Association of Family Practice PAs & NPs

The Complexities of Mentoring From a Malpractice Viewpoint

Posted 10 months ago by Monique Ochoa

The Complexities of Mentoring From a Malpractice Viewpoint

Robert M. Blumm, MA, PA, DFAAPA, PA-C Emeritus

Proficient Practice as a PA or an NP is initiated in the academic classroom but requires, in addition, an adequate rotation experience for various reasons. The student must have practical knowledge on how to approach the patient, perform a history and physical exam, devise a coherent plan of care, and, if necessary, perform some type of procedure.

Approaching the patient in a friendly, professional and engaging manner should not be a concern for litigation unless the student makes an offensive, judgmental, biased or suggestive remark. I have learned that “the exception becomes the rule” and once the comment has been made, it is too late to change history. After forty years of mentoring and preceptoring, I am of the opinion that anything can happen and appreciate Murphy's Law. This also refers to the history, the physical examination and all that follows.

Precepting or mentoring is an honor and a responsibility that we owe to our professions and to the next generation of clinicians. But it also has the the attachment of responsibility to the mentor, the clinical facility, the physician director of the department, the respective programs and their malpractice carriers and the PA/ NP students themselves. Perhaps because of this reality, it has become increasingly difficult to encourage our professional members to become involved in this worthy process.

So, the question of the moment is, why precept or mentor? President John F. Kennedy summed it up in his famous statement; “Ask not what your country can do for you, but what you can do for your country.” This is why I feel the obligation to teach, to mentor, and to affirm. PA or NP students are held to the same standard of care as the preceptor and, therefore, they are required to have malpractice insurance. Their respective programs have the same insurance. The bylaws of the facility have an affiliation agreement and they are covered under their insurance as they, too. are involved in the liability of the student. When there is a chief or director of a department, they, too, are held legally responsible for the actions of the student and the mentor. And finally, the Good Samaritan, you, the mentor or preceptor are responsible.

How can you be protected beyond your facility malpractice policy as the mentor or even the student? There exits only one instrument, the most important instrument on the Mayo stand: a personal liability insurance policy. If ever I need a safety net, it is when I am supervising a student in the direct care of patients. I have personally mentored hundreds of students and I do it carefully and with a prayer because the law of averages is working against me and I may be culpable in the future.

My final words on this subject are: be the best clinician that you can, be an excellent mentor and treat yourself for a change as you are the most important part of the equation. Treat yourself to an occurrence policy like mine, with a trusted company of seventy years and the highest rating in the industry. I purchased mine again last week, from CM&F, a broker that you can trust with your future.


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