Advice on Group Coverage, E-Mail Use

A.The benefit of a group policy for a psychiatric group practice is the streamlining of administrative duties. There is one renewal, one premium, and one source from which to obtain claims histories. This allows a greater efficiency of policy management for the group administrator.

The Psychiatrists’ Program (the Program), the APA-endorsed Psychiatrists’ Professional Liability Insurance Program, offers liability insurance to psychiatric group practices (may vary by state). It provides protection not only for the psychiatrists but also for mental health professionals who work for the group. All of the benefits and features of the Program’s individual policy are available with group coverage, such as discounts for working only part time, being a child/adolescent or early-career mental health professional, and participating in risk management education. Risk management services, including the toll-free Risk Management Consultation Service, are also available for all insured members of the group.

A. At this point, there is little specific, detailed risk management advice to give regarding the use of e-mail with patients. Risk management advice is derived from the lessons learned in lawsuits, and as we do not yet have established e-mail liability law to study, the advice we can give is taken from similar liability situations and reasonable extrapolations of existing law.

Here are four basic steps you can take to minimize potential professional liability:

• Use e-mail only with established patients.

• Use e-mail only in the state or states in which you are licensed.

• Address security and encryption issues.

• Obtain and document specific informed consent to use e-mail.

Beyond these steps, you should review current literature and materials on the subject, including the AMA’s guidelines and those of other professional organizations. Also, check the guidelines of any third-party entity that you may use, for example, some vendors of online physician-patient services have published guidelines for use.

Realize that e-mail is not appropriate for every treatment situation or every patient. As with other treatment decisions, evaluate patients for appropriateness, document the clinical justification for using e-mail, and re-evaluate appropriateness periodically.

E-mail may be a wonderful tool in the practice of psychiatry; however, it is easy to become complacent with technology and to let it dictate one’s actions to some extent. Understand that the responsibility for patient care remains the same regardless of the treatment milieu or payment situation. Physicians always have a responsibility to provide thoughtful, professional care.

This column is provided by PRMS, manager of the Psychiatrists’ Program, for the benefit of members. More information is available by visiting the Program’s Web site at www.psychprogram.com; calling (800) 245-3333, ext. 389; or sending an e-mail to [email protected]. ▪