Common operational risks in dental clinics &; coping style

There are various risks in dental medical institutions. "Business risk" includes the risk of being stifled by wind comments (gossip and online posting), the generation of accounts receivable caused by over-investment in equipment and patient complaints, information leakage and so on.

"High risk" includes medical accidents, medical equipment failures, natural disasters and crimes. Now we need to take corresponding measures against these risks.

1. Types and contents of operational risks

2. Complaint risks and countermeasures

(1) Risk complaints brought by complaints can generally be used as valuable information resources to improve the hospital system, improve medical services and ensure safety. However, in recent years, cases of malicious complaints and abusive language and violence that have a significant impact on business have also increased.

Some malicious visitors, such as "foreign patients", have brought great risks to stomatological institutions.

Bad language refers to such words as slander (such as "quack"), abuse, sexual harassment, etc., which destroy the mood of other patients and employees or have an impact on business, including not only verbal words, but also leaflets and online postings.

In view of the above situation, we should think of measures in advance just in case.

(2) How to Deal with Malicious Complaints (Society) The Medical Management Countermeasures Committee of Sapporo Dental Association has launched a booklet entitled "Emergency Response Set" to its members. Here are some of the contents.

In case of emergency (Sapporo dentist will provide an extract of the treatment kit). ※

● Making unfair demands for many times is regarded as a mental problem, targeting money, slandering on the Internet, etc. , and was judged as a malicious complainant.

? Coping process?

(1) It shall be handled by the dean, and the specific content of dissatisfaction shall be confirmed (the detailed medical records and medical remuneration are ready).

(2) Take measures such as recording and video recording as required by the other party.

(3) Find a dentist association, a lawyer, and the police.

When subjected to violence.

Don't stop it easily, run away from the abuser first (setting an emergency bell is also effective) and call the police. Collect the testimony of patients, employees and other relevant personnel present, indicate the date and time, find all witnesses to sign and make evidence. Monitoring is installed in a conspicuous place where people can see it at a glance, which can play a deterrent role and reduce violence and swearing. As long as the warning slogan "To prevent illegal and criminal activities, hospitals are equipped with monitoring and recording images" is posted at the entrance, it will not violate the personal information protection law and privacy issues.

● Can you refuse to treat "incurable patients"?

According to item 19 of the Dentist Law, the hospital has the obligation of diagnosis and treatment, but if it is determined that the patient is in a drunken state due to obstruction, or the hospital can't handle it properly, it is deemed that there are justified reasons to refuse the consultation. However, the hospital shall not refuse to consult on the grounds that the patient does not pay medical remuneration.

In addition, some clinics have also produced countermeasures manuals on chatting and posting on the Internet.

■ Specific examples of manuals

● If the judgment is improper, the interview place will be designated by us. (It's best to be in a room with posters such as "violent eviction" by the police. The table is bigger and there are two entrances and exits. )

● The final person in charge, such as the dean, does not respond directly, but responds with more people than the other party.

● Respond in time.

● Record the dialogue. Some lawyers don't need to be told on tape. )

● Avoid misleading expressions and speculative statements.

● Don't stamp, sign or submit documents easily.

3, information leakage risk and countermeasures

(1) Personal information risk

Oral medical institutions have many opportunities to know personal information. From making medical records to taking X-rays to saving films or data. In addition, when submitting the detailed statement to the medical remuneration bill audit and payment institution, it provides information to other operators and carries out health diagnosis, sends the employee health diagnosis result notice to the work unit (operator), and sends the mechanic instruction book to the mechanic room. , will also provide personal information. Recently, there have been many cases of problems, such as leaking medical records and lending X-rays, which require extra care.

As mentioned above, oral medical institutions will have access to personal information and provide it to others under various circumstances. In this way, there are inevitably risks such as violation of law, dishonesty and damage caused by information disclosure. As medical personnel, we should strengthen our awareness in this respect and properly manage medical records, medical remuneration ledgers, photographic films and other items (paper, materials, films, etc. ) prevent the obtained information from leaking out.

(2) Personal information protection countermeasures

With the implementation of the Personal Information Protection Law in 2005, after the revision of the Medical Law in 2007, dental medical institutions were given the obligation to formulate safety management measures and nosocomial infection measures. The following describes the necessary measures for the protection and management of personal information.

■ Improvement of organizational system

① Establish a personal information protection committee.

② Appoint a personal information protection manager.

③ Improve the window function for handling personal information-related complaints.

■ Perfection of laws and regulations related to personal information

(1) Formulate personal information protection policies.

(2) Formulate regulations on the protection of personal information.

③ Specify the disclosure process of personal information.

(4) Formulate the response process (manual) when personal information is leaked.

⑤ Develop a process (manual) for handling personal information-related complaints.

⑥ Improve the relevant provisions of confidentiality obligations, including post-employment, such as labor contracts, etc.

⑦ Define the contractor's safety management measures and obligations in the outsourcing contract.

■ Open medical records and borrow X-rays.

In principle, we must respond to the request for public medical records as soon as possible.

(1) It is required to submit medical records and other public applications in the prescribed format of patients.

(2) When the agent and others require disclosure, they shall submit the power of attorney in the prescribed format.

(3) After confirming the application for publicity, deliver the reply in the prescribed format and reply quickly.

(4) Keep all records related to publicity.

4. Risks and countermeasures of accounts receivable

(1) Risk of accounts receivable placement

For oral medical institutions, the accumulation of small accounts receivable will also bring risks to the operation of clinics. Accounts receivable are mainly "unpaid and unpaid window payments", which are difficult to recover once they are generated. Patients who have completed diagnosis and treatment will have resistance to payment in the later stage, and it is difficult for hospitals to ask for it. The premise of recycling is to urge patients to come to the hospital.

(2) Accounts receivable countermeasures

① Precautionary measures for accounts receivable

The basic countermeasure of accounts receivable is to pay more attention to prevention than to recovery. It is very important to establish the recovery mechanism of hospital accounts receivable in advance.

■ New choice of payment method

● Collect a deposit.

If it is planned to implement high-cost treatment such as medical treatment on parole, it will be charged 5000 ~ 1 10,000 at the beginning of treatment.

● Adopt the installment payment system.

For patients who are worried about economic problems, put forward suggestions on installment payment in the medical expenses consultation window.

● Import credit and debit cards.

■ Provide sufficient information.

● The clerk actively communicates according to the content of diagnosis and treatment.

At the time of settlement, ask "Is there any problem or something you don't understand".

The content of diagnosis and treatment to be implemented after the doctor confirms it, and fully explains it.

● Privacy protection

Payment is a sensitive topic, so we should set aside a hidden space, such as consulting room.

② Recovery methods of accounts receivable.

● Direct or telephone recovery

● Send a general supervision letter to convey the meaning.

● Send the supervision letter by guarantee mail, and attach the content certificate.

● Follow the supervision procedure according to Article 382 of the Civil Procedure Law? civil action

When collecting accounts receivable, we should avoid escalating the situation into a doctor-patient dispute. Especially in recent years, there are more and more cases of patients deliberately not paying treatment fees, and the amount of each account receivable is also increasing. If the attitude towards payment (accounts receivable collection) is wrong, it may affect patients' mood and lead to negative word-of-mouth, so it is necessary to recognize the types of late patients as soon as possible.

5, excessive investment and investment risk countermeasures

(1) equipment investment risk Recently, various forms of oral medical treatment called "advanced" have appeared. The development of technology can easily make the impossible possible. Regenerative medical care and low-invasive medical care have developed particularly fast. From the initial laser, to the digitization of X-ray equipment, to the research and development and sales of dental CT, dental MRI and other equipment.

However, excessive equipment investment may bring huge losses to clinical operation. Unbalanced income and expenditure will lead to the deterioration of capital turnover and eventually face the risk of bankruptcy. It is important to consider the clinic's diagnosis and treatment policy, fully explore the current treatment needs and cost-effectiveness, and determine the equipment investment on this basis.

(2) Investment risk countermeasures For dentists who are committed to providing better diagnosis and treatment, "advanced" medical equipment is their dream. There are also standardized equipment, with high success rate and high diagnosis and treatment score. The expensive medical equipment listed in these two or three years will only increase the operating burden of the clinic and even lead to an operational crisis.

The "advanced" of medical staff has not yet penetrated into the hearts of patients. "Installing expensive equipment can greatly improve the success rate of treatment, and such dental medical institutions are very reliable." The patient has no such consciousness. Because the success rate at this stage still depends mainly on the knowledge and skills of the surgeon.

The competition of stomatological institutions will continue to intensify. It is very dangerous to consider investment according to the forecast of steadily rising business figures. It is best to consider and judge whether it can be purchased at present and whether it should be paid.

■ Matters needing attention in equipment investment

● Is it in line with the clinic's diagnosis and treatment policy?

● Does it meet the clinical needs of patients?

● Have you considered the cost performance?

● Judging from the current financial situation, will payment have an impact on the future?