The Final Frontier: Physician Practices Take Steps to Assess Safety and Risks

In October 1999, the Risk Management Reporter asked whether the physician office* was the “wild, wild West” of healthcare. Although that issue focused primarily on office-based surgery, the question applies to all aspects of what remains a largely unregulated and unstudied healthcare setting.

The physician office is also by far the setting most frequented by patients in U.S. healthcare. According to the most recent National Ambulatory Medical Care survey, 80% of all ambulatory medical care in the United States is provided in physician offices; nearly 1 billion visits were made to physician offices in 2005 (Cherry et al.). In spite of this, this widely used segment of the healthcare system has only recently begun to receive the attention it deserves regarding quality, risk management, and patient safety, even though inpatient facilities and other healthcare institutions were prompted to take action to reduce risks and improve patient safety following the 1999 publication of the Institute of Medicine’s report To Err Is Human: Building a Safer Health System.

Assessing whether physician offices have procedures and practices in place that reduce the likelihood of system breakdowns and errors in patient care is an initial step in managing risks and improving safety in physician practices. Risk managers with responsibility for physician offices should take the opportunity to learn more about ambulatory care risks and the patient safety issues present in these settings by performing an assessment of the office practices. When risks and safety issues are identified, strategies for risk reduction and safety improvement can be developed and implemented. Repeating the assessment, or portions of the assessment pertinent to areas targeted...