Understanding Arbitration The Doctors Company Arbitration Program - PowerPoint PPT Presentation

Understanding Arbitration The Doctors Company Arbitration Program Training

Overview • The Doctors Company does not require the use of arbitration • Arbitration is a physician decision • The Doctors Company will provide training tools to implement your arbitration program • Our goal–ensure you have all the information needed to decide whether or not to implement arbitration Arbitration Training / 2

Arbitration Is Not New • In use in CA since the 1920s • Is a valuable and viable alternative dispute resolution • Key to an effective arbitration program  The agreement Arbitration Training / 3

What Is Binding Arbitration? • An agreed upon contractual method for resolving disputes between parties • Dispute is presented and resolved by a neutral party… the arbitrator • Decision by the arbitrator is binding to the same extent as a judgment in a court of law Arbitration Training / 4

Advantages of Arbitration • Early resolution of a dispute • May decrease stress and anxiety for both parties • Less interruption of business • Arbitrator has knowledge of complex standard of care and causation issues  Lay jury must understand and form opinions based on competing expert testimony • Arbitration allows each party to put its dispute before knowledgeable, neutral arbitrators Arbitration Training / 5

Disadvantages of Arbitration • Discovery of facts does not occur unless each party specifically agrees to conduct discovery • Helpful information to defend or prove a fact may not be produced • For smaller claims (less than $5000) cost of arbitration may exceed the claim • Parties do not have an opportunity to their “day in court” Arbitration Training / 6

Disadvantages of Arbitration (continued) • Arbitrator may not follow prevailing law  Decision based on equity or a sense of fairness and justice • Compromise awards are more common with arbitration than court decisions • If a party is unhappy with outcome, successful appeals are rare Arbitration Training / 7

Arbitration and Health Plans • Most CA health plans include an arbitration agreement • Some health plans may limit the use of arbitration • The physician should identify any issues related to the limitations of arbitration in each patient’s health plan prior to implementing an arbitration program • Some health plans may:  Restrict or stipulate where arbitration will be conducted  Require use of particular arbitrator Arbitration Training / 8

Implementing Arbitration • Understand the process • Train staff adequately • Choose a knowledgeable staff member to be lead • Train a backup person • Provide a consistent message to patients • Use statements such as “this is our usual and customary practice” Arbitration Training / 9

Implementing Arbitration (continued) • Prepare staff to respond to questions • Determine how your practice will respond to patient's refusal to sign the document  Remember, you cannot refuse care • Be sure your patient can read • Provide a knowledgeable translator if patient cannot read English Arbitration Training / 10

Implementing Arbitration (continued) • Post a notice in the waiting room in advance of implementation • Implement the program on a specific date • Always ask if the patient has additional questions and whether he or she understands the arbitration document • File the form in the medical record Arbitration Training / 11

Implementing Arbitration (continued) • For patients you meet in the hospital, ask them to sign the agreement the first time they come to your office  Patient may initial Article 6 of the agreement to make date retroactive to treatment previously provided  Patient has the right to decline to sign the form Arbitration Training / 12

Commonly Asked Questions • May I require a patient to sign an arbitration agreement to receive care?  No • May result in an adversarial interaction with the patient before care begins • CA case law holds that if patient can show s/he was pressured into signing an arbitration agreement as a condition of necessary medical services, the arbitration agreement may be ruled invalid (CPLH, 2008, Vol. 5, Section 36:31) Arbitration Training / 13

Commonly Asked Questions (continued) • If one physician in a group decides to use the arbitration agreement are all other physicians in the same group required to do so?  Yes • There may be a conflict if one physician or allied health provider does not use the agreement, as in a call coverage situation. All of the physicians and allied health personnel within the group should agree whether or not to use arbitration before it is implemented. Arbitration Training / 14

Commonly Asked Questions (continued) • May a patient rescind the arbitration agreement?  Yes • The agreement may be rescinded by the patient in writing within 30 calendar days of signing the agreement • Develop a consistent way to document when a patient revokes • Is a photocopy of the agreement valid?  No • A valid agreement requires a notice regarding the implications of arbitration be printed in bold red type, which may not copy on a photocopy machine Arbitration Training / 15

Commonly Asked Questions (continued) • What if the patient does not speak or read English?  Utilizing an English only arbitration agreement for a non-English speaking patient may not be enforceable  If using a translator, be sure to document the name of the translator Arbitration Training / 16

Commonly Asked Questions (continued) • Who can serve as a translator?  Use bilingual staff member or qualified interpreter • Physician must ensure that the interpreter is competent • Competency requires more than self-identification of being bilingual (CPLH-2008, 1:66)  Family members are not recommended • Cultures vary • Family members might be unable to ask some questions • Translation may be incorrect Arbitration Training / 17

Commonly Asked Questions (continued) • When is the best time to implement an arbitration program in my practice?  After you understand the arbitration process and have trained your office staff about the program • How do I get the arbitration forms?  Forms may be purchased online through the California Medical Association (CMA), www.cmanet.org/resource-library  Membership in CMA is not necessary to purchase forms • What if I change my mind and do not want to use the arbitration process?  There is no need to contact The Doctors Company if you elect to discontinue the use of arbitration Arbitration Training / 18

Commonly Asked Questions (continued) • What if my staff has additional question?  The Doctors Company is available to support you and your staff with implementation of the arbitration program. Please call the Patient Safety Department for additional support. 800-421-2368 ext. 1243 Arbitration Training / 19

Mission Statement 1-800-421-2368, ext. 1243 Our Mission is to advance, protect, and reward the practice of good medicine. For additional Patient Safety information, visit our Web site at: www.thedoctors.com and click on Patient Safety Arbitration Training / 20