Re: Abuse of curbside consultation
Puter Tech
First, this was not my patient. It was the other docor's pt, but the other doc did not reveal anything to me.
Second, I am not a covered entity under HIPAA, because I do not bill electronically (Go to behavenet dot com and look for my blog post Nice to be N.a.C.E.). The other doc probably is. Even if I were a covered entity, it would only be a breach if the "patient" could be identified. And I could argue that I didn't release info about the non-patient anyway.
The lounge setting is a bit of a red herring here.
I do like that you said, "This should also only be done if the clinician [has] a legitimate reason to seek the counsel of a colleague. "
My position is that the doc who approached me did NOT have a legitimate reason to approach me, but did so under false pretenses.
I find it most interesting how strongly you and Dr. R feel about discussing cases in the lunch room/lounge. I wonder whether you have spent time in one recently. At our hospital I believe the medical staff actually encourages discussion of cases in the lounge as improving quality of care. We rarely identify the patients, although often the docs are already working as a team to care for the patient. I would be very surprised if this is not standard practice in most hospitals.
Another reality is that 90% of the time that I call another physician to coordinate care the other physician expresses no need to get authorization from the pt.
Thanks for jumping in.
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