Below are common scenarios and guidance on how to handle these encounters:
Patient’s room/patient’s exam room – When you enter the patient’s room or patient’s exam room, there may be other people in the room in addition to the patient. You must ask a question similar to the following: “Hi, my name is Dr. Smith from Cooper University Hospital and I’m here to talk to you about your treatment plan. Is it okay if we continue this conversation with your visitors in the room or may I ask them to leave?”
Bottom line: You cannot discuss patient information with other people in the room unless the patient has given his or her consent. Know who you are speaking with and do not assume that an adult in a pediatric patient’s room is the parent or guardian authorized to make medical decisions. If in doubt – verify!
Semi-private rooms/treatment areas – Cooper has a number of semi-private rooms and treatment areas, such as the emergency department. While HIPAA recognizes that it is not always possible to provide total privacy, specific precautions are necessary when discussing patient care and treatment options in these locations. When in a treatment area or when the patient’s roommate is in the room, the first thing to do is to ensure that the curtains are drawn between patients. The second thing is to lower your voice as much as possible while ensuring that the patient can hear and understand you when you’re talking with him or her about his or her treatment. Recognizing that Cooper is a teaching institution, and the importance of the patient rounding experience, you must take every precaution to mitigate the other patients overhearing the discussion concerning your patient’s condition and treatment.
Minors – In New Jersey, minors have the right to consent to many health care services without the permission of a parent or guardian. The following health care services are examples of situations where adolescents have the right to consent to care, and to know that confidentiality may be maintained:
• Contraceptive counseling and services
• Abortion
• Medical care related to pregnancy
• Substance abuse
• Testing/treatment for sexually transmitted infections or treatment for sexual assault.
When dealing with minors in any of the above situations, you must provide the minor the opportunity to disclose relevant history, conduct the appropriate physical examination and recommend treatment without the parent or guardian in the room, unless the minor requests their presence. If the minor decides not to have the parent or guardian present, you ask the minor about the components of the history, physical examination and treatment plan that they wish to disclose or not disclose to their parents or guardians. The rationale for privacy and rights of the minor should be discussed in advance, respecting the parents desire to be informed and promoting opportunities to disclose and encourage their involvement.
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