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
• f 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

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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

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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

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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

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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”

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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

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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

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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”

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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

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Implementing Arbitration (continued)

• Post a notice in the waiting room in advance
• f 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

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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

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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)

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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.

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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

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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

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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

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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

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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

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Mission Statement

Our Mission is to advance, protect, and reward the practice of good medicine.

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1-800-421-2368, ext. 1243 For additional Patient Safety information, visit

• ur Web site at: www.thedoctors.com

and click on Patient Safety