What liability to I carry if don't take my clients to the hospital?
I need to know how to protect myself from medical liability issue for the couple I care for. The problem is they have a son who talks them out of letting me take them for urgent care when needed. An example of this is the 82 year old mother had a blood pressure of 88/47 with a heart rate in the normal range because of a pace maker. I felt that she needed to be taken to the ER but the son convinced his dad (85 years old) that it was not needed. The same type of thing happen not two weeks earlier but with his father. The only difference is that the father did not go to ER the first day but did allow me to take him the second day. He was admitted and the doctor's found a serious problem with the arotec value. I want to protect them as well as myself. What do I do?
Expert Answer
It is not clear why the son is objecting to the emergency care you find necessary. But it is clear that you cannot continue to do your job in this way. You need both an understanding of why the son is interceding as he is"”and the authority to get the care your charges require.
If you haven't done so, sit down with the son and listen to his views. In both situations, you describe ER and Urgent Care. In many areas, as well you know, people receive adequate care from such providers. But as you also know, many people whose experiences with waiting and shoddy care or catch-as-catch-can practitioners in such environments has warned them away from ERs except in the most dire circumstances. So first listen to where he's coming from, since he seems to have the ultimate sway over his parents. Does he fear substandard care? Is he opposed to the high cost of such services? Concerned that insurance might not cover them? Simply worried or feeling guilty that you are taking over decisions he should be making?
In the best of all worlds, you can explain to the son that you need to be able to contact outside providers for medical help when needed. You and he might be able to come up with some alternate medical coverage should symptoms appear or condition worsen in the future. The parents' primary care doctors or a good gerontologist or a geriatric care manager should be able to help with such a plan.
Once there is an understanding and plan, it should also be clear who is authorized to get outside help"”and when. If the son is especially stubborn or unreasonable, it may be of some help to get this authorization in writing.
The parents could also complete a power of attorney for medical care authorizing you as their healthcare agent in specific circumstances. While this may be the most clear source of authority, they may balk at doing it"”especially if the son is as overbearing as he sounds.
At a minimum, they might be willing to intercede and emphasize to the son that you have been hired to take care of them"”and you need to be allowed to make some decisions as part of that caretaking process. It's surprising what a strict talking-to by a parent can do"”no matter what age the child.
If all else fails, you may just need to make clear that you will not be able to continue doing your job unless some changes are made"”and move on if they're not.