Magazine article Medical Economics

When a Spouse Asks about Your Patient

Magazine article Medical Economics

When a Spouse Asks about Your Patient

Article excerpt

Malpractice CONSULT

Answers to your questions

Q: Some of my foreign-born female patients insist that their husbands accompany them into the exam room Often the husbands are even the ones who make the appointments and answer questions for their wives-- all with their wives' apparent consent Can I be sued for violating confidentiality if I reveal information to a husband that his wife doesn't want him to know?

A: Nothing can prevent a patient from suing, but, in this scenario, yod probably win. It appears that the patient has waived her right to confidentiality. To better protect yourself, however, check with the patient to make sure it's okay if her husband accompanies her into the exam room. If your care involves a sensitive topic, such as an STD, ask the patient again if she wants her husband to be present.

Make sure to explain the confidentiality of the doctor-patient relationship, and ask the patient specifically whether she wants to waive the privilege. Document the discussion and your patient's consent in your progress notes. You may also want to ask the patient to initial your progress note, or to sign a consent form.

But even without that documentation, there may be an implied consent. That was the ruling of a Pennsylvania appellate court in a recent case involving a woman who objected that her husband was told that she might have herpes.

The Syrian-born couple sought treatment because of the wife's complaints of pain during intercourse. The husband made the appointment and was present during the pelvic exam. The doctor took cultures and told the patient and husband that he would discuss the results when they came back. The husband persisted in questioning the doctor during the visit and by phone afterwards. After the test results were in, the physician informed the husband during one of the phone calls that he suspected herpes, although the tests were equivocal. …

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