Forensic Corner; Reading Your State Statutes
Lee H. Haller, M.D.
Here it is September. Your are feeling refreshed from
a relaxing summer with a slower pace, time in the sun,
and vacations. Having read several novels, you are now
looking for something meatier to tackle to get you back
into the swing of disciplined thought. Let me suggest
for your professional enlightenment that you undertake
a review of the laws and regulations of the state in
which you practice as they apply to physicians.
For many of you, this would be the last choice for
reading material. Nevertheless, it is important to periodically
review the statutes, so that you are well versed in
those which are relevant to your practice and to note
any changes that have been enacted since your last perusal.
Not only will you find material that covers child abuse
and neglect reporting, confidentiality and privilege,
continuing medical education requirements, and criteria
for involuntary hospitalization, but you may well come
across some topics that you would not expect which will
be of assistance to you in your practice.
For example, in reviewing the statutes of Maryland,
there are two that deal directly with money. Whereas
you might expect that these statutes would deal with
required fees that must be paid or other means by which
money will be taken out of your pocket, these particular
statues have to do with adding income to your practice.
The first covers allowable fees for photocopying, stating
that up to .50$ per page may be charged when photocopying
of a record is required. Additionally, a $15.00 handling
fee may be added, as well as the direct cost of postage.
Furthermore, these fees are allowed to be indexed for
inflation.
The second statute states that interest rates must
be paid by insurance companies for past due bills submitted
to them. The statute even spells out the specific rates
that may be charged, starting at 1.5% from the 31st
through 60th day and increasing after that.
Unfortunately, no other statutes from my state turned
out to be financially beneficial. However, there are
a few others which merit attention as examples of what
you might look for in your own state laws. For example,
a problem that becomes increasingly large with each
passing year of practice is storage of old patient records.
Records must be maintained in accordance with statutes.
For example, Maryland law mandates that medical records
be kept for at least five years after the last contact
in the case of adults, and three years after a child
reaches the age of majority or five years after the
last contact with the minor, whichever is longer. Once
you learn what the statute requires, you can mark a
date on the file once treatment is finished, indicating
when the chart can be shredded.
Another area covered in Maryland is the use of psychiatric
assistants (P.A.). Before such a person can practice,
he/she must be individually approved by the state medical
board. Once authorized to practice within the state,
the P.A. can only do so under the direct supervision
of a psychiatrist. The law states that the psychiatrist
shall personally examine, diagnose, and establish a
treatment plan for each patient before assigning said
patient to a P.A. Thereafter, adequate supervision must
take place. Additionally, whenever the P.A. finds a
new diagnosable condition, such information must immediately
be brought to the attention of the supervising psychiatrist
who shall then direct appropriate treatment. It is the
psychiatrist's responsibility to keep a record of all
patient reviews carried out with the psychiatrist's
assistant. That record shall include the psychiatrist's
observations and recommendations.
A final topic, which one might not expect to find in
the statutes, relates to physician advertising. The
statute states that a physician may only advertise as
being a specialist if he or she has been identified
as a specialist in that field by the Board of Physician
Quality Assurance. The statute further defines what
statements may or may not be contained in any physician's
advertising.
You may well find other pearls of wisdom in the statutes
of your own state. A compendium of the applicable laws
and regulations generally can be obtained by contacting
the State Medical Board Office. This allows you to find
all the laws that relate directly to the practice of
medicine in your jurisdiction without having to sort
through volumes of material. Enjoy your fall reading.
Dr. Haller is in the private practice of forensic psychiatry
in Potomac, Maryland
AACAP
News/September-October 1996 |
