A level of risk management and preparation should be taken at any time a physician becomes unavailable to a practice. Some fundamental loss prevention measures should be considered for even brief periods of time, such as going on vacation, observing holidays, attending medical conferences, suffering from personal illness, or even taking a long weekend. At all times, appropriate coverage arrangements should be in place. The primary responsibility for most situations in which you are out simply focus on good communication- with your patients, your answering service, office staff, and the hospital where you are on-call- in order to help avoid claims of abandonment. According to Medical Protectives VP of Clinical Risk Management, Theresa Essick, "many times communication issues are at the root of claims that involve inappropriate follow up that might be due to physician absences or handoffs that result in poor patient outcomes." No matter how short the absence, your vulnerability to claims is no less on these occasions.  If you are planning to be out of the office, here are some tips to follow to help cover your practice and your liability:

Before you go
1. If your absence will require the substitution of care by a locum tenens, contact your agent to verify coverage details.  All Professional Liability policies are not the same when it comes to providing coverage for a substitute physician. They can limit the amount of days per policy term to use a locums services. Some protection is not always automatic, and requires approval before allowing a substitute to work in your place. In every case, dont assume that you or your practice is fully protected, even if they have their own professional liability policy. Call your agent and consult your policy.
2. Advise your patients of the coverage arrangements. Information should be communicated regarding when your absence will be, for how long, and how your absence will affect their continued medical care. If your absence entails temporary coverage by another physician, be sure that a patient is provided with the covering physicians name, phone number, and the duration of the substitute health care provision.
3. Prepare a listing of those patients that are hospitalized, in the midst of diagnostic work-up, or have special medical problems or needs. Furnish this information to covering physicians, documenting any specific advice you may have provided. Inform the attending physicians or hospitalists of those hospitalized patients of your coverage arrangements, and document the hospital chart in this regard.
3. Each hospital where you have on-call responsibilities should be made aware of the dates of your unavailability and the identity and phone numbers of the covering physician.
4. Similar notice should be added to your answering service and provided to all office staff.

When you Return
1. How much time you will have often depends on your specialty and practice environment, but it is suggested that you allot time on your first day back to catch up, review and prioritize correspondence, review and return telephone messages, and attend to matters that require your immediate attention. This investment in time may seem like a luxury, but will facilitate a smooth transition upon your return to practice. It will prevent an inadvertent break in the continuity of care attributed to oversight or delay, rather than an absence from the practice.
2. Promptly confer with all covering physicians. Document what you were told by the covering physician relative to any significant developments in the patients clinical course or treatment while you were away.
3. Run down the patient list that you prepared before you left for vacation. Peruse all correspondence, phone messages and lab reports. Review follow-up orders written and appointments or diagnostic studies scheduled by the covering physician to avoid any falling though the cracks.
4. Promptly deal with any patient who may have experienced a difficult event or
medical complication while you were away.