Communicating

My malpractice is through SVMIC.  They periodically sent out a newsletter with upcoming seminars and an article or two on ways to improve your practice/ decrease your risk of getting sued.  The current issue’s article is “Communicating with Patients Who Are Deaf.”

The article reminds us in health care of the Americans with Disabilities Act (ADA) which prohibits all physician's offices (except those operated by religious entities but notes the similar Rehabilitation Act of 1973 covers physician’s offices operated by religious entities) from discriminating against people with disabilities, including those who are deaf.

Key Points:

1.  The physician’s office must provide effective communication which meet the patient’s individual needs.

2.  The physician’s office must pay for the cost – qualified interpreter, video interpreting service, etc.

3.  If there are two equally effective methods or sources, the physician has the right to chose the most cost effective.  The caveat here is equally effective for the individual patient. 

4.  The physician’s office is prohibited from passing along the cost of providing the auxiliary aids/services to the the patient.

5.   The ADA does allow physicians to refuse to provide a specific auxiliary aid/service if doing so will create an undue financial burden (significant difficulty or expense).  This is hard to prove, as it isn’t as simple as weighing the cost of the service against the payment for the appointment.

Examples of auxillary aids and service include 1) qualified interpreter, 2) note takers, 3) open or closed captioning, 4) video interpreting services, and 5) exchange of written notes.

REFERENCES

1.  Deaf Patients, Doctors, and the Law:  Compelling a Conversation about Communication (pdf file); 2008, Florida State Law Review, Vol 35:947

2.  Communication with Deaf and Hard-of-hearing People: A Guide for Medical Education; Barnett, Steven MD; Academic Medicine: July 2002 - Volume 77 - Issue 7 - p 694-700

3. Department of Justice ADA Enforcement page 〈http://www.usdoj.gov/crt/ada/enforce.htm〉. Accessed 2/26/12. United States Department of Justice, Washington, DC, 2001.