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Enhance Your Private Practice Risk Management Now

We welcome today, an attorney of twenty-nine years who specializes in health care law, medical malpractice defense, health-related contracting, and so much more. He is highly qualified with his experience as a University Adjunct Instructor in multiple areas, an author of many articles published, and a frequent accredited conference lecturer.

Steve was interested in law his whole life, and jumped straight into law school, formally beginning his practice in 1987. A health care law related job with a firm with an orthopedic surgeon fell into his lap when he began searching for a career in Florida, and the rest was history.

In regards to building a business, Steve expressed that the best advice he has received was to, first, keep your overhead low, and especially when you are just getting started. Keep your eye on the prize (and the expense line) and avoid spending a ton of cash on things other than the sole goal of developing a practice. His second piece of advice was to concentrate on building your relationships.

Steve stated, “The single most important relationship is your existing client”, and he urged for us to remember how priceless word of mouth referrals truly are!"

Why is it important for someone to incorporate and when should they do that?

  • If you are a therapist new to private practice and you are renting space from someone or sharing space with someone who is responsible for the property, you may not need to be incorporated. As long as you have no employees, property, or any other responsibility, it is not crucial to spend the money.

  • Once you become responsible for an employee, a lease space, and other things you need to protect whether personally or professionally, THEN spend the money, it’s worth it! Get corporate protection. -This will be a shield against liabilities that are committed by people other than yourself, or have to do with ownership of your business.

Steve, what is a good type of incorporation for a new therapist in business?

  • Two options: Limited Liability Corporation vs. Professional Limited Liability Corporation. -Steve’s choice? PLLC. -PLLC offers less formalities required in keeping books, and things of those sorts. It also gives more flexibility when you decide to partner with someone else.

Moving onto the scary topic of Risk Management…

  • Steve’s definition of risk management: The process of avoiding or managing legal risks, which can be presented into your business.

  • It is essential to move past the discomfort and look at what the risks are! Do your research on malpractice risks, liability associated risks, billing risks, tax risks, and anything else you can get your hands on!

  • Malpractice risks: Liable for negligence of your license and the licensure standard you are held to.

  • Liability associated risks: Hiring someone else can lead to an incident like a slip and fall case, an auto accident, etc.

  • Billing risks: The improper billing of your services. This is more common than you think – when an individual is unclear with their insurance company, they could be given the wrong impression as to what type of license they have, or what type of training or degree they have.

  • Be familiar with the words “kickback”, bonus, rebate, fraud, abuse, and the laws in your state as well!

  • Tax risks: Make sure you are paying your taxes, or not withholding taxes on an employee that is due.

Next, we moved onto the issue of boundaries!

  • Liability-wise, if you are going to do any non-conventional types of therapy, make sure you receive documentation from your client, with the clear understanding that what is occurring is non-conventional.  Also identify any risks the client may receive by engaging in this non-conventional style of therapy, ie: equine assisted therapy.

  • Clarify your therapist role and ethics, and avoid dual relationships!

Process vs. Progress Notes

Process Notes are notes taken in the process of the therapy, writing what the client is thinking, what you are thinking, and what your subjective thoughts on the therapy are. These notes have a higher level of protection. Providing these notes could be detrimental to the client’s welfare if they view a copy, because of the therapist’s inclinations. These differ from the generalized notes that are Progress Notes.  Keep in mind, documentation can be your best friend or your worst enemy, depending on if you narrate poor or well.

“Don’t get into something that you don’t know the rules about.” Steve went on to say that the key is to go out and learn things from the law. Go to the risk management seminars, pay attention to the Medical Errors courses (which Kate and Katie both teach in person and online - check out our websites if you are needing the course), understand the specific laws of your state. These things can put you far above the crowd.

Resources to familiarize self with:

  • Websites for licensing boards

  • Be aware of what malpractice carriers offer

  • HIPAA laws

Steve left us with words of wisdom that were straight and to the point…

“Don’t be afraid to seek legal help.”

Check out the podcast for Steve’s INCREDIBLE giveaway!! Seriously, you won’t want to miss it!

Assure you subscribe so you can stay in the loop of ALL the podcasts we release.  The Private Practice Startup would also be super grateful if you could rate and review our podcasts.  We are trying to be the next "New & Noteworthy" - thanks again for allowing us to Inspire YOU from Startup to Mastery!

~Dr. Kate, Katie & The Private Practice Startup Team



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