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James R. Banfield Director, Risk Management Associate General Counsel

Trainee Legal Risks The GME ACTION 2014 Annual Education Conference April 24, 2014. James R. Banfield Director, Risk Management Associate General Counsel. Topics. Trainee selection Warning signs Evaluations Documentation When problems arise Difficulties with the legal case.

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James R. Banfield Director, Risk Management Associate General Counsel

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  1. Trainee Legal Risks The GME ACTION 2014 Annual Education Conference April 24, 2014 James R. Banfield Director, Risk Management Associate General Counsel

  2. Topics • Trainee selection • Warning signs • Evaluations • Documentation • When problems arise • Difficulties with the legal case

  3. Sample Case

  4. Trainee Selection • A thorough application, interview and screening process is • helpful to identify potential troublesome candidates • Filling that last slot with a marginal candidate can come back to haunt

  5. Warning Signs • Missing or delayed paperwork • E*value (or similar system) completion lacking • Attendance, punctuality, disappearing

  6. Warning Signs • Not returning pages or calls • Professionalism (behavior and relationships) • Not fulfilling other requirements

  7. Evaluations • Honest • Accurate • Realistic • Complete • Timely

  8. Documentation • What is the training file? • Administrative • Administrative (applications, credentialing) • Acknowledgement of policies and procedures • Performance • Communications (emails, letters, comment cards) • Maintain communications at least until graduation • Evaluations • It should all be created and maintained to be considered peer review and thus protected by statute and case law

  9. When Problems Arise • Progressive discipline • Awareness meetings (documented) • Remediation • Involve mentors, ombudsman • Leave • Probation • Suspension • Termination

  10. When Problems Arise • Due process must be provided at all stages • Err on side of providing more than less, unless patient safety is an issue or criminal behavior • Fitness for duty evaluation

  11. Difficulties with the Legal Case • Evaluations and documentation don’t support action taken • Inherent difficulty in demonstrating behavior is actually sufficient to warrant action taken • Issues primarily concern the trainee and one faculty member • Demonstrating that professionalism is as important as trainees providing quality patient care

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