Which of the following patients would a physician most likely treat as a matter of professional courtesy?

By Anne Carrie, Updated June 27, 2022

A recent study from Johns Hopkins suggests that medical errors are now the third-leading cause of death in the U.S., having surpassed strokes, Alzheimer’s, and diabetes. In addition, one in seven Medicare patients receiving care in a hospital are victims of a medical error. However, medical errors can occur in almost any healthcare setting including hospitals, clinics, surgery centers, medical offices, nursing homes, pharmacies, and patients’ homes. This post will explore the most common causes of medical errors.

Which of the following patients would a physician most likely treat as a matter of professional courtesy?

A few of the most common types of medical errors include: medication errors, errors related to anesthesia, hospital acquired infections, missed or delayed diagnosis, avoidable delay in treatment, inadequate follow-up after treatment, inadequate monitoring after a procedure, failure to act on test results, failure to take proper precautions, and technical medical errors.

Studying these mistakes, learning how to prevent, monitor, and respond to them is key to changing the standards of care. By working to eliminate common medical errors, healthcare systems and providers can protect patients, protect themselves, improve standards of care, and lower costs.

Watch a sample training video from our Communication on Medications series:

The Eight Common Root Causes of Medical Errors

According to the Agency for Healthcare Research and Quality, there are eight common root causes of medical errors which include:

Communication Problems

Communication breakdowns are the most common causes of medical errors. Whether verbal or written, these issues can arise in a medical practice or a healthcare system and can occur between a physician, nurse, healthcare team member, or patient. Poor communication often results in medical errors.

Inadequate Information Flow

Information flow is critical in any healthcare setting, especially within different service areas. Insufficient information flow happens when necessary information does not follow the patient when they are transferred to another facility or discharged from one component or organization to another. Inadequate information flow can cause the following problems:

  • The lack of crucial information when needed to influence prescribing decisions.
  • Lack of appropriate communication of test results.
  • Poor coordination of medication orders for transfer of care.

Human Problems

Human problems occur when standards of care, policies, processes, or procedures are not followed properly or efficiently. Some examples include poor documentation and labeling of specimens. Knowledge-based errors also occur when individuals do not have adequate knowledge to provide the care that is required at the time it is needed.

These may include inappropriate patient identification, inadequate patient assessment, failure to obtain consent, and insufficient patient education.

Organizational Transfer of Knowledge

These issues can include insufficiencies in training and inconsistent or inadequate education for those providing care. Transfer of knowledge is critical in most areas specifically where new employees or temporary help is used.

Staffing Patterns and Workflow

Inadequate staffing alone does not lead to medical errors but can put healthcare workers in situations where they are more likely to make a mistake.

Technical Failures

Technical failures can include complications or failures with medical devices, implants, grafts, or pieces of equipment.

Inadequate Policies

Often, failures in the process of care can be traced to poor documentation and non-existent, or inadequate procedures.

Does the HIPAA Privacy Rule permit a doctor to discuss a patient’s health status, treatment, or payment arrangements with the patient’s family and friends?

Answer:

Yes. The HIPAA Privacy Rule at 45 CFR 164.510(b) specifically permits covered entities to share information that is directly relevant to the involvement of a spouse, family members, friends, or other persons identified by a patient, in the patient’s care or payment for health care. If the patient is present, or is otherwise available prior to the disclosure, and has the capacity to make health care decisions, the covered entity may discuss this information with the family and these other persons if the patient agrees or, when given the opportunity, does not object. The covered entity may also share relevant information with the family and these other persons if it can reasonably infer, based on professional judgment, that the patient does not object. Under these circumstances, for example:

  • A doctor may give information about a patient’s mobility limitations to a friend driving the patient home from the hospital.
  • A hospital may discuss a patient’s payment options with her adult daughter.
  • A doctor may instruct a patient’s roommate about proper medicine dosage when she comes to pick up her friend from the hospital.
  • A physician may discuss a patient’s treatment with the patient in the presence of a friend when the patient brings the friend to a medical appointment and asks if the friend can come into the treatment room.

Even when the patient is not present or it is impracticable because of emergency circumstances or the patient’s incapacity for the covered entity to ask the patient about discussing her care or payment with a family member or other person, a covered entity may share this information with the person when, in exercising professional judgment, it determines that doing so would be in the best interest of the patient. See 45 CFR 164.510(b). Thus, for example:

  • A surgeon may, if consistent with such professional judgment, inform a patient’s spouse, who accompanied her husband to the emergency room, that the patient has suffered a heart attack and provide periodic updates on the patient’s progress and prognosis.
  • A doctor may, if consistent with such professional judgment, discuss an incapacitated patient’s condition with a family member over the phone.

In addition, the Privacy Rule expressly permits a covered entity to use professional judgment and experience with common practice to make reasonable inferences about the patient’s best interests in allowing another person to act on behalf of the patient to pick up a filled prescription, medical supplies, X-rays, or other similar forms of protected health information. For example, when a person comes to a pharmacy requesting to pick up a prescription on behalf of an individual he identifies by name, a pharmacist, based on professional judgment and experience with common practice, may allow the person to do so.

Created 11/3/03

Content created by Office for Civil Rights (OCR)
Content last reviewed July 26, 2013

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