Shadowing = illegal?

[AndyMD]

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How are you guys still finding opportunities to shadow MDs these days? People are telling me that it violates the Health Information Patients Privacy Act (HIPPA), and that anyone who's had the chance to shadow recently must have had a physician lie on their behalf and pretend like they were a medical student. What's up with this?? I'm trying to find a way to observe doctors in the Texas Medical Center, but I don't know any doctors personally and I feel like I keep getting the run-around. Has anyone else experienced this, and if so, how'd did you deal with it?

 

[Prozach]

I've done A LOT of shadowing, both in private practice and hospital settings. I had to get HIPPA certified twice and everytime I wanted to go in with a doc, the patient had to give verbal consent to me being in the room. Some didn't want me in, so I couldn't go in even with HIPPA. I haven't ever had a physician lie for me :sqnteek: So, to recap, just get HIPPA certification (maybe your local hospital offers certification? That's where I got mine) and consent from each patient and you should be A-Okay!

 

[tulips]

I had the same problem. I tried to shadow at Georgetown last winter and I was pretty much blown off for the same reasons. The only way I've been able to do it was through my university which has a program that established a position called a House Staff Assistant specifically to avoid problems with the legality of shadowing. Even so, I've been with residents who have introduced me as a medical student instead of an undergraduate just to avoid any problems.

 

[kaikai128]

It has been a little while since I have been actively working in Health Information Systems...but I do not think that the new Hippa laws changed anything--as my office implemented them before I left. I think that these laws simply put into words what should have been normal practice. That being said, I believe that the confidentiality statement that you have to sign before reading any confidential information or seeing any patients should protect the doctor/hospital that you are working through. From what I have encountered, people are making these new hippa regulations much more difficult than they actually are.

 

[Robz]

illegal - is a sick bird....



I shadowed 8 physicians last year.

One asked me to sign a HIPPA form and he was a peds.

Not really an issue for me.

 

[exmike]

It is not HIPPA (what is that, a female hippo?)

Its HIPAA
and it stands for Health Insurance Portability and Accountability Act.

 

[MoosePilot]

Depends on how your particular place attributes HIPAA regs.

I got shot down when I asked my local flight doc, even though he thought it was ok. I did some research, took the same HIPAA training as the rest of the hospital employees (with a certificate as proof) and reargued my case. That opened the door.

If they use HIPAA to tell you no, tell them you're willing to train. If you can't get training through them, try to volunteer at a hospital through the Red Cross and you might be able to work HIPAA training through them.

 

[DieselPetrolGrl]

It is not HIPPA (what is that, a female hippo?)

Its HIPAA
and it stands for Health Information Portability and Accountability Act.

LOL HIPPO jokes! 🙁 🙁 🙁 🙁 🙁 🙁 🙁 🙁 ooohhhh its bedtime

 

[kaikai128]

It is not HIPPA (what is that, a female hippo?)

Its HIPAA
and it stands for Health Information Portability and Accountability Act.

hahaha...I knew that, guess that is what I get for typing in a hurry and not really thinking. Regardless, acronyms are annoying.

 

[AndyMD]

heh sorry for the misnaming of HIPAA ... i was trying to reproduce it from memory... and thanks for the suggestions, I'll look into how to get certified. Strange that no one I spoke to ever mentioned that I could be certfied ... they just seemed to use HIPAA as a way to blow me off.

 

[Medikit]

I was blown off by my old pediatrician's nurse using HIPAA. I'm going to call him at home though, he agreed last year, I'm sure it's just a mean nurse who loves protocol.

 

[dutchmaster]

I've shadowed in four hospitals, all of which had HIPAA certification protocols before i could shadow.

The best bet is to get a job in the hospital (CNA, EMT, ER or OR Tech, etc..), this allows you to shadow multiple docs from different specialities without worrying about the HIPAA rules since you'd be a hospital employee.

 

[Neuronix]

I think that this is a legal grey area. There's increased liability for you shadowing patients who you are not caring for, because you could potentially go tell someone else details of a case that gets back to the patient and sues the hospital. However, I'm not aware of this happening, and HIPPA itself doesn't forbid shadowing explicitly. There are provisions for training students.

I think "illegality" is being used simply because medical centers don't want to deal with pre-meds and it's a good way to blow you guys off. Alot of administrators and doctors just don't like pre-med shadowers because you contribute nothing, are a potential liability, and soak up time. To make matters worse, there's no guarantee you'll even get into medical school. You'll notice a total change once you get into medical school. The doctors will be like "Here's a medical student, let's recruit him/her into our specialty!"

I'm not arguing for this BS. I shadowed for three years before I came to medical school, and it's an important (if not absolutely necessary) thing to do before you come to medical school. There's nothing you can do about it, except to persevere and keep trying.

My 2 cents out...

 

[Scubadoc]

Don't know that this will help but I contacted the volunteer office at my local hospital and they had me attend the same all day seminars the volunteers attend where we learned about all things HIPAA. I had to sign some forms as well. They then got me in contact with a woman who worked in "medical education" at the hospital who set up different shadowing opportunities at the hospital for me. Maybe that would work for you?

 

[g3pro]

I am a "cardiology intern" at a large hospital. I visit patients with the fellows and go to the seminars and data analysis meetings with the other physicians and residents. 😀 HIPAA didn't come up once. When I volunteered at another hospital, they brought up HIPAA protocols briefly by stating: "Do not tell anyone anything specific about the patients here." It's a legality that some hospitals use to get j00 off their backs. I haven't had that problem.

For those who do have those problems, try not acting like a f***ing pre-med and be more mature. Doctors hate arrogant pre-meds grubbing for medical experience. Especially over-worked nurses.

 

[Emeri Onwunwa]

I shadowed an internist my second year in undergrad, and no one ever mentioned anything about HIPAA. She simply asked her patients if they mind if I watched while she did her job.

 

[Neuronix]

For those who do have those problems, try not acting like a f***ing pre-med and be more mature. Doctors hate arrogant pre-meds grubbing for medical experience. Especially over-worked nurses.

This is an excellent point. Where I used to shadow the following things would happen:

The pre-med comes, gets trained, then has a once-weekly shift in the ER to volunteer. The pre-med comes every other week (at best), stands around, does nothing, and leaves. After they accumulate 50 - 100 hours (which sometimes takes 1+ years), they quit. They then get crappy LOR out of the experience and bitch. All the pre-meds therefore get a crappy reputation and nobody really bothers with them unless they prove themselves to be useful, reliable, and genuine. Meanwhile, the undergrad nearby views the hospital as using their students for scut-only, which sours any relationship the undergrad might have with the hospital.

The same crap happens in research. The pre-med is completely unreliable, won't work when they're there, and then bolts after getting a LOR. This is alot more common than not, so alot of PIs just won't deal with pre-meds.

So the point of the poster I'm quoting is well taken. Make yourself useful, be reliable, and stick with whatever you do. Don't be a typical pre-med.

 

[nina512]

Two points about shadowing...

Most of my shadowing experience was part of a preceptorship. The doc lied to the patient and told him I was a med student. It made me feel very uncomfortable...and dumb when I put the stethescope on backwards.

Also, I was a patient at a teaching hospital. I told my doc I didn't mind if students came to check me out. Let's just say I felt like some specimen on exhibit at the museum...lots of stares and nods and no one even tried to speak to me. So from a patient's point of view...I didn't really appreciate all the students looking on.

I guess those two experiences turned me off from shadowing...which (by the way) is not the only way to get clinical experience.

just my 2 cents
-Nina

 

[Cerbernator]

I've been all over the hospital and havent heard a word bout hippa

 

[Neuronix]

Most of my shadowing experience was part of a preceptorship. The doc lied to the patient and told him I was a med student. It made me feel very uncomfortable...and dumb when I put the stethescope on backwards.

Haha, when you're a med student they'll start calling you Doctor. Don't sweat it too much...

 

[CeLo]

I shadowed a cardiologist in the beginning of May and never once heard a word about HIPAA. Technically I was suppposed to be a current med student, but it didn't really seem to be an issue. He introduced me to his patients by saying that I was going to be a medical student this fall, and no one had a problem with it. Actually, they were all very nice and told me good luck, good for you, etc. I think it depends on the doc, because the guy I went to has students all the time because he loves teaching.

 

[SwineLake98]

I had trouble finding a physician willing to take me on as a shaddow due to the HIPAA regulations which is why to this date I have not done any shadowing. It seems to depend on doctor and the clinic. I was told the problem was insurance and that med students are covered by their schools and there is nothing that covers undergrads. Sucks, doesn't it? 🙁

 

[kchan99]

I haven't had any problems with shadowing. And again, the offices can't use HIPAA as an explanation because they know that I know about law. I interned at the district attorney's office when I was in high school. Then I worked at the federal government in the summer before college with a low level security clearance.

It helps when physicians you would like to shadow are alum of your school, even high school.

I get introduced as a med student to be. I applied once in for 2003 entering class and got waitlisted-never got in. Reapplying this year for 2005. It helps if you can help the doctor with things when you shadow. I checked patients insurance benefits and looked up drug interactions.

Karin

 

[Eyecon82]

well...if dr.s are saying that...then they're really scared by the hipaa or just dont want you around....but most dr.s who don't mind just ask the patients beforehand to see if its alright if you can come in....some patients say no...and some patients dont care...that's the way to get around the hipaa

 

[g3pro]

Try to find a physician you know personally.

Fortunately, I know several physicians in charge of residents, fellows, and interns. So I fit in nicely.

 

[farrago]

Most of my shadowing experience was part of a preceptorship. The doc lied to the patient and told him I was a med student. It made me feel very uncomfortable...and dumb when I put the stethescope on backwards.

Haha, when you're a med student they'll start calling you Doctor. Don't sweat it too much...

I find this sort of behavior unethical. Do you not? If I were lied to in this way by a physician, I would feel abused.

 

[LuckyMD2b]

I find this sort of behavior unethical. Do you not? If I were lied to in this way by a physician, I would feel abused.

I don't think it's unethical at all. It doesn't affect patient care at all to have an interested and motivated student watching a procedure or interview. Who cares really, patients often like having students around. As long as you are respectful, genuinely interested, and act in accordance with HIPAA it should be all good.

If you think that's unethical how do you feel about "medicine's dirty little secret" How do you think that residents who have never done a procedure before get experience? Attendings never let their patients know that Docs in training will be doing most of the procedure. You gotta start some where.

 

[LuckyMD2b]

PS: immoral maybe, unethical I don't think so

 

[biophiliac1]

<Even so, I've been with residents who have introduced me as a medical student instead of an undergraduate just to avoid any problems.>

how do you feel doing that just so you can get "experience". how would you feel if you were the patient that got lied to? the policy is a law!! people may want to be a doctor but don't you think it is unethical to some extent? there are other ways to get "experience".

by the way not all patients are comfortable with being lied to or having others their with their personal info. being shared with someone other than a doctor that they have built a relationship with.

is there realllyyy any confidentiality in this world....hmmm

 

[biophiliac1]

when you go to teaching hospitals you take the chance of being treated by people learning. and well even when you go to the hospital period because there are doctors who don't know how to do certain procedures.

 

[LuckyMD2b]

How do you practice delivering a baby? Or removing an appendix? Or suturing a laceration? Draw blood, take a blood pressure, give an injection? As long as the resident/ med student is properly supervised by an attending it is completely legal, and that's the way it's been done for 100 years.

I don't think doctors should lie to their patients, by the way. Although when I was an undergrad a doc I worked with did tell the patients that I was a med student, and I got to see some real cool stuff. And that doc's letter of rec did get me into a pretty good med school. I don't think that it hurt any one. I was a student, learning medicine. I just wasn't in med school.

Now there are times when I'll go to a patient, tell them I'm a medical student and wear a name tag that says student on it and some people will still think I'm a doctor.

 

[biophiliac1]

so i'm guessing you would have no problem if u were lied to by your doctor or one of your close friends/relatives because doctor's SHOULD be allowed to do that in certain cases? when do you draw the line? i think it is a matter of ethics. this is a question for all of you who want to shadow and think the policy is more of a problem than protecting patients or whatever

 

[LuckyMD2b]

so i'm guessing you would have no problem if u were lied to by your doctor or one of your close friends/relatives because doctor's SHOULD be allowed to do that in certain cases? when do you draw the line? i think it is a matter of ethics

I said I don't think doctors should lie to their patients.

Learn how to read.

 

[biophiliac1]

<this is a question for all of you who want to shadow and think the policy is more of a problem than protecting patients or whatever> let's be cordial about things i was asking a sincere question

 

[Neuronix]

I find this sort of behavior unethical. Do you not? If I were lied to in this way by a physician, I would feel abused.

I think it's completely unethical. Unfortunately, we are evaluated on a hierarchicial system where your grade depends alot on how much you get along with the person that's evaluating you. Therefore, I'm not saying squat about it directly to the person above me. I could go and report it to someone even higher, but it's probably not going to change anything, since it's a widespread practice.

 

[gujuDoc]

I shadow at the James A Haley VA, and all the doctors I've ever shadowed have been sooooo nice. I also coordinate getting shadowing opportunities for students via help from the volunteer coordinator there.

Anyhow, I'll tell you something. None of the people that I have set up at the VA have ever had problems. In fact, the doctors always treat them very well, the patients never seem to mind that someone is in the room observing, and actually on a couple of occasions, when I was shadowing the patient offered me a chair.

The patients also have talked to me and what not. Many VA patients are older patients and don't really care if we observe. But the doctor has never done anything illegal and told the patients that we are medical students.

Also, we get Hippa Certified through the hospitals volunteer services.

Other people that I set up in shadowing radiologists, cardiothoracic surgeons, radiation oncology, ophtamology, and cadiology, have told me that they have gotten to see a great array of things and none of the patients care that they are observing. The doctors also have said you know email me if you have questions or things like that.

The radiology and ophthamology people even got to see surgeries and what not.

But overall, I've never had any problems with patients minding or with doctors getting annoyed.

 

[mikedc813]

I'm actually starting a clinical research project at the James Haley VA hospital and the doc I'm working for is really really nice. He's offered to let me observe surgeries whenever I want and told me to just let him know when. So I'm sure if you have the right connections you can't get past needing to be certified...

 

[2112_rush]

Even having been accepted to medical school I am having difficulty shadowing. Went to a local ER to shadow a doc and the nurse told us it would be a HIPAA violation. Now I am working at the school I will matriculate to in a couple months and I am told that I'm not allowed to shadow even though I went through HIPAA training during employee orientation. As a pre-med in my hometown I never encountered a problem, even though I shadowed in a variety of settings. Go figure.

 

[hakksar]

The problem is a lot of healthcare providers are confused about HIPAA. There is a lot of disagreement about what HIPAA requires (and what is allowed and not allowed). Since HIPAA became law I have worked in several healthcare settings and have heard many different interpretations. I think that if the first place says it is a violation you should try somewhere else since in reality HIPAA does not necessarily say that a premed or med student cannot be present. It really depends on how the person shadowing is viewed by the hospital (ie a general member of the public or a student being educated). Since the first is not allowed to receive confidential health information under HIPAA (which in reality they never were due to patient confidentiality) the hospital may not allow the person to shadow. However, if the person shadowing is considered a student in training they are then considered part of the healthcare team (although a very limited member of the team) and are allowed to be present. Even if they let you shadow it is imperative that you ensure patient confidentiality. HIPAA originally was a problem for one of the EMS agencies I worked for because nurses would not give us patient updates which hindered quality assurance and education (it made it hard to determine if we treated the patient appropriately and how they responded to treatment which are both useful in improving the way we treat the next patient). This has now been resolved with the help pf some education by our physician advisor and the hospitals legal team.

 

[kchan99]

I remember being a patient at an eye clinic a few years ago. They found something interesting on my cornea (used wrong bottle of contact lens solution). A med student and a technician asked me if they could take a look at the interesting find on my eye, and I said fine. You see, only one person can look at one time. 5 people working at the clinic ended up looking my eye. I didn't want to be mean to the 3 others behind the two who asked, but my eye got to be soooo tired and more sore. As I was telling this story to one of my friends, she said that I should have brought a container to collect money. Yes, tickets required to look at my eye because that was work for me trying to keep my eye open...