When Doctors Resist Compliance Training

"No doctor, compliance training is not optional"

We often receive calls from clients asking for creative ways or guidance to get the doctors in their practice to do compliance training along with the rest of the office staff. The doctor doesn't have time or just wants to "review" the policies and procedures, which they won't. This seems to be a fairly common thread with compliance training and doctors.

Many offices have similar issues with doctors resisting training and as a medical office manager or compliance training administrator you may need to be less coddling or creative and more firm and direct. 

The bottom line is that HIPAA, OSHA and Medicare do not simply suggest training. It is REQUIRED that ALL EMPLOYEES receive compliance training annually (including management and particularly doctors). They don’t simply recommend this or say if it is convenient but that it is REQUIRED for compliance.

It may be necessary to send a message reminding ALL staff members of this fact and the importance of being in compliance for the safety of patients and staff, privacy issues, the legal requirements and financial/reputation ramifications for the practice as a whole due to violation or non-compliance.

Including the information on specific regulations may be useful to get the message across. For example:

The HIPAA Privacy CFR discussing administrative requirements for training can be located in 45 CFR § 164.530(b)(1) and for HIPAA Security 45 CFR § 164.308(a)(5).

Similar resources for OSHA can be found on the Guide to Compliance with OSHA Standards for Medical and Dental offices website. Note that each standard requires training.

Medicare and most insurance companies also require attestation (to affirm to be correct, true, or under oath) that ALL staff receives Fraud, Waste and Abuse training to maintain receipt of payment.

As for HR and Employment Law, we were recently contacted by a client about an unemployment claim issue. Because of the Doctor making a poor decision they will likely end up paying that unemployment claim when normally they would have been able to contest it. Due to that doctors lack of HR training, his bad decision will now cost the practice unnecessarily. Please see this previous article that spawned from this incident:
The greatest risk to any organization comes from within.


Another key item of importance is that workforce member can't just read over some notes on policies or procedures and be considered "trained". There needs to be a formalized consistent method of training that includes Documentation of the training processes, dates, etc. As the saying goes, if it isn't documented it didn't happen.

Compliance and Compliance Training is not optional and is very crucial to the legitimacy and success of your practice or medical facility. Make these requirements clear to your Entire Workforce as a fundamental part of your organization's culture and a non-negotiable condition of employment at your practice. End of story!

Source(s): http://www.hcsiinc.com, https://www.law.cornell.edu, https://www.osha.gov, https://www.teachprivacy.com

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The Importance Of Yearly HR/Compliance Training

HR Training Can Save Your Practice in the New Year

As we prepare for 2016, I remind our clients to think about annual HR and compliance training for all practice employees.  Not surprisingly, clients often complain that it’s unnecessary because “nothing has changed” or employees still remember their training from last year. In my experience, employees forget most of their training (almost immediately) and those who do remember are complacent about applying their knowledge or are unable to practically apply training to real-life situations.  For example, last year, just weeks after training a client’s practice, the following occurred:

A nurse in the practice (“Sue”) complained she had been sexually harassed by a male supervisor nurse (“Tim”).  Sue and Tim are immediately put on different schedules so they could no longer interact and statements were taken from both parties (which tell opposite stories).  There is no video evidence and no direct witness to the events, although statements are taken from other staff members.

Sue appears at work the next day apparently distressed and under the influence.  Another nurse “friend” (let’s call her "Jane") provides prescription medication to calm Sue and drives her to the hospital.  Later, Jane is “so concerned” about Sue’s condition that she accesses the hospital’s EHR system (to which the practice is connected) to check on Sue’s status.

Sue calls the practice manager the next morning to inform him that she considers herself on family and medical leave (FMLA) and further insists the practice should have to pay for her leave (due to her complaints) since she has no accrued paid time off (PTO) left.  The practice’s policy does not call for any paid FMLA leave (if Sue was to qualify).

This may seem like a crazy scenario, but it’s really not that surprising at all! What is unfortunate is that every one of the employees in the above scenario had been completely trained numerous times on the practice’s policies and yet various violations still occurred. 

First, with regard to the alleged sexual harassment, there could be no conclusions made after the investigation was complete.  The results of the investigation were still distressing since numerous witnesses, in addition to Sue and Tim, admitted there was a pattern of lewd, vulgar  and inappropriate discussions going on throughout the workday and numerous employees complained (during the investigation) that they had asked Sue, who seemed to be the main source, to cease such behavior.  It appeared that various staff and physicians were aware and participated in such sexual discussions, which clearly violated the practice’s sexual harassment policy.  Specific scenarios during training had covered the exact violations that occurred and yet no employee recognized there was a violation of the policy.  To address the matter, the practice issued warnings to all involved and hired an expert to bring in more training, which will now be repeated twice annually.  Every employee will acknowledge and sign a new policy as well. 

Another issue in the scenario that occurred was Jane’s violation of HIPAA by accessing another employee’s EHR at the hospital. She also went against practice policy by prescribing medications to an employee of the practice (who already appeared impaired).  This was not Jane’s first HIPAA violation and per practice policy, she was terminated.  Action is still being considered on the prescription issue and Sue’s appearance at work under the influence.

Finally, like other practices, this client has a policy for FMLA and paid time off. Our advice is that the practice should always try to follow its policies consistently and without exception. When a practice opts to reach a unique arrangement with an employee (such as letting them dip into future PTO), this should be documented.  Certainly, a practice should never pay an employee who has made threats against the practice without talking to counsel, as such payment could be deemed an admission of wrongdoing.

No matter how much training a practice provides, there are always going to be violations of a practice’s policies that occur.  The expense and hassle of dealing with the repercussion of such event is far greater than scheduling and/or paying for annual training.  If you think your staff remembers everything they have been trained on in the past — try asking a few random questions and see whether you are surprised by the results! 

By Ericka L. Adler from http://www.physicianspractice.com

For more information on this and other healthcare compliance topics related to HIPAA, OSHA, Medicare and HR, simply email your questions to support@hcsiinc.com, 
visit our website at http://www.hcsiinc.com or post a question on our LinkedIn group at: http://bit.ly/1FWmtq6

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