Having Students at My Medical Practice Provides Lessons in Liability

January 30, 2012

I fully understand that those who wish to pursue clinical jobs need time with actual patients …but I still need to protect my patients and my practice.

As a former faculty member, I am used to having medical students, residents, and fellows shadow me. I have had them see my patients, after which I would review their work and confirm their findings and either agree or disagree with their assessment. After that, I would go over the plan with the patient. During all of this, I would pause for “teaching moments.”

Since my departure from faculty life, I have only had one resident ask to do a rotation with us. I actually enjoy teaching, although it can make the work a little slower.

From time to time, I have received requests from “non-physician-to-be”s to shadow me or my associate or my medical assistant. These are nurse practitioner and medical assistant students. From a purely work-related standpoint, I have no objection to this. Again, for the NP, I enjoy teaching. It also ends up being educational for the patients. And a medical assistant student could help my MA out - taking vital signs, helping patients get their shoes on and off, and assisting in procedures.

And I know these students need to get their clinical time in and that other offices do it all the time. Nonetheless, I wonder about issues such as patient privacy and liability. I always ask my patients if it is OK for a student (even med student or resident) to sit in with us, or to start a visit; but what if a student discusses a patient with another student? Or anybody for that matter? Is my practice in violation of HIPAA?

What if said student gets injured in my office? What if he or she gets stuck with a needle? If they are going to be around for several months, do they need to be on my insurance policy?
I fully understand that those who wish to pursue clinical jobs need time with actual patients, and I would be happy to oblige, but I still need to protect my patients and my practice. I’d be happy to hear from anyone with experience in this.

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