My Practice Is Short-Staffed and Over-Booked. What Are My Duties to Current Patients?

Are you struggling to fill one or more open positions at your practice and thus can’t accommodate patients seeking timely appointments? This situation may put you at risk of breaching your professional duties.

Woman holding papers and thinking.

It has always been challenging to hire and retain the best team of clinicians. But with a worsening healthcare worker shortage, keeping a practice fully staffed is more difficult than ever.

The difficulty of hiring new staff has led many practices to reduce service and require lengthy appointment wait times. This can be frustrating for both patients and practices. Practice owners want to help patients but cannot always provide quick and accessible care. Meanwhile, patients often have established relationships with their healthcare providers and want to be seen by someone they know. They also don’t want to wait months to do it. 

To complicate matters, healthcare providers have an ethical and legal duty of care to patients. But what happens when you can’t find enough clinicians to provide services to all patients?

From your point of view, being unavailable to patients is an unintentional and inevitable consequence of the worker shortage. However, as a practice owner, you still have legal obligations to patients with whom you’ve already established a provider-patient relationship. More specifically, two duties come into play when you can’t find anyone to hire: the duty not to abandon patients and the duty to provide adequate care to those you treat. First, we’ll discuss these duties individually. Then, we’ll address how you can tackle them in tandem when you’re short-handed.

Patient Abandonment

Patient abandonment occurs when a provider terminates the provider-patient relationship without reasonable notice and without assistance in finding a replacement provider. Patient abandonment can be considered malpractice and a violation of many licensed professionals’ practice acts and ethics codes. For example, in Illinois, as in many other states, patient abandonment is grounds for disciplinary action against a physician’s license. Disciplinary actions may include suspension, probation, revocation of one’s license, monetary fines, or mandated continuing education, depending on the severity of the situation.

While limiting available appointments isn’t necessarily a termination of the provider-patient relationship, patients can feel “abandoned” when they can’t schedule a visit, particularly if they have urgent needs.

For more detail, see our video, “What is Patient Abandonment in Healthcare?

The prospect of a patient abandonment claim is alarming. So, even if you’re understaffed, you might react by shortening appointment lengths and trying to see as many patients as possible. However, physicians and other healthcare providers also have a duty of care, which means that handling a higher volume of cases can have risks, too.

Duty of Care

The duty of care requires that clinicians provide care to a “reasonable” standard. Generally, this ethical and legal obligation is based on the hypothetical level of skill and care that a reasonably competent healthcare professional would provide to a patient in comparable circumstances.

Stretching your team too thin by booking too many patients increases the risk of mistakes. It can also leave patients feeling rushed and unheard. A patient who felt they were treated unreasonably or below the standard of care could claim malpractice, particularly if something is overlooked and causes harm. It’s essential that every clinician at your practice provides an adequate level of service to patients, does a thorough job at appointments, and ultimately fulfills their duty of care. 

See our related article, “As an Employer, Am I Responsible for the Actions of My Licensed Workers?

If you’re struggling to keep up with demand and can’t find any new hires to help, you’re not alone. Taking just a few steps may help ease the burden.

Communicate with Patients

Letting patients know why your near-term availability is limited can help ease confusion and set expectations. Be empathic, diplomatic, and even a little bit vulnerable. 

Most people appreciate knowing that their healthcare providers are making reasonable efforts to be available, even if they fall short of the ideal. While you may be focused on the big picture (the many people who need care), individual patients want to know that you have sympathy for how the situation affects them. Patients don’t need to know all the details of your difficulty hiring or retaining staff, but communication can help reassure them that you are working on a solution.

Patients also need practical information. Be sure to inform patients with urgent issues about how to reach you or what to do to find help. For example, if you have telehealth availability that patients aren’t using, provide more education about when virtual visits are appropriate and how they work. Let your patients know if there are ways to take advantage of last-minute cancelations to get an earlier appointment, such as joining a waiting list or periodically checking your online booking page. 

Evaluate Your Caseload

If you’re still seeing new patients regularly, you may want to prioritize existing patients and those with urgent needs. While building a business, promoting your practice, and creating a client base is continuous work, that work might need to take a back seat when you’re short-staffed.  In other words, it might be wise to cut back on marketing activities and new patient intakes. 

Provide Alternatives

If you need to reduce your availability, consider providing patients with recommended alternative providers they can visit until your staffing woes end. Sure, there’s a risk that the patient might switch providers altogether. However, offering viable alternatives can help ease patients’ immediate concerns and help protect you against claims of abandonment. Those with urgent needs may need to see a specialist or emergency provider, and a trusted source (like you!) can help make transferring care a better experience for the patient. 

Your patients chose to pursue a relationship with you because of your strengths. While running a practice might feel like extreme juggling – especially during a hiring shortage –  ensuring that patients get the care you’re obligated to provide while making them feel heard and understood needs to be a top priority.

Get Legal Help

For guidance on your ethical and legal duties or to ensure that your recruiting and hiring efforts comply with rapidly changing federal, state, and local laws, seek an experienced healthcare attorney.  If your practice operates in one of the states where Jackson LLP  has licensed attorneys, reach out to us for a free consultation to find out if we’re a good fit for your needs.

This blog is made for educational purposes and is not intended to be specific legal advice to any particular person. It does not create an attorney-client relationship between our firm and the reader. It should not be used as a substitute for competent legal advice from a licensed attorney in your jurisdiction.

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