The Risk Authority

Heather Foster

Hospitals across the country have come to recognize that they must pro-actively evaluate and develop multi-faceted risk abatement strategies to address the fluid nature of risk in their health care organization.  But how do physician practices develop their own risk management strategies?


Concerns about improving patient safety and mitigating risks in the physician office environment remain just as prevalent as in a hospital setting – so how do the risk management strategies differ?


Doctor’s offices provide medical care to the largest segment of the American population.  The CDC estimated that 82.1% of American adults had contact with a health care professional in the year 2012, and that there were one billion visits to a doctor’s office


Yet today’s physicians face a myriad of challenges which did not exist even five or ten years ago.  The strong movement towards greater integration of physician groups with ACOs and hospital systems presents increased challenges for coordination and communication among multiple caregivers.


The implementation of the Affordable Care Act poses its own legal challenges for physicians, not the least of which will be increased patient case loads. And of course, many states like California face November ballot initiatives to raise non-economic damage caps originally established by “MICRA” type legislation.


If passed, these changes could impact the number of medical malpractice cases that plaintiff’s attorneys bring.  However, the greatest impact will likely be reflected in both the settlement value of claims, as well as in the monetary amount of jury verdicts should plaintiffs prevail.  In a very real sense then, today’s physician practices face greater exposure to medical malpractice claims and litigation than at any other point in history.


The Risk Authority establishes comprehensive Risk Management Strategies for Physician Groups


TRA recognizes that physician groups face significant risks which differ from those presented in a hospital or large medical clinic setting.  We take a proactive approach and tailor our risk management and patient safety plan to each group, based upon a personalized assessment of each clinic’s specific and unique needs.


Best Practices

TRA offers comprehensive office evaluations to our physician practices and clinics; we work with our physicians in the development of written policies and procedures to guide staff.  We are partners in the education of the entire office and we offer concrete suggestions on the best ways to address patient complaints and concerns.


24/7 Support

Our approach at TRA is multi-disciplinary, and “hands on”.  We offer 24/7 clinical risk support and we manage claims and litigation with an in-house legal team.  Our Claims & Litigation Team offers guidance, such as how to handle medical record production, HIPAA compliance, and what to do when legal correspondence is received.   We strive to support a culture of open, honest communication between care providers, patients, family members and hospital administration.

In the event of an unanticipated medical outcome, our clinical risk managers work hand in hand with our claims & litigation team to evaluate all potential outcomes, and to help facilitate discussions with the patient and/or their family members.  Ultimately it is our job to mitigate exposure for the group while simultaneously fostering a culture of patient safety.


Early Resolution

We believe whole-heartedly in early disclosure and resolution programs for our patients and their families.  We work cooperatively to investigate all of the facts surrounding any unanticipated event, adopting a cooperative approach between our clinical risk team, claims & litigation team, and the patient’s family.



While early resolution of potential disputes is one goal – the underlying theme that guides our work day in and day out is support for our physicians and medical staff so that they can deliver the highest quality of medical care.


In the Risk Management world, the size of the institution or number of staff may differ greatly between physician offices to clinics, to hospitals.  But the implementation of best practices remains equally crucial to the success of the practice.  The ultimate goals remain the same: supporting the quest for patient safety and delivering the highest quality medical care possible.


By: Heather Foster, Esq.

Heather currently serves as a Assistant Vice President of Claims & Litigation with The Risk Authority – Stanford.  Prior to joining The Risk Authority, Heather was a partner with the law firm of Lieff, Cabraser, Heimann & Bernstein, LLP.  Throughout the course of her sixteen year career, Heather served as her law firm’s Claims Manager; Administrative Director of Torts Practice Group, Paralegal Manager, Legal Nurse Consultant Administrator, and Litigation Support Supervisor. Heather is admitted to practice law in the state of California, as well as The U.S. Court of Appeals for the Seventh and Ninth Circuits.  She is a member of The American Bar Association, The Bar Association of San Francisco, The Bar Association of San Mateo and Phi Alpha Delta Legal Honors Society.