The American Medical Association and its nine-member Judicial Council publish a guide for ethical behavior for physicians that is beneficial to medical assistants who act in concert with their physician/employer. The guidelines are based on the publication Code of Medical Ethics Current Opinions of the Council on Ethical and Judicial Affairs of the American Medical Association, 1992. Information shared here is not meant to be exhaustive; however, physicians and their employees will find it helpful to consider information on the following topics, which was summarized from this publication. The complete guide can be purchased from AMA office in Chicago, IL. See Appendix A for the address and phone number.
Advertising
Physicians and professional people have traditionally not advertised; however, it is not illegal to do so if claims made are truthful and not misleading. Advertisements may include credentials of physicians and a description of the practice and kinds of services rendered. Testimonials from patients are best avoided. Indeed, most physicians discover that word-of-mouth advertisement from patients is the best source of advertisement for their practice.
Media Relations
Physicians and all of their employees are not allowed to discuss a patient's medical condition with any member of the media without the patient's expressed approval. This does not apply to informa-tion that is considered ''public domain," which includes births, deaths, accidents, and police records.While more hospitals than ambulatory care settings will be involved in media relations, the following is an example of information released that is considered public domain and does not require the patient's consent.
Confidentiality
Physicians must not reveal confidential information about patients without their consent unless they are otherwise required to do so by law. Confidentiality must be protected so that patients will feel comfortable and safe in revealing information about themselves that may be important to their health care. The following list contains examples of the kinds of reports that allow or require health professionals to report a confidence.
1) A patient threatens another person and there is reason to believe that the threat may be carried out.
2) Reportable injuries and illnesses must be reported. They include injuries such as knife and gunshot wounds, wounds that may be from suspected child abuse, and communicable diseases such as influenza, AIDS, and sexually transmitted diseases.
3) Information that may have been subpoenaed for testimony in a court of law.
When in doubt, it is always recommended that a physician have the patient's permission to reveal any confidential information.
Medical Records
The medical chart and the information in it are the property of the physician and the patient. No information should be revealed without the patient's consent unless required by law. The record is confidential. Physicians should not refuse to provide a copy of the record to another physician treating the patient so long as proper authorization has been received from the patient. A record cannot be withheld because of an unpaid bill.
Upon a physician's retirement or death, or when a practice is sold, patients should be notified and given ample time to have their records transferred to another physician of their choice.
Professional Fees and Charges
Illegal or excessive fees should not be charged. Fees should be based on those customary to the locale and should reflect the difficulty of services and the quality of performance rendered. Fee splitting (a physician splits the fee with another physician for services rendered with or without the patient's knowledge) in any form is unethical. Physicians may charge for missed appointments (if patients have first been notified of the practice) and may charge for multiple or very complex insurance forms. Physicians and their employees must be diligent to assure that only the services actually rendered are charged or indicated on the insurance claim. Only what is documented in the patient's chart is to be billed.