Frequently Asked Questions from physicians

Am I required to report abuse that I suspect has occurred to a patient?

What can I do if I think my patient is too old to drive?

Am I covered under the "Good Samaritan" law if I provide medical care at a sporting event or community event?

What should I do if someone has stolen my prescription pad and writes a prescription using my name and DEA number?

Can I refer my patients to an ambulatory surgery center (or MRI or cancer treatment center, etc.) that I own?

Am I responsible for my office nurse if she is administering injections, vaccinations or other treatments?

What should I do if a parent asks me to examine their minor child to determine illegal drug use, sexual activity or STD?

What are the legal requirements for medical record retention, release of information, storage, etc. for my medical practice?

What are the ethical and legal issues in receiving compensation for moving patients from brand name drugs to generics?

Can the AMA help me with my employment contract?

How can I "terminate" a patient from my practice?
In order to terminate a patient/physician relationship, it is recommended that you notify the patient in writing of your decision and give the patient their recommendations for physicians who can be contacted. If the patient is currently being treated by the physician for an acute illness, it is recommended that the physician wait to discharge the patient until the patient has completed treatment and is stable.

Am I required to provide an interpreter for a deaf patient in my office?
Under the Americans with Disabilities Act, a physician is required to make a reasonable accommodation to patients. However, if there is another means to communicate with a hearing impaired patient (family interpreters, lip reading, writing) and the patient agrees, then an interpreter may not be necessary. The situation determines "reasonableness." If an interpreter is needed, the physician is responsible for payment for those services. Learn more.

I'm leaving the employment of a physician group practice, can I take my patients and patient records with me? Can I notify patients I am leaving?
The records belong to the practice. Unless your employment agreement provides otherwise, you may be able to notify patients that you are leaving the practice and notify them of your new address. However, you should be very clear about what you are allowed to do regarding notification of patients when leaving the practice. It is recommended that you discuss/negotiate the process by which you will exit the practice. Request the right to notify your patients of your new address of your departure and information on how to contact you at your new location.

Patients are not prohibited from requesting that their medical record be forwarded to another physician, however, a physician should be very careful to avoid breach of an employment agreement, breach of privacy or patient confidentiality in accessing, copying, or taking patient records. AMA members can download the Model Employment Agreement to learn more. (PDF, 460KB) - December 2003

Am I required to report abuse that I suspect has occurred to a patient?
State law may require a report of abuse — child, elder, or spousal. You should call your state medical society if you are unfamiliar with the law in your state.

What can I do if I think my patient is too old to drive?
Some states have mandatory reporting laws. You are advised to contact the state department of motor vehicles for specific requirements.

In addition to any state requirement, the physician can evaluate and counsel the patient who may be at risk for driving and document the assessment and recommendation.

Am I covered under the "Good Samaritan" law if I provide medical care at a sporting event or community event?
Good Samaritan laws vary by state, so you should consult with your attorney or state medical society. However, generally, if a physician comes upon an emergency situation and provides assistance, that would generally be a "Good Samaritan" situation. If the physician is a team physician, then that may not necessarily be a "Good Samaritan" situation.

What should I do if someone has stolen my prescription pad and writes a prescription using my name and DEA number?
If you know the identity of the person, you can report it to local authorities. If you don't know the identity, then you may notify local pharmacies where you suspect the prescription may be filled, but you are not required to do this.

Can I refer my patients to an ambulatory surgery center (or MRI or cancer treatment center, etc.) that I own?
The AMA cannot provide individual legal advice to physicians. You are strongly encouraged to seek legal counsel regarding business ventures. However, the Stark anti-self-referral law addresses those situations in which a physician refers his/her patients to a facility in which he/she has an ownership/investment interest. This law is complex and legal counsel is advised.

Am I responsible for my office nurse if she is administering injections, vaccinations or other treatments?
This depends upon the law in your state regarding the practice of nursing. If a nurse is practicing within the scope of nursing, as defined by state law, the nurse is responsible for his/her actions. So, if the nurse is within the law by administering injections — and you have no reason or knowledge that he/she is not capable/competent to provide the services, then the nurse is responsible for his/her actions. However, you should consult your professional liability insurer or attorney if you have questions regarding the treatments your office nurse is performing.

What should I do if a parent asks me to examine their minor child to determine illegal drug use, sexual activity or STD?
Generally, parents may authorize treatment for their minor children. However, tests like these are often requested for minors who are perhaps "mature minors" who object to the test. State laws vary regarding age of majority, disclosure of patient information to a parent as well as testing minors for STDs. Some state laws allow physicians to treat minors for some conditions without parental consent. However, you should contact your attorney to verify state law regarding this. A physician is not obligated to perform these tests or examinations.

What are the legal requirements for medical record retention, release of information, storage, etc. for my medical practice?
State laws generally address medical record requirements, such as retention storage, so you may contact your personal attorney or the state medical society if are not familiar with the law in your state. There are federal laws that address privacy and release of health information, including psychiatric and alcohol treatment records (HIPAA) which are very specific. Visit the AMA's HIPAA website to learn more.

What are the ethical and legal issues in receiving compensation for moving patients from brand name drugs to generics?
American Medical Association (AMA) Policy H-125.984 recognizes that generic drugs can be less costly alternatives to brand-name products. H-125.984 also states that physicians should be free to use either the generic or brand name in prescribing drugs for their patients, and physicians should supplement medical judgments with cost considerations in making this choice. Recently, the AMA has learned that some health insurers are offering to pay physicians to switch patients from brand-name drugs to generic. The AMA has received numerous inquiries from the Federation of Medicine concerning the legality or ethical propriety of accepting this type of compensation.  Read more.

Can the AMA help me with my employment contract?
The AMA cannot provide personal legal advice to physicians. You should consult a qualified attorney in your state.