29 hours ago · Difficult situation #4: A patient reports their pain medication as lost or stolen. Advice: It is not unusual for a patient to report to their prescribing clinician that they have discovered that their prescription pain medication (or the written prescription) has been either lost or stolen, leading them to request a new prescription. >> Go To The Portal
Obtain the patient’s informed consent when reporting is not required by law. Exceptions can be made if a physician reasonably believes that a patient’s refusal to authorize reporting is coerced and therefore does not constitute a valid informed treatment decision.
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Difficult situation #4: A patient reports their pain medication as lost or stolen. Advice: It is not unusual for a patient to report to their prescribing clinician that they have discovered that their prescription pain medication (or the written prescription) has been either lost or stolen, leading them to request a new prescription.
However, there are some specific situations when mental health professionals are legally obligated to report something that a client does or says during a therapy session. “I like to tell my clients that therapy is kind of, ‘What happens in Vegas stays in Vegas.’
Likewise, physicians who do not report are protected from liability they might otherwise face if an unreported patient causes injury to himself, others, or property [7]. Pennsylvania has strict reporting requirements on the books that have been interpreted more leniently by the courts.
Physicians who receive reports of alleged incompetent or unethical conduct should: (f) Evaluate the reported information critically and objectively. (g) Hold the matter in confidence until it is resolved. (h) Ensure that identified deficiencies are remedied or reported to other appropriate authorities for action.
Speaking of pharmacists, they are required to report lost or stolen drugs. Federal regulations require that pharmacists and their employers to notify the DEA Field Division Office in their area of any theft or significant loss of any controlled substance.
One of the recommendations to reduce medication errors and harm is to use the “five rights”: the right patient, the right drug, the right dose, the right route, and the right time.
Let's take a look at your rights.The Right to Be Treated with Respect.The Right to Obtain Your Medical Records.The Right to Privacy of Your Medical Records.The Right to Make a Treatment Choice.The Right to Informed Consent.The Right to Refuse Treatment.The Right to Make Decisions About End-of-Life Care.
The physician must be professionally competent, act responsibly, seek consultation when necessary, and treat the patient with compassion and respect, and the patient should participate responsibly in the care including through informed decision making, giving consent to or declining treatment as the case might be.
The 7 Most Common HIPPA Violations (And How to Avoid Making Them)Failing to Secure and Encrypt Data. ... Device Theft. ... Employee Misconduct. ... Improper Records Disposal. ... Non-Compliant Partnership Agreements. ... Failure to Perform an Organization-Wide Risk Analysis. ... Inadequate Staff Training.
Doctors can breach confidentiality only when their duty to society overrides their duty to individual patients and it is deemed to be in the public interest.
If the patient's condition should be treated, is the provider obligated to care for the patient? a. YES: unless a formal discharge has occurred, the provider is obligated to treat the patient.
Frequency – how often a medication must be given. MAR – medication administration record. Route – how a medication is given. Time – when the medication is scheduled on the MAR.
In total, 113 551 issues were found to underlie the patient complaints. These were analysed using 205 different analytical codes which when combined represented 29 subcategories of complaint issue. The most common issues complained about were 'treatment' (15.6%) and 'communication' (13.7%).
Physicians are expected to provide care in emergencies, honor patients' informed decisions to refuse life-sustaining treatment, and respect basic civil liberties and not discriminate against individuals in deciding whether to enter into a professional relationship with a new patient.
The key duties of a physician are to:Order tests and analyze their results.Refer patients to specialists.Create treatment plans.Explain side effects of medications and treatment options.Perform basic medical procedures.Record medical history.Identify symptoms and diagnose patients.More items...
A physician shall uphold the standards of professionalism, be honest in all professional interactions, and strive to report physicians deficient in character or competence, or engaging in fraud or deception, to appropriate entities.
The problem of reports of stolen prescriptions is more ominous because there is another person involved, and potentially, another person has been put at risk. Medication theft is a situation that requires some form of investigation and should be reported to the appropriate authorities. It is important for the patient to think about who might have stolen the medication.
Describing how you address these problems before the patient has begun treatment, and before incidents of lost or stolen medication, is part of your description of the treatment plan , and it demonstrates the principal of shared responsibility .
It is important to distinguish between lost medications and stolen medications. Losing a prescription form or a vial of medications may result from the occasional lapses that all patients may have. If this occurs only once it may not have significant medical implications, and the prescriber may choose to replace it without much concern.
If you are not replacing the lost medication, you will need to inform the patient about the potential for withdrawal, and offer to prescribe medications to help diminish withdrawal symptoms. Prescribing these medications needs to be individualized, based upon the patient’s age, presence of other medical problems, use of other medications, and the patient’s ability to follow-up.
Repeated medication loss, or theft, is a strong indication that the patient is at high risk and that it is not safe for this patient to remain on this medication. If a medical reason, like cognitive decline, is discovered, this may be successfully addressed so that the patient can continue on the medication. However, if this cannot be done, or if the patient lives in an unsafe environment, the best course may be to taper and discontinue these medications, substituting treatments that are lower risk.
Clinicians in practice with multiple-providers should establish and circulate a uniform, clinic-wide policy among patients and staff, to avoid confusion about what they do. Some practices choose a “one and done” policy, (the first time you lose it I will refill it, but never again), or a stricter policy of zero-tolerance, and no early refills, under any circumstance.
Physicians should also protect patient privacy when reporting by disclosing only the minimum necessary information.
Discuss any suspicion of abuse sensitively with the patient, whether or not reporting is legally mandated, and direct the patient to appropriate community resources.
In Opinion 8.10, “Preventing, Identifying and Treating Violence and Abuse,” the Code explains that all patients may be at risk for interpersonal violence and abuse, which may adversely affect a patient’s health or ability to adhere to medical recommendations. Physicians, in light of their obligation to promote the well-being of patients, have an ethical obligation to take appropriate action to avert the harms caused by violence and abuse.
Patients in your exam room may be experiencing one of a number of forms of abuse—domestic violence, human trafficking or other violence— and identifying those being abused can sometimes be tough.
The authors noted research showing that 88% of victims had contact with a health professional while being trafficked, but none were identified or offered help in getting out of their situation during the medical encounter.
Obtain the patient’s informed consent when reporting is not required by law. Exceptions can be made if a physician reasonably believes that a patient’s refusal to authorize reporting is coerced and therefore does not constitute a valid informed treatment decision.
Not allow diagnosis or treatment to be influenced by misconceptions about abuse, including beliefs that abuse is rare, does not occur in “normal” families, is a private matter best resolved without outside interference, or is caused by victims’ own actions.
Reporting a colleague who is incompetent or who engages in unethical behavior is intended not only to protect patients , but also to help ensure that colleagues receive appropriate assistance from a physician health program or other service to be able to practice safely and ethically.
Medicine has a long tradition of self-regulation, based on physicians’ enduring commitment to safeguard the welfare of patients and the trust of the public. The obligation to report incompetent or unethical conduct that may put patients at risk is recognized in both the ethical standards of the profession and in law and physicians should be able ...
A health care provider’s “duty to warn” generally is derived from and defined by standards of ethical conduct and State laws and court decisions such as Tarasoff v. Regents of the University of California. HIPAA permits a covered health care provider to notify a patient’s family members of a serious and imminent threat to the health or safety ...
HIPAA permits a covered health care provider to notify a patient’s family members of a serious and imminent threat to the health or safety of the patient or others if those family members are in a position to lessen or avert the threat. Thus, to the extent that a provider determines that there is a serious and imminent threat ...
Thus, to the extent that a provider determines that there is a serious and imminent threat of a patient physically harming self or others, HIPAA would permit the provider to warn the appropriate person (s) of the threat, consistent with his or her professional ethical obligations and State law requirements.
In the case of suspected child abuse, therapists must file a report if they have “reasonable suspicion” about child abuse.
“If a therapist fails to take reasonable steps to protect the intended victim from harm, he or she may be liable to the intended victim or his family if the patient acts on the threat ,” Reischer said.
Therapists are held to very high ethical standards by their governing state board and a violation of those ethics could result in fines, loss of licensure, or even jail time , said Walwyn-Duqesnay. While each state has its own set of guidelines and regulations on what its mental health professionals are required to report, there are common themes that transcend across the country.
Cinéas said a therapist may have to step in and report a situation when vulnerable people are threatened, which could include children, elderly individuals and those living with a disability.
A therapist may be forced to report information disclosed by the patient if a patient reveals their intent to harm someone else. However, this is not as simple as a patient saying simply they “would like to kill someone,” according to Jessica Nicolosi, a clinical psychologist in Rockland County, New York. There has to be intent plus a specific identifiable party who may be threatened.
Most situations will stay under wraps. For instance, Reed noted that even if a wife is cheating on her husband and they are going through a divorce, the therapist has no legal obligation whatsoever to disclose that information in court.
“Clients should not withhold anything from their therapist, because the therapist is only obligated to report situations in which they feel that another individual, whether it be the client or someone else, is at risk,” said Sophia Reed, a nationally certified counselor and transformation coach.
Accordingly, it is often best to seek the counsel of a knowledgeable medical malpractice attorney if you believe a medical mistake may be the cause of an injury. A skilled attorney can review the circumstances of your injury and help determine if medical negligence it to blame.
According to data recently reported by NBC News, up to 440,000 people die each year as a result of medical mistakes in the United States alone. Sadly, this means that medical mistakes and hospital errors are the third leading cause of death in the U.S. – trailing only cancer and heart disease. While many efforts have been made to eliminate these deadly medical errors, they have proven hard to eradicate as many of those employed in the health care industry are hesitant to confess their mistakes, thus making it more difficult to address the root of the problems head on. Interestingly, this dilemma is further compounded by the fact that many co-workers in the health care industry are reluctant to even report the mistakes of their colleagues. However, a recent report published in The New England Journal of Medicine indicates that open communication between colleagues and patients regarding possible medical mistakes may be one of the best ways to ensure patient safety. When coming to their conclusions, the authors of the report made note of the fact that doctors are expected to put the needs of their patients ahead of their own – meaning that concerns of repercussions for medical errors should not deter doctors from being truthful with patients. After all, patients who suffer injuries due to medical mistakes will often need a great deal of assistance getting better, and it doesn’t help them if doctors, and their colleagues, fail to give them accurate information regarding the errors. Additionally, given that the authors of the recent report opined that the “transparent disclosure of [medical] errors is a shared professional responsibility,” they also proposed various guidelines for as to how doctors should disclose and address the medical mistakes of their colleagues. Importantly, the report indicates a doctor who suspects another colleague has made a mistake should first get the facts surrounding the incident and speak with the alleged offender about what actually happened. This conversation should also include a discussion as to the best way to convey the information to the patient. Obviously, some doctors may be defensive if accused of mistakes, but ignoring a possible issue will not assist patients in getting better. Tackling medical mistakes directly not only aids the injured patient, but also helps ensure that similar problems will not occur in the future.
However, victims of medical errors need to know that remedies may exist if they have been injured at the hands of a negligent doctor or other hospital staff. Accordingly, it is often best to seek the counsel of a knowledgeable medical malpractice attorney if you believe a medical mistake may be the cause of an injury. A skilled attorney can review the circumstances of your injury and help determine if medical negligence it to blame.
But if he told his therapist that he can’t stop thinking about raping the teenage girl next door, she is legally required to report the crime to the girl’s parents or the police. These kind of limits to therapist confidentiality in criminal cases are not limited to the informed parties either.
If a counselor believes an adult client has abused or neglected a child, dependent adult or elder person, the therapist must report the crime. He also must report anyone he reasonably suspected to have viewed or downloaded child pornography.
Therapist Confidentiality: Crimes Involving a Psychologist. Additionally, the limits to therapist/patient confidentiality mean that a mental health professional is not required to keep discussions confidential if a patient tries to use them in order to commit a crime.
While therapists do not need to report crimes that have already happened in most cases, there are exceptions when it comes to therapist confidentiality in crimes involving crimes against children, the disabled or the elderly. This applies to both adult clients who may have committed crimes against their children or clients under 16 who have had ...
For example, if a patient tells her psychiatrist that she has ADHD and needs a prescription for Ritalin, but the psychiatrist can tell she is lying simply in order to obtain pills to get high, the doctor is no longer restricted by patient/doctor confidentiality laws.
If the patient is a minor under 16 and the therapist has reason to believe that she has been the victim of a crime and the therapist believe s it is in her best interest to report the crime, the therapist can choose to break patient confidentiality.
Waiving Therapist Confidentiality for a Crime Defense. On occasion, it might be in your best interest to waive your right to therapist confidentiality in criminal cases. For example, if you and your lawyer decide to make your mental state part of your defense strategy, your therapist may be called as a witness.
Laws Concerning Disclosure of Impaired Drivers. Many states have enacted laws to address the problem of impaired drivers. Some of these laws mandate disclosure to motor vehicle authorities, while, in others, disclosure is voluntary. Some states require reporting for specific conditions but not for others [4].
Sometimes drivers act voluntarily in ways that make them unsafe, such as driving while intoxicated or exhausted. In these circumstances, we rightfully hold them responsible for injury or damage caused by their choices.
Whether they mandate reporting, prohibit it, or make it voluntary, the laws have much room for improvement. Ethically and professionally physicians’ duties do not stop with existing laws; they are encouraged to “work with their state medical societies to create statutes that uphold the best interests of patients and community and that safeguard physicians from liability when reporting in good faith” [14].
Although a number of states mandate or permit physician reporting of diseases or illness that may impair driving abilities, those that don ’t address the physicians’ role in reporting put physicians in a peculiar position. On the one hand, the American Medical Association’s Code of Medical Ethics explicitly acknowledges that physicians have a responsibility “to recognize impairments in patients’ driving ability that pose a strong threat to public safety and which ultimately may need to be reported to the Department of Motor Vehicles” [14]. On the other hand, the law may prohibit physicians from disclosing confidential information without an explicit exception. In other words, if informing driver’s licensing agencies (i.e., the Department of Motor Vehicles) about potentially dangerous drivers is not a legally sanctioned reason for breaching confidentiality, physicians may be unable to disclose. So, if they follow their professional obligation to report patients (pursuant to detailed guidelines [14]), doctors may face civil and criminal liability for unauthorized disclosure under some state laws [15].
Physicians should be aware of their professional responsibilities and the legal requirements of the states in which they practice. When determining whether to report a patient’s medical condition that may impair driving, physicians may have to weigh conflicting guidelines: a professional obligation to report and a legal requirement to maintain confidentiality, even in the face of danger to the public.
Oregon, for example, has broad regulations. Its laws require physicians ( especially primary care physicians) to report conditions that impair sensory, motor, and cognitive functioning to state authorities [5], and they provide comprehensive standards for determining when a driver is impaired.
Where obligated to report, physicians must do so. When reporting is voluntary, they should also consider their professional obligations before deciding on a course of action. Certainly, limited criminal and civil liability protections that place the physician at legal risk should be a factor in cases where reporting is not mandated.