Legal Public Duties And Drug Screening

Legal Public duties:

Physicians have a duty to the public to report diseases and injuries that jeopardize public health and welfare. Transmittable or contagious diseases and injuries resulting from knife or gunshot are examples and these must be reported to the appropriate authorities. This is done without the patient's consent because it is required by law. When reporting, it is important to do so properly and according to the laws in the state in which one is employed. Knowledge of which illnesses, injuries, and conditions to report, to whom to report, and the appropriate forms to submit is essential. Copies of all information must be kept for the office or clinic. Some states have laws specific to the release of information relative to mental or psychological treatment, human immunodeficiency virus testing, acquired immunodeficiency syndrome diagnosis and treatment, sexually transmitted diseases, and chemical substance abuse. Local or state health departments can provide lists of diseases and injuries to report and will also provide the appropriate forms.

Drug Screening:

States vary in the laws they have regarding the abuse of alcohol and other drugs. In general, employers are allowed to screen an employee for chemical substances if they believe the employee's work performance is being affected by the abuse. Great controversy surrounds pre-employment and random screening for drugs in the workplace. Some states allow widespread random testing of employees.
It is important that the worker's right to privacy not be violated. A tort of defamation of character could be claimed against an employer if the results of the testing become known to others. Get the patient's written consent when asked to collect a specimen for drug screening. Be certain the laboratory that performs the screening is qualified to perform the test. The possibility of liability is great if the ambulatory care setting does not have specific policies and procedures to employ in regard to specimen collection and testing. It should be carefully documented on the patient's record which medical personnel are responsible for the specimen from the time it was collected until the results are known.

The release of patients' records that pertain to chemical substance abuse is protected by federal laws under the Federal Drug Abuse Prevention, Treatment, and Rehabilitation Act. The law prohibits disclosure of information that identifies the patient as a chemi-cal substance abuser. Also, information about the patient's treatment cannot be divulged without the patient's written consent. The records can, however, be released by order of a subpoena to another health care professional during an emergency situation or if the records are to be used for research and program evaluation.

Changing societal values have contributed to an explosion of lawsuits in medical practice. Patients are more aware than ever of their rights, especially those of confidentiality and the right to privacy, consent, and records ownership. They readily seek redress when they perceive their rights to be violated. A healthy relationship between physicians and patients and between medical assistants and patients, as well as respect for the patient's rights, lowers the potential for the likelihood of a lawsuit. Knowledge of the laws that regulate medical and business practices in your state are necessary in order to be in compliance. Sources of information regarding state and federal laws can be obtained from the state medical society, the physician's liability insurance company, the state medical assistant society, the state attorney general's office, or the public library.