All over the U.S., medical boards are suspending the licenses of doctors and publishing guidelines on what it takes to be a competent doctor. State medical boards warn doctors who “practice drift.”

Posted in Risk Management on Wednesday, May 24, 2017

What is “Practice Drift”?

In 2016, the Federation of State Medical Boards (FSMB) adopted a position and policy on the topic of “Practice Drift.”  Practice drift is when physicians offer patients treatment which falls outside those typically recognized within their area of specialty. For example, a pediatrician once called to inquire about coverage for providing Botox treatment to the parents of his pediatric patients as well as other adult individuals in the community who might be seeking treatment. Another example is the trend of OB/GYNs looking to provide Botox and laser treatment for cosmetic purposes. Economic pressures are usually the cause for practice drift with many of the procedures being offered on a cash-only basis. 

Most state licenses grant the licensee the full scope of practice. However, professionally and ethically, the licensee has a responsibility to practice competently, putting the best interests of their patient’s before their own. Remember, any act that breaches your professional practice or standards may prompt an action by the medical board. Common occurrences for medical board actions include incompetent practices, medication errors, documentation errors, practicing outside the scope of your license and/or certification, patient complaints and failure to timely renew your professional license.

From an Insurance Carrier’s Perspective

Your coverage was underwritten and issued based on the information you provided on the application for coverage. When changes occur to the procedures you are offering, particularly when planning to offer services which are not typical to your specialty, it is good practice to contact your agent and/or carrier to advise them of your practice plans.  The carrier can review what you are planning to offer, your education, and determine if those procedures will affect your liability exposure. 

This is a prudent first step if services being provided are typically those provided by a specialist outside of your specialty. In the event of a claim or suit, it will be a specialist who will be opposing your treatment of the patient. In other words, you may be held to the level of care of a particular specialist’s treatment.

Once your insurance carrier has approved insurance coverage for the new procedures you must be able to confirm at any time that you are qualified to perform a specific treatment or procedure on a specific patient. Confirmation of your education and training should be presented to the patient at the time of the informed consent discussion.

Be sure to maintain all records regarding:

• Formal continuing education 
• Additional training
• Literature review
• Self-study opportunities
• Mentoring situations
• Involvement in professional societies or organizations

For more information on practice drifting and its risks, contact PSIC.