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“If a physician does treat a close friend, family member, or employee out of necessity, the patient should be transferred to another physician as soon as is practical.”


self-treatment or treatment of immedi- ate family members in emergency set- tings or isolated settings in which no other qualified physician is available. “Physicians should not hesitate to treat themselves or family members until an- other physician becomes available. In addition, while physicians should not serve as a primary or regular care pro- vider for immediate family members, there are situations in which routine care is acceptable for short-term, minor problems,” the opinion states. The opin- ion stresses that except in emergencies, physicians shouldn’t write controlled substance prescriptions for themselves or their immediate family members. The American College of Physicians’


of Councilors and a San Antonio otolar- yngologist, says medical schools teach students they shouldn’t treat their fam- ily members. “That black-and-white policy doesn’t


make sense in private practice, particu- larly in a small town in isolated Texas,” he said. “If those physicians can’t treat their family members, friends, or em- ployees, they may have to drive 50 or more miles to seek medical care else- where.” Dr. Moss says physicians need to


make sure they keep complete medical records for all family members, friends, and employees they treat. “Physicians can run into problems if


they treat family members or employees and don’t keep a record of it,” he said. The American Medical Association


has also weighed in on the topic. Opin- ion 8.19 in AMA’s Code of Medical Eth- ics, http://bit.ly/qahmUB, pertains to physician self-treatment or treatment of immediate family members. The opin- ion says in general, physicians shouldn’t treat themselves or their immediate fam- ily members for the following reasons:


36 TEXAS MEDICINE October 2011


• Professional objectivity may be com- promised.


• Physicians’ personal feelings may unduly influence their professional medical judgment, thereby interfer- ing with the care being delivered.


• Physicians may fail to probe sensitive areas when taking the medical history or may fail to perform intimate parts of the physical examination.


• Patients may feel uncomfortable dis- closing sensitive information or un- dergoing an intimate examination when the physician is an immediate family member.


• Physicians may be inclined to treat problems that are beyond their ex- pertise or training.


• Family members may be reluctant to state their preference for another phy- sician or decline a recommendation for fear of offending the physician.


• Physicians may feel obligated to pro- vide care to immediate family mem- bers even if they feel uncomfortable providing care.


The AMA ethics opinion addresses


Ethics Manual also features a posi- tion on care of the physician’s family, friends, and employees, http://bit.ly/ qMt9ui, that advises physicians not to treat themselves, close friends, or fam- ily members. The college cautions physi- cians to be careful about assuming the care of closely associated employees. It says in these situations physicians may not take an adequate patient history or physical examination and could lack professional objectivity due to the physi- cian’s emotional proximity to the patient. “If a physician does treat a close friend,


family member, or employee out of ne- cessity, the patient should be transferred to another physician as soon as it is prac- tical. Otherwise, requests for care on the part of employees, family members, or friends should be resolved by assisting them in obtaining appropriate care,” the position states.


HIPAA privacy, security audits coming


A new round of audits for compliance with Health Insurance Portability and Accountability Act (HIPAA) data secu- rity and privacy requirements are set to begin this year or early next year. The Department of Health and Hu-


man Services (HHS) has contracted with Booz Allen Hamilton and KPMG to audit


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