Physicians are often unaware of federal regulations that may apply to their practices as well as the healthcare organizations in which they participate. This could lead to legal hassles and severe penalties. For instance, a physician may not be knowledgeable regarding the legal concept of negligence or the standard by which their actions are judged and the applicable case law. Lack of awareness regarding such aspects could lead to medical negligence or malpractice cases that involve medical record analysis and other formal processes. Similarly, physicians may not be familiar with antitrust laws and the increasing importance of these laws in modern American healthcare. There are state-specific laws that cover topics such as privacy and access to health information, disclosure of personal health information, patient medical records, and standards for health insurers including Medicaid. The laws and regulations of medical boards may also vary according to each state.
Here is a look at certain practices of physicians that could lead to legal concerns.
- Not maintaining medical charts on friends, family, and employees: Physicians may provide informal prescription to their family members, friends, and co-workers. This is risky, but in case they do so, it is best to create and maintain appropriate medical charts. A medical chart is proof the doctor-patient relationship, makes available the patient’s medical history to the entire care team, and is a valuable piece of evidence in case you are sued.
- Referring to the wrong type of specialist or negligent referral: Potential liability risk exists if a physician refers a patient to the wrong type of specialist, such as referring the patient to a chiropractor when the patient in fact needed a neurosurgeon or an orthopedist.
- Acting in violation of the Stark Law:The Stark Law prevents doctors from profiting in an inappropriate manner from referrals. Under the Stark Law, doctors are not allowed to refer their patients for services that are to be reimbursed by federal healthcare programs to an organization with which the doctor has any type of compensation arrangement or interest.
- Accepting kickbacks: Doctors are at special liability for kickback schemes. The anti-kickback statute is a criminal law that prohibits remuneration to persuade or reward patient referrals or other business involving the federal government. Remuneration in this regard may be money, gifts, fancy meals and hotel stays among other things. Hospitals must also make sure that all physician relationships are not merely a means to obtain payments for physicians for referrals. Healthcare organizations can face legal issues if they offer services to a medical practice or when they provide discounts or pay for unnecessary services.
- Prescribing over the internet: Fines, warnings, and revocation/suspension of license can happen if physicians prescribe to patients they have not seen, and without performing a proper history and physical exam. There are regulations related to providing telemedicine services as well. A valid physician-patient relationship must be established before providing telemedicine services.
- Not double checking before surgery: Before a surgical procedure, surgeons must check that the surgery is being done on the right patient. In case any mistake is made, inform the patient and document the mistake in their chart.
- Pre-signing prescriptions: Though many physicians do this to save time, they can land in trouble if these scripts go missing for some reason or other. Misuse of pre-signed prescriptions could lead to disciplinary actions from both the employer and the medical board, and this could include monetary penalties, license suspension, and even termination. It is best to sign scripts as and when you write them because that is the law. The Code of Federal Regulations prohibits prescribers from pre-signing prescriptions.
- Not reporting psychiatric issues: Mental illness of a physician can compromise patient care and lead to medical malpractice claims. Physicians who have a mental illness that could interfere with their practice of medicine should either self-report or be reported.
- Withholding medical records: It is illegal in most American states to withhold the medical records of patients who have not paid for care. Physicians can, however, require the patient to pay copying fees to cover the cost of printing the medical records.
- Not reporting impairments that healthcare providers have: If physicians themselves or somebody whom they know have a problem with drugs or alcohol, it should be reported confidentially. Not reporting amounts to doing a disservice to the patient community.
Medical malpractice attorneys and providers of medical records services to such attorneys know how complex the legalities associated with practicing medicine are. Physicians may not know the gravity of certain practices they indulge in. When not sure about a certain practice, it is best to take legal advice.