Celebrity Patients Require Extra Supervision

Celebrity patients present a number of unique challenges for medical practices and require additional supervision of staff and compliance measures to protect the practice, the patients and staff.

In last week's discussion I provided some detail on the death of Joan Rivers during her treatment at an outpatient surgery center (ASC), and provided a warning about the focus a celebrity death or "bad outcome" brings to any medical practice. This increased attention from the media, the public, and regulators comes regardless of any question of negligence on behalf of the doctor or facility. But in this case, a variety of allegations emerged including: significant HIPPA violations alleged against the treating physician for taking one or more "selfies" with Rivers during her treatment, potential claims about lack of supervision by a properly credentialed anesthesiologist, and an allegation of an unapproved procedure consisting of a throat biopsy. Interestingly, all of these allegations are closely related to the exact warnings I provided last week about laxity in compliance and lack of written processes at some ASCs that is evident in the nature of the most common claims against these facilities. There are already a variety of reports alleging that Rivers' family has retained counsel and may seek eight figures in damages.

What is a celebrity?

It's important to understand that a variety of patients may bring the same level of additional stress and exposure to a practice, not just celebrities in the traditional sense of media personalities like Rivers. While all patients deserve the same high-level of care, some certainly present additional challenges, including professional athletes, high-net-worth business people, foreign dignitaries, government officials, and many others that have a higher than average level of interest from the media. And in many cases, physicians must deal with a long list of people who are actively trying to discover and reveal what they have a legal duty to keep private. Some of these media sources will pay your employees for information, hire hackers, and even use private detectives to perform a variety of discovery operations - from following and observing patients to going through your trash to find the information they want and desperately hope exists. (And in the worst cases, manufacturing that information or making unfounded allegations when it doesn't).

If your practice regularly treats these kinds of patients, it should be clear that your office needs a special VIP protocol which should include:

• The appropriate HIPPA releases that allow you to communicate with the patient's entourage including managers, assistants, and others that these individuals typically delegate a variety of tasks to, including coordinating treatment and communicating with your office;

• A professionally drafted employment policy that includes not only standard HIPPA and patient confidentiality guidelines, but an affirmative duty and confidentiality agreement regarding both patients and the practices and business activities of the medical office itself;

• Increased levels of supervision, and perhaps even assigning the care, correspondence, and billing of certain "flagged" high-profile patients to senior staff who have had these issues reviewed and explained to them in detail; and

• Security and access protocols (patient and clinic) for patients who may be high risk, controversial, or have large and diverse numbers of staff and family visiting.  Your practice should also have guidelines for receiving high value or a high volume of gifts, cards, flowers etc., that may also present a security issue or be "tainted" in some manner - including maliciously, as in poisoned or infected or electronically "bugged" in some way, including with cameras.