How Reality TV Can Spark Passion In Your Practice


Passion for Your Practice

There are so many businesses out there that exist only to go after the almighty dollar and you get the feeling that the world is full of greed. Well, I believe there is more to business than just that. As a business owner, it’s wonderful to see your client’s eyes light up or hear the gratefulness in their voices when you’ve saved them money and provided them what they wanted and needed. This is what truly inspires me in my business.
All of this makes me wonder about physicians and what inspires them to continue in their practices. There’s a lot of doom and gloom coming from new government rules and regulations and this must be extremely difficult. But I am certain if doctors can see past this, they can make their practices shine so they can inspire their patients to help them get well and be excited about that.

Passion in the Treehouse Masters

I’m going out on a limb here (pun intended) to say I enjoy some reality shows. One show I enjoy is The Treehouse Masters. It’s exciting for me to see the enthusiasm in Pete Nelson’s voice as he meets with his new clients to discuss building their new tree house. Nope. It’s not the money the inspires Pete, but it’s pure joy he sees in his clients’ faces as they take the tour of their newly build tree house masterpiece. Throughout the show, I can see the same enthusiasm as he talks about the project with his riggers and carpenters in instructing them how to build their client’s dream. Of course, not all projects are the same. They are not your basic tree house. Pete’s clients want tree houses for recording studios, spas, and man caves and Pete goes beyond his clients’ desires and throws in some neat surprises, just because he wants to. That’s passion and I am inspired by that! Click here for a peek into Pete Nelson’s Treehouse Masters world.

Ideas to Spark Passion in Your Practice

So, let’s come back to your medical practice. How can you create enthusiasm in your office, not only for your patients but your employees as well? No. We are not talking about Patch Adams here, but I’m sure there are things you can find to create a better practice. Here are some ideas:

  • Put aside your laptop EHR system and listen and understand your patient’s background, history, complaints and reason for the patient visit. Listen for cues that might not be spoken, but seen through the patient’s eyes or movements.
  • Create a team effort. I know that as a patient, I work harder on my health goals when I have a “We’re in this together” feeling with my doctor and care team. Just this exhibits passion and shows that you and your practice care. Think back and deep into why you became a physician. Chances are, it’s not all about the money. Start using that forgotten inspiration in your practice today.
  • Follow-up. If a patient is really not well and you are concerned. Take the time to follow-up yourself and call. I can tell you that means boatloads to patients.

I hope this has given you some food for thought. What other ideas can you come up with? We’d love to know. Share them here in the comments section below.

What a Hidden Arbitration Clause Really Means

Arbitration Clause

Arbitration Clause and Consent to Settle

One of the best phrases to see in a Medical Malpractice insurance policy is “Consent to Settle”. This phrase suggests that your insurance company’s defense will seek your approval if a claim settlement is presented by the plaintiff. What if there are other terms in your policy that could change the effects of your Consent to Settle? Consider the Hammer Clause, as we discussed previously in this Consent to Settle blog.  Another term we’ve noticed with more frequency is the Arbitration Clause, which unfortunately, has the potential to wash away your consent.

Arbitration Clause Definition

According to Wikipedia, “An arbitration clause is a clause in a contract that requires the parties to resolve their disputes through an arbitration process.”
So, in medical malpractice policies, this clause defines the defense process should the claim be brought to arbitration but also redefines your Consent to Settle clause. Let’s take a look at actual defense clauses from two medical malpractice policies.

Policy 1 – Does not contain the Arbitration Clause

Defense and Settlement

The Insurer may make any investigation it deems necessary and may, with the written consent of the Named Insured, make any settlement of any Claim.

Clearly, within this policy, there is no arbitration so this exhibits pure Consent to Settle. The insurance carrier must obtain your approval prior to settling a claim. Period.


Policy 2 – Contains Arbitration Clause

Defense of Claim and Settlement

Insured’s written consent to settle any Claim if the Insurer believes that settlement is proper. If the Insured withholds consent to a settlement recommended by the Insurer and acceptable to the claimant, the issue shall be submitted to binding arbitration pursuant to Section XVI.

– – – – Several pages further in the policy . . .

Section XVI

Arbitration Clause

Solely in the event that the first Named Insured withholds consent to a settlement recommended by the Insurer and acceptable to the claimant, it is agreed by the Insured and the Insurer that this issue will be resolved by submitting to binding arbitration.

The policy goes on to discuss the process of arbitration, then states:

Where the recommended settlement is found by a majority of the Arbitration Panel to be reasonable under the circumstances, the Insurer shall have the right to enter into such a settlement without the first Named Insured’s consent. If a majority of the Arbitration Panel determines that the recommended settlement is not reasonable under the circumstances, the Insurer shall not have the right to enter into such settlement without the first Named Insured’s consent.


Ramifications of the Arbitration Clause

At first glance, this second policy appears to have the same full Consent to Settle. However, the second sentence states that if you do not consent to the offered settlement, the case will be brought to arbitration, which is an alternative dispute resolution method. The ending of that sentence refers you to another section, where you must search for further in the policy. In reading this section, it indicates that if the Arbitration Panel believes the settlement to be reasonable, that becomes the final decision of the case and your right to consent is withdrawn.
When reviewing your policy, we recommend you always read the Defense language carefully. Some policies contain fine print allowing arbitration to settle the dispute, which may favor the insurance company. Always look for your best interest.
Do you have any coverage concerns about your malpractice policy or questions about this blog? If so, please comment below.

3 Benefits of Healthcare Tweet Chats

Healthcare Tweet Chats - Symplur
Do you have a diagnostic or treatment question and wish there were a place you could visit to find answers outside of your practice? Do you ever wonder what your diagnosis and treatment is like from your typical patient’s perspective?   How about reaching into the minds of other healthcare leaders on communication, patient safety, insurance issues? Imagine if you had a place where you could visit regularly that could help provide answers to all of these questions.

Welcome to Healthcare Tweet Chats

So what are Healthcare Tweet Chats?  According to our friends at Symplur:

A tweet chat affords Twitter users the opportunity to engage in conversation with each other. A tweet chat can either emerge from a new community that coalesces around a particular subject or keyword, or serve to focus the conversation of an existing community.

At Perron Insurance Services, we have been participating in the weekly #hcldr tweet chat for about a year now.  We find ourselves increasingly involved in reaching out to others, like yourself, to spread the word about the #hcldr community and other healthcare tweet chats. So, why do we believe in this medium and, how can it benefit you?

Benefits of Healthcare Tweet Chats

  1. Education – Participants gather with common interests and, since participants may be from different interest groups, such as patients, consultants, and other healthcare professionals, there are a variety of opinions, sharing and learning from one another.Healthcare Tweet Chats can be specific to a medical specialty, diseases and conditions, leadership and many others. I am especially excited when I participate in a tweet chat that provides valuable information that I can bring back to my clients.Here are some examples of some current weekly scheduled tweet chats:

    • #bioethx    bioethics, healthcare, medical ethics, medical humanities, nursing ethic
    • #AlzChat   Alzheimer’s Disease, alzheimer, caregiving, dementia
    • #bccww     Breast Cancer
    • #solvePT   Physical Therapist Issues. physical therapy
    • #MedEx     doctor, Medical Education physician
    • #CPHC      crowdsourcing, empowerment, healthcare information, transparency

  3. No Geographic Location Boundaries – Communicate with participants in your field, who could be in the same state as you or found internationally.  The #hcldr tweet chat has participants in the United States, Canada, Philippines, and Australia.

  5. Participate in International Healthcare Conferences – Without being there!  Our veteran #hcldr participant, Bernadette Keefe, MD @nxtstop1 was not physically present at the Doctors 2.0 (#doctors20)conference held in Paris earlier this year, but she was able to take in information and tweet it out to her followers. Why is this a benefit of healthcare tweet chats? Well, without #hcldr, we wouldn’t have gotten to know Doctor Keefe who willingly shared this information.

Need more convincing? Here are some comments from our #hcldr community when we asked them why they participate in healthcare tweet chats.


Resources for Healthcare Tweet Chats

Take a look at Symplur’s web page on Healthcare Tweet Chats. Within it you will see a schedule of healthcare tweet chats, including related hashtags.
When you select a tweet chat from the list, you will be able to see details of the chat, including the description, top influencers, transcripts and analytics. Check out our #hcldr tweet chat page. This is serious stuff here! Go ahead. Try it.
Find a tweet chat that interests you and search Twitter for that hashtag and participate. Or, check out our favorite tool for tweet chats, which is Just go there at your scheduled time, sign in, enter the healthcare tweet chat hashtag and voila. See the stream of chats. If you are nervous in the beginning, feel free to observe, and check it out. We won’t tell.
Most chats have a dedicated topic of the session and some, like #hcldr, maintain a blog where participants to visit, read about the topic of the session, and see the questions we will be discussing.
We also recommend Symplur’s Healthcare Hashtag Project, which tracks hashtags for healthcare tweet chats, conferences and diseases.We’d love to hear from you. Share your comments below. If you like what you see, please consider sharing this post by clicking the share buttons above. Thank you.

5 Dental Malpractice Coverages That Will Make You Smile

Dental Malpractice Coverage

Malpractice insurance coverage is a necessity for healthcare providers and dentists are no exception. In our experience, we have found that some dentists who come to us seeking coverage are somewhat lost and others even admit they don’t understand the current coverage they have in place. We understand that the quicker a dentist can cross “buy malpractice insurance coverage” off their To-Do list, the happier they are until….. there is a claim.
The good news is that claims have significantly dropped over the last ten years.  Take a look at the data we retrieved from the National Practitioner Data Bank.
Dentist Data

We’d like to take this time to give you a brief overview of five important things to look for when seeking coverage so you can be well protected and rest easy should a claim arise.


Dental Malpractice Coverage Considerations:


  • Consent to Settle

We consider this to be the most important dental malpractice coverage clause in your policy. Here’s why. Let’s say, your coverage includes Consent to Settle, but, there is a tiny bit of additional wording that says, “subject to the Hammer Clause”. The Hammer Clause basically says, we will seek out your request to settle a claim. But, if you do not agree to our settlement and want us to keep defending, we will, but you may be on the hook if a claim ends us settling higher than the original settlement amount. We have dedicated an entire blog to the Consent to Settle clause, which you can find here.


  •  Who Is an Insured

It stands to reason that you, the dentist, is an insured. But, what about your employees and your entity? With some policies, dental malpractice coverage for your employees and entity is provided at no cost on a shared limit basis or, if you would like, you may purchase separate limits. Making sure everyone who provides services at your practice, whether employed or not, can save you money in the long run.


  •  Vicarious Liability

If you have independent contractors working at your facility, is your facility protected if a claim arises due to their care or lack thereof? Having vicarious liability within your dental malpractice coverage will protect you and your entity on behalf of your independent contractors’ acts.


  • Regulatory Liability and Information Security Privacy Coverage

Because of the increase in data breach vulnerabilities and government regulations, some, but not all, carriers are now including additional dental malpractice coverage to protect against these types of losses. Although your EHR company may have it’s own coverage, you need to protect yourself and your practice if there were a data breach stemming from your office. Be sure to find coverage that includes response notifications and consistent communication with you throughout the breach remedy process.


  • Botox

Due to the increase in popularity of Botox and other injectables, some carriers are now including these procedures within their policies, based on evidence of proper training and certification. If you provide these services and/or possibly plan to add new up and coming aesthetics procedures, you want to be sure you have a carrier that will provide coverage for these procedures.

We believe these dental malpractice coverage considerations will be beneficial to your practice now that you know what to look for. We invite you to share your comments below and welcome any questions or concerns you may have about your current policy.
For more information on dental malpractice coverages we offer and to find out more about our special dental program, click here.
You may find information on additional savings to your dental practice through the Dental Purchasing Group, which you may find here.

Risks and Rewards in a Risk Retention Group

Let’s just admit it, insurance is not fun. We know it’s especially difficult if you are a physician struggling to make ends meet in your practice. You may be faced with an unaffordable renewal premium or even a non-renewal notice from your current carrier. You may be wondering what your options are and hope that your insurance broker is honest in laying out all the facts.

Our experience over the years has taught us a lot about Risk Retention Groups and our goal is to share this information with you. This is why we created our 22 page ebook entitled, Risks and Rewards in a Risk Retention Group.

Risk Retention Groups

Here is a sample of what you’ll discover:

  • Advantages and Disadvantages
  • Evaluation Tools
  • What You Need to Know to Make an Informed Decision

You can get my new ebook free just by registering for my email list. This way you don’t have to visit my blog to stay up-to-date. Instead, you can get updates via email.  Whenever I post fresh content, I will send you an email message. It’s that simple.

Just click to the right, enter your email address and first name, and I will immediately send you the link to download your ebook Risks and Rewards in a Risk Retention Group.  Be assured, you can unsubscribe at any time.  Privacy Guarantee: I will never share your e-mail address with anyone else.

Question: What are your concerns as you face your medical malpractice insurance renewal? You can leave a comment by clicking here.

Policy Conditions

Policy Conditions – Knowing These Will Keep You Covered

Policy Conditions


Importance of Knowing Your Policy Conditions

Did you know that your medical malpractice insurance coverage contains policy conditions that must be met in order to keep the policy in compliance?  Not knowing and not following through on these conditions can be detrimental to your coverage, including cancellation.   We are telling you this because it happened to one of our clients, even though we strongly recommended he read the medical malpractice insurance coverage, including its policy conditions.

We do not want to see this happen to you.  Let’s take a close look at the Conditions Clause from one of our medical malpractice insurance policies:

Policy Conditions – Obligation to Report Material Changes

The FIRST NAMED INSURED shall notify the COMPANY of any changes that might affect the terms of this insurance, including but not limited to any of the following:

1. a change in the location of the practice of any INSURED.

2. if any INSURED or LOCUM TENENS is denied medical staff privileges or has had such privileges restricted, revoked, suspended or reduced by a licensed health care facility.

3. if any INSURED or LOCUM TENENS voluntarily restricts, revokes, suspends or reduces medical staff privileges by a licensed health care facility.

4. if any medical licensing or other governmental agency investigates, restricts, revokes, suspends, places on probation, reduces or otherwise takes any other action with regard to the medical license or DEA authorization of any INSURED or LOCUM TENENS.

5. if any INSURED or LOCUM TENENS voluntarily restricts, revokes, suspends, reduces or otherwise takes any other action with regard to his or her medical license or DEA authorization.

6. if any criminal proceedings are instituted against an INSURED or LOCUM TENENS that are based upon, attributable to or directly or indirectly related to his or her status or conduct as a health care provider.

7. if any INSURED or LOCUM TENENS is ordered or instructed to enter or voluntarily enters a diversionary or rehabilitation program for alcohol, drugs or other substance abuse. Notice must also be provided upon the individual’s departure from such program.

8. if any INSURED intends or seeks to practice in an additional (1) location, (2) health care facility, or (3) area of medicine not designated in the PROFESSIONAL SERVICES endorsement attached to this policy.

9. a change in partners, officers, members or any changes in the structure of operations, ownership or control.


Policy Conditions Not Met – Real Example

One month ago, we received a Cancellation letter on behalf of our client. The insurance company chose to cancel the policy because the insured had not given notice of one of the items that was listed and required to report.  Further, the Cancellation provided only 15 days in which to find replacement coverage.  Here is the Cancellation Clause taken from this same policy:

Policy Conditions – Cancellation Clause

The COMPANY may cancel this policy more than sixty (60) days after its effective date by mailing or delivering such notice to the FIRST NAMED INSURED at least fifteen (15) days before the effective date of cancellation, provided such cancellation is based upon the following reason:

* An act or omission by any INSURED that substantially increases the hazards insured against, including but not limited to one or more of the material changes identified in Article IX.H.2.-7 (Referring to Obligation to Report Material Changes).

Subsequently, we needed to find replacement coverage in a hurry. In addition to losing the policy, the insured also lost time that he invested in earning a free tail upon his retirement.  Now, he will now have to start investing time with his new carrier, which will make him eligible for a free Extended Reporting Period, also known as Tail Coverage, in another five years (v.s. three with the prior carrier).

In conclusion, we recommend you read your policy carefully so that you do not run into issues like the one explained here. We are happy to take the time to review your current policy with you upon request. We welcome you to add your comments. If this article has provided value to you, we ask that you share it.

Social Media for the Medical Practice

Social Media for the Medical Practice

Recently, members of the New Hampshire Medical Group Management Association (NHMGMA) were treated to an engaging presentation, given by Dan Dunlop of Jennings. This presentation on Social Media for the Medical Practice showed members how it could benefit and improve their own practices. Because the audience enjoyed the material, we thought we would share it with you since you may be wondering how social media might be useful in your practice.
(If the video does not load, simply refresh your browser.)

We would love to hear your thoughts on this presentation. If you already use social media for your medical practice, let us know what you are doing and how your response has been. In addition, we would love to hear your questions. Just simply add your thoughts to the comments box below. And, of course, if you have enjoyed this post, we would love it if you would share it.  Thank you!
This Social Media for the Medical Practice presentation was provided by Dan Dunlop. Dan is principal of Jennings, a leading healthcare marketing and audience engagement firm. He is a healthcare marketer, brand consultant, blogger, author, and sought-after speaker, regularly serving on the faculty of national and regional healthcare conferences.
Dan is the author on the chapter on marketing the medical practice in Essentials of Physician Practice Management, published by Jossey-Bass 2004. Editor Blair Keagy MD. It is a textbook used in medical schools. Essentials of Physician Practice Management offers a practical reference for administrators and medical directors and provides a comprehensive text for those preparing for a career in medical administration, practice management, and health plan administration.
Dan Dunlop - Social Media for Medical Practices
Dan Dunlop – Jennings
104-A North Elliott Road
Chapel Hill, NC 27514
p: 919.929.0225
f: 919.968.8278


Patient Safety

Digital Devices and Patient Safety

Digital Devices and Patient Safety


Digital Devices and Patient Safety

Our blog on Digital Devices and Patient Safety comes from the October 22, 2013 #HCLDR tweet chat.  This tweet chat is held on Tuesday evenings at 8:30 p.m. EST.   In an open group, individual healthcare stakeholders from all over the world come together each week to discuss healthcare topics that affect us all. Who are these stakeholders?  They include patients, nurses, physicians, techies, geeks…. anyone who has an interest in improving healthcare.
Consider this as your personal invitation to join us!

We are particularly fond of this October session that focused on Digital Devices and Patient Safety. Since the subject was interesting and relevant to our promoting risk management and patient safety, we think our blog will provide some good food for thought in using digital devices and being mindful of how it affects others. This is great learning for all of us!


Question on Decreasing Digital Distractions in the Workplace

Here is our Digital Devices and Patient Safety question, provided by our co-pilot, Lisa Fields, aka @Practical Wisdom:


“T1” refers to our participants answering this question.  Before reading some of our participants’ responses, we invite you to pause and think about this question and how affects you and your work environment.



There is a lot of truth to this statement.   It’s exciting to learn and use new devices, but they are being added on top of our very busy worlds.


Digital Device Interface design is important and must come from the users, since they know their work processes best.



Absolutely!  See references below.



It’s natural to think that multitasking increases the number of tasks we can check off our lists.  Not so. Focusing on one task at hand and getting it done provides more accurate results and the satisfaction of checking that one To-Do item off your list.



Think about it.  If your physician were to provide little eye contact and engagement because he was too busy typing office notes into his/her computer, how would that make you feel?  How does this affect your experience as the patient? Does this spark any changes you want to make as a physician in your own practice?



Doesn’t this make sense?  We get so mentally involved in our thinking during digital tasks, that sometimes we have to “wake-up” to the issues right in front of us.



Doesn’t this say it all?  We hope you found this discussion enlightening.  We welcome your comments and suggestions on what you would like to see in future blogs.


Resources for our Digital Devices and Patient Safety blog:

Our #HCLDR tweet chat is hosted by:  Colin Hung (@Colin_Hung) and Lisa Fields (@PracticalWisdom). Thank You!

For this session, our Pre-Tweet Chat Blog entitled Maintaining Our Focus in a Digitally Distracting World:

Are You Tired of Alarm Fatigue?:

Distractions Lead to Mistakes by Nurses:

Consent to Settle

Consent to Settle Clause

Consent to Settle

Consent to Settle language within a malpractice insurance policy is important for insureds to understand prior to purchasing coverage.  This is because the language within the clause details the extent to which an insured is responsible for claims payment, and how the claims will be paid. It can provide the insured with superior coverage or coverage left with unexpected holes in it.  Let us look at the following Consent to Settle Clauses from two actual policies:


Consent to Settle – Example 1

The COMPANY shall not settle any CLAIM without the written consent of the INSURED against whom the CLAIM has been made. If the INSURED refuses to consent to any whole or partial SETTLEMENT of a CLAIM recommended by the COMPANY within the applicable Limits of Liability, the COMPANY’S obligation to make any further payments for amounts in connection with the CLAIM incurred after the recommended SETTLEMENT was proposed shall not exceed the amount for which the CLAIM could have been settled by the COMPANY had the INSURED consented to the SETTLEMENT. The INSURED is not entitled to, and the COMPANY will not be obligated to pay, any DAMAGES or CLAIMS EXPENSE beyond that amount. To the extent the COMPANY pays any DAMAGES or CLAIMS EXPENSE beyond that amount, you agree that, after the CLAIM ends, such amounts shall be repaid to us by the INSUREDS , each according to his or her respective interest.

Does this first example scare you?  Well, we hope it does.  This clause means that that if you do not agree to the proposed settlement, you may be left hanging with a large out-of-pocket bill, including final damages beyond the original settlement amount and defense expense costs, including expensive attorney fees.

Consent to Settle – The Hammer Clause

This first example contains what is commonly called the Hammer Clause, which is defined as: *A provision (also known as the “hammer clause” and “blackmail settlement clause”) found in professional liability insurance policies that requires an insurer to seek an insured’s approval prior to settling a claim for a specific amount. However, if the insured does not approve the recommended figure, the consent to settlement clause states that the insurer will not be liable for any additional monies required to settle the claim or for the defense costs that accrue from the point after the insurer makes the settlement recommendation.

Okay, let us look at – Example 2:

Consent to Settle Example 2

We will obtain written consent from you before we settle a claim against you arising from a medical incident. You agree to waive such right to consent under the following circumstances:

  • The settlement amount is within any deductible amount applicable to the claim
  • You are deceased or adjudicated incompetent
  • Judgment is entered
  • Your license to practice medicine is suspended or revoked
  • The claim was reported under an Extended Reporting Period Endorsement to this policy
  • You, after reasonable efforts by us, cannot be located

Aside from the understandable exceptions, this clause provides full consent, meaning should you decide not to settle, the carrier would keep defending on your behalf at no additional cost to you. The only caveat is if the final judgment goes beyond your purchased policy limits.

Making the Decision That’s Right For You

Understanding the Consent to Settle clause will help you in deciding which coverage is right for you. Should you choose coverage with full consent, such as the second example, you will be able to enjoy peace of mind in knowing that your carrier is really fighting for you.  If you have any questions regarding your policy, we would be pleased to provide a no cost / no obligation consultation.

What are the concerns you have about your coverage?  We welcome your comments below.  If you find this post helpful, we simply ask that you share it.

*Reference provided by: International Risk Management Institute

The content is for informational purposes only. All matters must be analyzed on a case by case basis.