Ok, let’s suppose that you work for a medical office, and one day you’re not feeling well so the doctor examines you. Based on what’s discovered in that examination, they fire you. Is this a breach of doctor/patient confidentiality?
I don’t know. Who told who what? Did the patient sign a release?
QtM, MD
Possibly, but based on your OP information it’s impossible to say. It would generally be a breach if the doctor told the company without permission from the patient; exceptions are made for breaching confidentiality when potential harm to third parties is serious (infectious disease, the “Tarasoff” case when the patient directly threatens a potential victim, child/elder/spouse abuse, impaired driving, suicidal/homocidal patients).
And what do you mean by “work for a medical office”? Did the boss of the hypothetical you examine you, or do you work in a different department in a clinic or large medical center?
I work in a medical center/hospital, and my last job was in one as well. At my last job, when my coworker fell ill and was being treated by a doctor in a different department in the hospital, the physician who treated her called to say she was sick and would not be returning to work for a little while. The physician would not reveal the nature of the illness or even speculate on how long my coworker would be out. I could have used my access to pull up her records on the computer, but that could have led to disciplinary action or my firing, and my name would have come up on the “last viewed by” list (last 10 personnel to view a record are listed) on her record, so it would have been noticed quickly.
Could you give a little more detail, in some cases medical folk are required to report things to law enforcement. IIRC doctor/patient does not apply in certain criminal situations.
Honestly I can’t see that this would be a breach of doctor/patient confidentiality when your doctor is also your boss… it’s a good perk to have working in a doctor’s office to have ‘free’ doctor services, but they also must take into consideration knowledge that they have with regards to their employees, regardless of how they came across it.
For example, if the doctor and the boss were two separate people but friends, and your doctor told your boss - your boss can fire you on provable information (assuming that whatever was found is out of line with working requirements). The only person liable in this instance would be the doctor for breaching confidentiality… but again, if they are one and the same…!
Are we talking about substance abuse here? (i.e., doc examines you and suspects you are on drugs, drunk, etc.) Seems to me that could be upheld pretty easily–do you want the nurse or tech (for example … could be the janitor for all I know) high? That (risk to patients) would seem to outweigh confidentiality.
Ok, a little more detail . . . it’s a small pediatric practice with about 25 employees, including 5 or so doctors. The patient/employee (who is not a child) has an obscure but not terribly serious medical condition.
Is it a communicable condition?
I tested positive for TB many years ago. I now have to agree to periodic chest x-rays as a condition of employment in a health care setting.
Is it a condition for which disclosure was required upon hiring?
I once worked at a hospital with a nurse who confided in me that she had an eating disorder. We worked on an eating disorders unit at the time. She was eventually fired (not through my intervention) because she was engaging inappropriately with clients about how they shouldn’t trust the rest of the medical staff’s interventions.
Another nurse told me that she had cancer, which she said kept her from meeting the health criteria at most hospitals in the area. She said that she was working at our present hospital because they had such an inadequate physical exam for employees that she was able to lie about having cancer.
Since you say it’s not serious (i.e., won’t become life-threatening–like a lumberjack with a heart condition–won’t endanger coworkers or patients–like a bus driver with severe narcolepsy–won’t interfere with performance–like a pianist with crippling arthritis), then unless it’s
(a) communicable
(b) a medical condition that is required to be disclosed upon accpetance of employment for any reason (a la Shoshana’s sugg.)
then it seems to me you have a simple discrimination case, that doesn’t necessarily have anything to do with doctor-patient confidentiality. If I had, say, irritable bowel syndrome, and my current boss (not a doctor) discovered it and thought that was reason enough to fire me, then she’d be hearing from my lawyers.