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Medicolegal Risk of Volunteering Medical Services

Matthew DeLaney, MD
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20:22

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Review medicolegal risks that can occur with volunteer versus emergency situations.

 

Pearls:

  • The risk of being involved in a lawsuit around care we provide in a volunteer capacity is low, but not zero, and we need to protect ourselves.

  • Awareness of  4 common misconceptions can help us protect ourselves AND serve our communities.

 

  • We want to help people.  We have the skills to help people.  It is mind-boggling that we cannot just show up and offer our services where they are needed.  But we cannot.  In the US, our medicolegal climate does not let us volunteer free of risk. How can we provide medical care outside of our traditional practice environment and protect ourselves from a legal standpoint?

  • In this segment, we will discuss working as event providers: volunteering at a sports event, summer camp, music festival or similar public event in the United States.  If you leave the country to do a medical mission trip or otherwise practice medicine outside of the country, the laws of that country apply.

  • Overall, the risk of being involved in a lawsuit as an event provider is really low.  There have only been a handful of lawsuits.  But, this does not mean that there is not significant risk there.

  • There are 4 misconceptions regarding the risk of being an event provider:

    • Misconception #1: Good Samaritan laws protects me.

      • Every state in the US has some form of a Good Samaritan Law.  The basic premise of these laws is that if you have some form of medical training, encounter someone with a medical emergency, and you offer emergency care without compensation or the expectation of compensation, that your liability should be limited.

      • If you submit a bill to the patient, you have violated the Good Samaritan law

      • Most states have an exception for gross negligence or misconduct - if you do something totally out of the scope of reasonable practice, the Good Samaritan Law will not protect you.

      • Typically the Good Samaritan Law applies to emergent care only

        • A lot of the events we might cover will have patients with ailments that are not unanticipated emergencies.  For example, if an attendee at a music festival becomes dehydrated, many states would say that this is an expected ailment at a music festival during a hot summer, and is not an unanticipated emergency.

        • Other settings like volunteering for high school sports physicals also do not fall under the protection of the Good Samaritan Law.  These are not medical emergencies.

    • MISCONCEPTION #2: The event has liability coverage that will cover me.

      • Covering medical providers is not included in the typical insurance policies that events will obtain.  They have to purchase a separate and specific policy to have medical providers covered.

      • It is important that you ask this question when you are approached about providing care for events.  “Does your insurance policy cover my medical services?”

    • MISCONCEPTION #3: My medical malpractice insurance will cover me.

      • As a hospital or clinic (i.e an Urgent Care) employee, the insurance policy is written to cover you for the care you provide at that hospital or clinic.  You are typically not covered at another hospital or clinic, or when providing care from your home (i.e. a neighbor needs a prescription for antibiotics) or an event location.

      • There are policies that will cover if you want to volunteer your services or practice event medicine regularly, but most routine policies do not

    • MISCONCEPTION #4: Waivers signed by participants release me from liability.

      • We all know about these types of waivers and have all signed them in the past.

      • In legal situations, however, they tend to not hold up as protection for the event holders because juries are very sympathetic to an injured person who states that they did not understand what they were signing.

      • As healthcare providers, these waiver are almost useless for several reasons:

        • Courts have decided over and over again that a provider cannot require a patient to sign away any potential future liability.

        • The argument has been that people have a right to medical care and you cannot hold people hostage, refusing to provide care until the patient releases the provider from liability.

        • A parent cannot sign away the future rights of a child.

        • Waivers are best thought of as helpful in defense, but not complete protection.

  • What can we do to lower the chance of a bad outcome for both us and our patients when we decide to volunteer at an event?

    • Step 1: Be involved with event planning as much as possible.

      • Know what resources are and are not available at the event.

    • Step 2: Know what experience you have and what you are comfortable treating or diagnosing.

      • There was a case where an orthopedist, who was the team doctor for a high school football game, was found negligent when a player had a bad outcome from a cervical spine injury because the jury determined that he did not have the expertise to diagnose and treat the injury he encountered.

For further reading, see Ross DS, et al. Action in the event tent! Medical-legal issues facing the volunteer event physician. Sports Health. 2013 Jul;5(4):340-5 [Free open access link]

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Franks and Beans Full episode audio for MD edition 191:27 min - 90 MB - M4AHippo Urgent Care RAP - July 2017 Written Summary 279 KB - PDF