While most healthcare providers are compassionate and want to provide optimal care to their patients, implicit biases exist. Healthcare providers may not be aware of implicit biases, which may be subtle and unintentional, that can influence clinical interactions, lead to a lack of trust between the patient and the healthcare provider, and result in healthcare disparities.

You strive to provide quality care and good customer service to your patients. But inevitably, you will have a patient or patient’s family member that is not satisfied with the care you (or your staff) provided.

Physician burnout is a long-term stress reaction characterized by emotional exhaustion, depersonalization (indifference toward or detachment from work), and a decreased sense of personal achievement. Physicians are especially prone to burnout with almost half of physicians reporting at least one symptom of burnout.

Causes and Effects of Burnout
Physician burnout not only negatively affects physicians and their families, but it also puts patients at risk. Evidence suggests that physician burnout worsens the quality of patient care, increases the risk of medical errors, and decreases patient satisfaction.

Excessive workload, high patient volumes, administrative and regulatory burdens, increased documentation requirements, limited control over work schedules, and lack of support and autonomy from their organizations have been shown to increase physician stress levels and lead to a lack of work-life balance, emotional exhaustion, and poor relationships with colleagues and patients. This all creates burnout.

Steps You Can Take to Prevent Burnout
Here are some steps you can take at your practice to help reduce stress and prevent burnout:

Workplace violence in healthcare settings is on the rise, putting providers at risk physically, emotionally, and legally. According to the Occupational Safety and Health Administration (OSHA), healthcare workers are five times more likely to experience workplace violence than workers in other industries. For podiatric medical physicians, this presents not only a safety concern, but a risk management priority. Implementing strong de-escalation techniques can protect staff, improve patient care, and reduce liability.

The Growing Threat of Workplace Violence in Healthcare
Healthcare environments are particularly vulnerable to aggression and violence. Contributing factors may include:

It is not uncommon for lawsuits to arise from wound care treatment. You can provide care to the best of your ability, and sometimes poor outcomes still happen. A poor outcome does not necessarily mean medical negligence; however, when a poor outcome happens, patients can perceive that the standard of care was not provided, become unhappy, and file a lawsuit. Common allegations include delay in diagnosis, failure to properly treat, failure to timely refer, and failure to obtain informed consent. Therefore, it is of utmost importance to take measures to protect yourself and your patients during the wound care process.

All healthcare professionals like to receive positive online reviews. It’s a great way to let people know about you and the exceptional care you provide. Which, in turn, can help send new patients your way. 

To have a thriving practice, you must have patients. While it is great to get new patients, it is important to focus on retaining established patients, too. If you create loyal patients, they not only return to your office for appointments, but they promote your practice to their friends and family which is great for business.

As a doctor, you use your knowledge, experience, and medical judgment to determine the best course of treatment for your patient. However, adult patients with decision-making capacity have the right to choose or refuse to follow your treatment plan.

A doctor’s obligations regarding how to respond to medical records requests from Medicare, Medicare Advantage, and insurance companies can easily cause confusion. Receiving medical records requests is a frequent and common occurrence and it’s important to note that responding to these records requests does not require the doctor to acquire a medical records release form from the patient first.

HIPAA Rules for Releasing Medical Records
In fact, HIPAA allows medical records to be released without a patient release form in many different settings, including for patient treatment, billing, etc. Because HIPAA allows information sharing for billing purposes, any language on a CMS 1500 form is superseded by HIPAA guidelines – the CMS 1500 form does not prevent a release of records that is otherwise allowed by HIPAA. 

Regarding record requests from Medicare, Medicare Advantage, or commercial insurance plans, HIPAA also allows the doctor to provide medical records without a patient release form. HIPAA allows sharing of patient records for purposes of “health care operations,” which includes quality control, audits, licensure matters, etc. Additionally, most (if not all) provider agreements contractually require doctors to provide records to the insurer or to Medicare upon request and doing so does not require a patient release form.

Patient Medical Records Release Forms vs. Informed Consent Forms
Also keep in mind that a patient medical records release form is different from an informed consent form. A medical records release form pertains to the sharing of health information, while an informed consent form relates to the authorization of medical procedures or treatments after understanding the associated risks.

Comply with Medical Records Requests to Avoid Issues
A simple and reliable recommendation is that doctors comply with record requests from Medicare, Medicare Advantage, and commercial insurers, and remember that patient medical releases are not required to do so. Furthermore, refusing to comply with record requests is playing with fire – Medicare can revoke a doctor’s billing privileges for refusing to comply, and insurers can terminate the doctor’s provider agreement for failure to comply. It is never advisable for a provider to withhold or refuse to provide records in response to a request from a payer, whether governmental or private.

The Need for Fairness in Healthcare
In a perfect world, healthcare access and provision would be fair for all people, regardless of ethnicity, race, religion, gender, socioeconomic status, geographic location, language, age, disability, and other variables. Unfortunately, this is not always the case. To help address disparities in healthcare and improve patient outcomes, here is some guidance for practicing patient-centered and culturally competent healthcare.