Develop an effective and comprehensive safety program.
10. Make sure your staff is well trained and interacts well and properly with your patients.

������ A final observation.� I was struck a dozen times as this book came together how much of the work and prevention would be already in place if a dentist implemented either of our SOPs books. Particularly the job descriptions and the task inventory sheets, the detailed process checklisting for recordkeeping, almost all of the other elements of documentation, and the more thorough (and caring) interaction the staff would have with the patients.
������ That's enough introduction. Before beginning this chapter, Jack Mumme's biography appeared. I hope you read it. That's why I think he is precisely the right person to write this book. The words and thoughts that follow are his. (Alas, any errors or omissions in presenting them are mine!)

Gordon Burgett Publisher, Dental Communications Unlimited

Risk Management for dentists has a three-part purpose:

1. To reduce liability exposure through loss prevention and loss control.
2. To assure proper and adequate insurance coverage.
3. To preserve assets.

Let�s discuss each of these three, define the term �risk,� look at the kinds of goals needed to define your particular risk management program, and identify additional reasons you need risk management. �

Loss Prevention and Loss Control

Loss prevention includes

1.� Establishing policies and procedures for identifying risk.
2.� Preventing accidents and incidents that will create claims or lawsuits against you, in part through the establishment and maintenance of a safety program.
3.� Establishing guidelines that will help you select, train, and provide continued education for you and your employees.
4.� Learning and following the state statutes and the business and professional codes that apply to the practice of dentistry.

Loss control includes

1. Learning how to communicate with an injured patient so that the patient will not retain an attorney to sue you.
2. Establishing policies and procedures for immediately notifying your insurance company so they can settle a claim if there is liability.
3. Settling a claim before a suit is filed, to save expenses and possible time in court.
4. Keeping a claim for damages in line by helping your attorney negotiate a fair settlement, if warranted.
5. Assisting your defense attorney in selecting expert witnesses and preparing the defense of your case should the case go to trial. �

Insurance Coverage

Risk Management assures that you have the right insurance program by helping you

1. Select the right agent or broker.
2. Select the right coverages for property and casualty insurance.
3. Select the right kind or professional liability policy.
4. Determine the proper limits. �

Preservation of Assets

What assets do you want preserved?� Usually

1. Your reputation.
2. Your dental license.
3. Your practice equity.
4. Your bank account.
5. Your home.
6. Your car.
7. Your retirement fund.
8. Other investments.
9. Your baseball cards. Kidding of course, though when it comes to risk management such kidding is no laughing matter. �

�Risk is defined as hazard, danger, peril, exposure to loss, injury, disadvantage, or destruction.
�A bungy-jumper leaping off a bridge or tower takes serious risks, such as the cord being too long or breaking from the weight. Both have the same dire result: the jumper will hit the ground or water at full speed.� A dentist sticking any kind of needle or tool into a patient�s mouth risks injuring a nerve, cracking a tooth, or breaking the patient�s jaw.
�Life and dentistry are risky businesses.� Risk management in either attempts to identify and either remove or lessen those risks.� With insurance, it also helps compensate those affected should the risks nonetheless manifest themselves. �

�If you elect to have a risk management program, you must set goals.
�Why? Because insurance companies will ask you if you have a risk management program and what goals you have set for yourself and your staff.� (Sometimes just having the risk management program will lower the premiums you pay.)� National accreditation organizations and managed care organizations will also want to know about your goals.

�What might some of your goals be?

1. Reduce the potential of dental malpractice claims.
2. Develop procedures for assessing and identifying liability exposures.
3. Reduce actual or potential risk.
4. Develop a dental malpractice prevention program, particularly for new employees.
5. Offer regular, updated safety and risk management programs to the staff.
6. Encourage continued education programs concerning safety and risk management.
7. Establish a claim program to assist your insurance company and your attorney in the defense preparation of a lawsuit.
8. Promote patient satisfaction.
9. Develop a patient education program.
10. Develop better documentation in the patients� records.
11. Keep better records when acquiring equipment, plus have better equipment maintenance records.
12. Maintain a �no-show� log.
13. Have your staff pay more attention to selecting patients.
14. Develop better informed consent procedures.

Other reasons you need to practice risk management

1. It is easier to attract qualified personnel when they know your practice is well organized and your risks are identified and being dealt with.
2. It gives you peace of mind�you can sleep better at night not worrying how you are going to pay a judgment against you.
3. Your staff (and patients) will think better of you knowing you carry insurance to protect them.
4. Having proper safety programs and adequate insurance will help if you are audited or surveyed. This is particularly important to HMOs or other providers who will closely check all aspects of a risk management program.