The PRMS Blog

The Life of PRMS: Donna Vanderpool, Vice President, Risk Management


When I had accomplished everything that I had wanted to at my prior position managing a busy surgical practice, I was leisurely exploring what new opportunities were out there. I found an ad for a job that sounded interesting, but not actually for me because it was very close to the DC line in Virginia, and I will do anything to avoid DC. (Did you know that there can be two exact same street addresses in different quadrants of DC? I learned that lesson the hard way!) Since I hadn’t interviewed in a while, I decided to use this as a practice interview. About five minutes in I realized, to my dismay, that I had to have this job! I love to educate, and that was a big part of what the job required. Whether one-on-one with psychiatrists who call our helpline, doing talks for groups of psychiatrists, writing articles, or educating our colleagues in the office on new psychiatric treatments, educating others has continued to be a huge part of why I have enjoyed my time at PRMS so much.

I had taken the subway to the interview (that’s a whole different story – up a huge hill to the office, only to find the public bathrooms were locked, so no freshening up before the interview!), and am very unfamiliar with locations near DC. Later, as I was I was literally crying to my best friend – because I wanted the job, but I cannot do DC – she reminded me that I had managed to travel to the same area each day for law school, so I would be able to do the commute again for this dream job. And since being hired, I have managed to do so!

The best thing about working at PRMS is the people I am lucky enough to work with each day. Everyone here is great and very professional, but for me I have to thank my former manager and mentor, Jackie Melonas (who had the audacity to retire!). She put together quite the team of risk managers, including my colleague and AVP, Dave Cash. I’m extremely grateful for Dave’s significant contributions, along with those of the other risk managers Ann and Justin, to the clinical risk management expertise that we are continuously developing and sharing with psychiatrists.

Seventeen years later, why do I call this the best job in the world? Because of the opportunities I have to educate and help our psychiatrists practice good medicine, which increases patient safety, and decreases professional liability risk – and may even allow a few psychiatrists to sleep better at night!

I’m now sharing my risk management thoughts and reflections via LinkedIn (and have actually done close to 100 posts!) that can be read here.

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The Life of PRMS: Victoria Chevalier, Assistant Vice President, Underwriting


In addition to providing the best client service possible, a hallmark of PRMS is our ability to identify talented individuals and allow growth and new opportunities for our team. I am an example of that promise having started in 1998 as a temporary administrative assistant. A few months later, I was hired as a full-time assistant in the Underwriting Department and today I write this blog as the Assistant Vice President, Underwriting.

Born in Trinidad, I arrived in the United States first at age nine for a year and returned when I was 13. The transition at that age was difficult but I learned life-long coping skills and the importance of education. With this background, I bring a unique perspective to PRMS along with a rich understanding that we are indeed a nation of nations – as is often the case with many of our clients who also have immigrated to America.

Although my work experience prior to PRMS was limited, I brought organizational skills and a strong work ethic that was recognized by my supervisor. Today I manage a professional team of underwriters and daily have the privilege to work with psychiatrists. The mentoring and the sharing of knowledge have helped me grow in my role. I was encouraged to obtain my property/casualty license and most recently, obtained my RPLU status (Registered Property Liability Underwriter). Through the years, I have learned not just about insurance but most importantly about mental health and the dedicated psychiatrists who care so deeply for their patients.

And not only did I grow professionally during my 19 years at PRMS, but I also was so fortunate to have started a family. PRMS has always put family first and thus, I am able to balance work as a working professional with meeting the needs of my immediate and – at times – extended family.

When I came to PRMS, I felt like I had come home. And that goes to the core feelings of family, service, opportunity and recognition.

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The Life of PRMS: Ann McNary, Senior Risk Manager


Almost 30 years ago, I left law school with the dream of becoming a charismatic family law professor (and my having watched a few too many episodes of Arnie Becker’s escapades on LA Law), as I had it in my head that negotiating divorces would be a really fun way to spend my career. It wasn’t long before I realized that this had not been my best idea and began considering finding another area of practice. One day purely by chance, I happened upon an opening for an attorney at a medical malpractice insurance company. Honestly I had no clue of what this would entail, but I knew and liked the woman who would be my boss, and it just had to be better than arguing over china and dog visitation, so I took a leap of faith and accepted the job.

In my initial position, I helped to supervise the claims department and also assisted in risk management taking calls from insureds and giving risk management talks. I have to admit that at first I was intimidated (strike that – terrified) by the fact that I was actually going to be giving advice to doctors. I quickly realized, however, that physicians are kind people who crave knowledge and were appreciative of what I had to share. I grew to love this type of work and stayed at that job for eight years and later took another job at a second medical malpractice insurance company where I remained for five years before coming to the Risk Management department at PRMS.

Having worked for companies that insured all specialties, I wondered at first if I would find less interesting to work with just one specialty. What sorts of challenges could there be for me in advising psychiatrists? I was about to find out. Psychiatrists, I quickly learned, are in a league of their own. Over the last eight years (has it really been eight years???) I have heard amazing stories of psychiatrists dealing with the most complicated of patients and have marveled at the level of care they have shown and their willingness to go the extra mile with patients who are often not easy to treat or always appreciative of their efforts.

Whenever I hear people bashing physicians, I wish they could see the side of them that I see.  I get to spend my day talking to intelligent, caring people. Many have made me laugh and a few have brought me to tears.  Many have been so delightful to speak to that I wish they would call more often.  I love the challenge of working together with a psychiatrist (often taking into account, legal, ethical and standard of care requirements), and coming up with a solution that benefits both doctor and patient. 

When I’m not manning the RMCS helpline, I also spend time giving talks to various psychiatry groups and educating residents through our PRMS Residents Education Program (PREP) as well as writing articles and editing our quarterly newsletter Rx for Risk. I didn’t have the aptitude to go to medical school but in speaking to and educating physicians, and helping them work through various patient care issues, in my own small way I feel like I’m making a contribution to healthcare.

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Guest Blog: Suicide Training in Elementary Schools and Transgender Health Care


As a part of PRMS’ ongoing commitment to behavioral health we invited Anna Weaver-Hayes, Executive Director of the Colorado Psychiatric Society, to be featured as our guest blogger this month.

The Colorado Child and Adolescent Psychiatric Society (CCAPS) is tackling big topics in its spring meetings. In 2016, our Spring Meeting focused on school-based suicide prevention, which was followed by elementary school trainings through a partnership with Denver Public Schools. For the 2017 Spring Meeting, the focus is transgender health care and what EVERY health professional should know.

Some readers may find it shocking that suicide training is needed in elementary school. I know I did when the topic was suggested by Ellen Kelty, Denver Public Schools’ program manager for the Department of Social Work and Psychological Services in the Office of Social and Emotional Learning. But I quickly learned 3 facts that reshaped my thinking:

  1. It happens. At the end of 2015, two 11-year-olds completed suicide in one week in Colorado.[i] As AACAP President Gregory Fritz, MD, noted in a CBS interview, “Adults need to realize that school-age children as young as 5 kill themselves.”[ii]
  2. Although completion is rare in very young children, behaviors and attempts are not as rare as previously thought. It is difficult to determine the number of attempted suicides in general. This is especially true with children, where attempts and even completions may be classified as accidental. While young children often lack the cognitive skills and ability to complete suicide, research suggests that about 1 in 10 children as young as age 3 years may have suicidal thoughts or suggestive behaviors.[iii]
  3. Starting prevention efforts in middle and high school is too late. By the time a child reaches middle school, where suicide prevention efforts often start, it may be too late. According to a University of Washington study, 40 percent of youths attempting suicide make the first attempt before reaching high school.[iv]

 

In 2014 alone, suicide deaths for Colorado youth aged 10-18 surpassed drowning, poisoning, homicide, cancer, and motor vehicle fatalities among the same age group.[v] With the limited number of CAPs, we need help from community partners who are engaged with students on a daily basis—such as teachers, school counselors and staff and coaches—to identify children in need of support and assist parents in getting them to the appropriate level of care. In 2016, with the guidance of then CCAPS President Kristie Ladegard, CCAPS set out to educate teachers and staff about what to do if they are concerned an elementary school student is suicidal. We also wanted to provide a list of Colorado resources that teachers could share with parents as well as educational references and resources for clinicians. You can read more about the ongoing trainings here.

Transgender and Gender Diverse Youth

Suicide prevention is of heightened importance for the population focus of the 2017 Spring Meeting, co-sponsored by CCAPS and the American Academy of Pediatrics, Colorado Chapter, titled “Transgender Health: What EVERY Health Professional should know.” With almost 28,000 respondents, the National Transgender Discrimination Survey (NTDS) is the largest survey devoted to the lives and experiences of trans people. It found that 40% of respondents have attempted suicide in their lifetime—nearly nine times the attempted suicide rate in the general U.S. population (4.6%).[vi] It is important to note that protective and risk factors for transgender individuals are similar to other populations—those with immediate family support are less likely to attempt suicide; those who have experienced violence, discrimination, abuse or are people of color are more likely to make an attempt.[vii] The 2017 CCAPS/AAP Spring Meeting will help providers ensure their clinical practices are gender affirming.

What YOU can do:

Adapt our elementary school suicide prevention powerpoint for your state, update our wallet cards for your community and listen to the words and actions of kids.

Learn more about caring for trans and genderfluid patients by attending the CCAPS Spring Meeting on April 8th. Register at www.coloradopsychiatric.org/events.

Resources:
http://www.aacap.org/aacap/Regional_Organizations/CCAPS/Links.aspx – Visit our website for the elementary school suicide prevention powerpoint, wallet cards for teachers and staff, a list of Colorado resources and guides for teachers, school staff, parents, families and providers.

www.thetrevorproject.org – The Trevor Project provides crisis intervention and suicide prevention services to LGBTQ individuals.


[i] http://www.coloradoan.com/story/news/2015/11/23/deaths-two-11-year-olds-shake-fort-collins/76178140/
[ii] http://www.cbsnews.com/news/suicide-can-strike-children-as-young-as-5-study/
[iii] http://www.medscape.com/viewarticle/854958
[iv] James J. Mazza, Richard F. Catalano, Robert D. Abbott, Kevin P. Haggerty. An Examination of the Validity of Retrospective Measures of Suicide Attempts in Youth. Journal of Adolescent Health, 2011; 49 (5): 532 DOI: 10.1016/j.jadohealth.2011.04.009
[v] Colorado Health Information Data Set,  (2014) Retrieved from  http://www.cohid.dphe.state.co.us (3 drowning deaths, 9 unintentional poisoning deaths, 16 homicides, 18 cancer deaths, 35 motor vehicle deaths, and 50 suicides)
[vi] www.transequality.org/sites/default/files/docs/USTS-Full-Report-FINAL.PDF
[vii] www.transequality.org/sites/default/files/docs/USTS-Full-Report-FINAL.PDF

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The Life of PRMS: Christine Gray-Knight, Senior Litigation Specialist


I began my career with Professional Risk Management Services in the Claims Department in 2005. However, I started my insurance career many years ago handling automobile and injury claims for a major insurance company and felt this move to PRMS would be a good  transition that would allow me to grow using my insurance background to assist psychiatrists with legal issues.  Every day is a new and different challenge and an opportunity to expand  and share my expertise with colleagues who are as eager as I am to assist our clients with hands-on, personalized service, providing expertise and support throughout the claim process.

Because of PRMS’ standards and my desire to provide the best quality service for our clients, I have pushed myself to become more knowledgeable in the insurance field by obtaining my CPCU (Chartered Property and Casualty Underwriter) designation.  In addition, based upon the quality of profesionals  here at PRMS, I have had the opportunity to continue my learning experience from my colleagues who freely share what they have learned over the years.  I think I can say without a doubt that we are one of few companies who have a record of staff longevity throughout the organization, which speaks not only to our dedication as employees but also to the way the company values its employees.

I have enjoyed my time at PRMS thus far and hope to continue my experience here until my retirement.

Cristine Gray-Knight, Senior Litigation Specialist

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