Pain management — at the doc’s own risk

“Doctors want to provide relief, but they also want to keep people safe and stay out of trouble themselves — since doctors have been sued for undertreating pain and jailed for overtreating it.” (Lois M. Collins and Elaine Jarvik, “Doctors walk narrow line in treating pain”, Deseret Morning News/Casper Star Tribune, Jan. 5). Commenters at […]

“Doctors want to provide relief, but they also want to keep people safe and stay out of trouble themselves — since doctors have been sued for undertreating pain and jailed for overtreating it.” (Lois M. Collins and Elaine Jarvik, “Doctors walk narrow line in treating pain”, Deseret Morning News/Casper Star Tribune, Jan. 5). Commenters at Kevin Pho’s (Jan. 6) get specific about some of the legal headaches that an emergency room doctor may face when a chronic pain patient shows up claiming to need immediate relief: calling other local practitioners to check on whether the patient is known for “drug-seeking activity” is now a violation of the federal HIPAA health-privacy law, while giving a day or two’s worth of medication to tide them over risks litigation from family members accusing the doctor of enabling their relative’s narcotic habit.

3 Comments

  • Question: How might this article relate to Doctors in Oregon who are now able to legally end or assist in ending a patient’s life through drug induced measures?

  • Can’t they meet HIPAA by getting a waiver to check with other doctors for the patient’s medical records?

  • You can’t condition treatment on receipt of an authorization, so getting a “waiver” might be problematic. But, you might be able to justify the disclosure as an authorized HIPAA-compliant disclosure under the exception for uses and disclosures for “treatment purposes.” Knowing all the information about the patient’s possible pharmacopia from other doctors is necessary for this doctor to treat the patient, so the disclosure to other docs asking, and the disclosure back by other docs as to whether the patient is a drug-seeker, could be considered disclosures for treatment purposes.