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To “indemnify” or to “hold harmless” means to insure another party’s risk. Indemnity clauses appear in a wide variety of business contracts, including those between physicians, their groups, and the hospitals in which they treat patients. When a physician signs a contract to join a medical group, and the contract has indemnification language, the physician may be agreeing to take responsibility for the group’s malpractice liability if both are named in a lawsuit. Consequently, physicians should be wary of signing any contract with an indemnity/hold harmless clause.

In the following case, the group’s medical director over-utilized medical assistant (MA) externs for cost-saving purposes. Because he did not understand how his plan was putting patients at risk, he was resistant to negative input from his colleague. The physician conflict exacerbated the inherent risks of the externship program.

Like other people, physicians and clinical staff members may commit crimes and engage in other noncriminal activity that can expose their healthcare employers to liability and regulatory violation risk.¹ Therefore, it is important to have processes in place to conduct background investigations on any staff member involved in patient care and practice operations, even those with personal references from current clinicians or staff.

Patient activation has a significant effect on a patient’s management of chronic disease.¹ Various studies indicate that promoting discussion and problem solving to help chronic disease patients make informed self-management choices on an ongoing basis increases activation and improves outcomes.²

The ability of patients to comply with discharge instructions is related to their activation level. Research indicates that identifying and intervening on behalf of patients with low activation levels could reduce their risk of an unplanned rehospitalization.¹