“Physicians have no way of knowing what the patient’s relationship is like with the family member. It’s best to have an unbiased interpreter who has no personal involvement with the patient.”
the Hearing Impaired,” a white paper prepared by the TMA Office of the Gen- eral Counsel, is available from the TMA Knowledge Center. To request the white paper, call the Knowledge Center at (800) 880-7955, or email knowledge@
texmed.org.
TMB Public Information Officer Jar-
rett Schneider says the Texas Medical Practice Act gives TMB authority to discipline physicians who engage in un- professional or dishonorable conduct. This includes violating “any state or federal law if the act is connected with the physician’s practice of medicine.” Mr. Schneider says the medical board has received “a handful” of complaints this year related to failure by a physician to provide ADA accommodations, such as sign language interpreters, to a patient. Penalties for ADA violations include
sician does not provide proper accom- modations under the law. Ms. Soto adds having policies for hearing-impaired and limited-English patients can help physi- cians defend themselves against lawsuits and in a case before the medical board. TMA and the American Medical As- sociation have policies on communicat- ing with hearing-impaired and limited- English patients. TMA policy on improving patient care quality by decreasing communication er- rors from language barriers supports ed- ucating medical residents on “laws and regulations on the use in clinical prac- tice of medical translators, interpreters, and other communication services for patients who are deaf, hearing impaired, or with limited English proficiency.” The policy says that “each training site should educate residents on site-spe- cific policies including orientation on the availability of such services and how and when such services should be utilized. Further, residents should be provided the broader education needed, includ- ing information on the potential liabil-
50 TEXAS MEDICINE November 2013
ity risk, to ensure compliance with laws and regulations on the use of translators, interpreters, and other communication methods when the resident completes training and enters medical practice.” The AMA policy on unfounded bias against some medical patients affirms AMA’s “support for the dignity and self- respect of all patients and opposes all acts of medically unfounded categorical discrimination against patients because of their medical condition.”
ADA legal, financial implications Title III of ADA applies to most physi- cian practices and generally prohibits discrimination. It further defines dis- crimination to include, in part, “a failure to take such steps as may be necessary to ensure that no individual with a dis- ability is excluded, denied services, seg- regated or otherwise treated differently than other individuals because of the absence of auxiliary aids and services.” For more information on Title III, visit
http://1.usa.gov/18FSeQr. In addition, “Americans with Disabilities Act and
requiring physicians to complete con- tinuing medical education courses or the medical jurisprudence examination. TMB could fine the physician or resolve the case with a remedial plan. Remedial plans allow physicians to avoid formal disciplinary action primarily for minor administrative violations. TMB does not list the names of physicians who agree to the plan in its newsletter or press releases, but remedial plans are public documents and do appear on physicians’ public profiles. TMB doesn’t consider re- medial plans to be disciplinary actions and doesn’t report them to the National Practitioner Data Bank. For more information about TMB’s
enforcement process, visit http://bit .ly/1avCzT8.
Ms. Soto says TMB investigations can be time-consuming and cost physicians a great deal in legal fees. “A TMB case could take up to two years to resolve, and the board will re- port any disciplinary action to the Na- tional Practitioner Data Bank. The im- plications are serious, so it’s important that physicians take steps to adhere to regulations,” she said.
The Department of Justice (DOJ), which enforces ADA, provides guid- ance on appropriate auxiliary aids and services for hearing-impaired patients in the ADA Title III Technical Assistance Manual. DOJ regulations say aids for ef-
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