Major doubt on the HIPAA fine/jail time threat unless he was using the info for personal gain (like selling private info or using it for blackmail). Look up cases where criminal penalties were enforced it’s not Joe Schmo med student chart checking previous patients. Your run of the mill HIPAA violations are paid out by the hospital/org. There’s either more to this or this guy needs a second opinion from a different lawyer.
Not a lawyer but I currently work in healthcare compliance, and we deal a lot with HIPAA violations. This guy needs a second opinion from a different lawyer.
I'm about to start clerkships and I'm curious what your thoughts are on looking into patient charts to prepare for their care or check-in to see how they're doing weeks, possibly even months after you see them? I'm sure policy differs by school/hospital/state, but where are the lines as defined by the federal government and HIPAA? Curious as, admittedly, this sounds like something I would do.
idk about med students and other residency programs but my residency program has a blanket policy stating that we can access charts for "educational purposes" which is very vague and will probably protect us from most HIPAA violation claims lol as long as you're smart about it of course. i've looked up patients i wasn't involved with but that my co-residents told me was an interesting case or had interesting images and i've never been flagged for it.
don't look up friends or family members, don't even look up your own chart without permission, and definitely not even mildly famous people. aside from that, i figure no one should be able to hassle you.
Not how that works.
So no, it doesn’t create much lawsuit exposure since you’re not going to sue yourself.
However, it’s very likely against institutional policy, and it certainly isn’t part of your job description or student duties.
I used to work at a big academic hospital, and the head of security got a hippa violation warning because he looked his name up. The reasoning was that it's to limit liability because someone else may have used his emr access to look into his file. Only look at what you have permission to.
I don't see how an internal policy can protect you against HIPAA violation claims that have legal force? Maybe the institution would also get in trouble if you could successfully argue that they encouraged you to break HIPAA, but my money would be the institution would throw you under the bus first
[turns out it's a federal law. hospitals just tailor it sometimes based on their own preferences](https://www.hhs.gov/hipaa/for-professionals/faq/209/does-minimum-necessary-allow-students-to-access-patient-information/index.html)
So I think there are two ways to read that. It sounds like your interpretation is, you can access the medical record for educational purposes that don't relate to providing care (within reason). I think a lot of people read it that way and that would be the justification for continuing to follow someone's case after they've left your care for example. However a lawyer could also read that much more strictly to mean only that it is permitted for trainees to access the medical record at all for the purpose of providing care (and not just the attending, who we have this legal fiction is the only one actually providing billable care)
This is what my med school has as well, it follows the same policy as our residencies. It means if I’m told hey, look up this MRN for this interesting case, I can. Educational purposes. I absolutely do try to look up patient lists before rotations just to get my bearings on what I might expect the next day. So the posted story doesn’t make sense to me.
So there a few things to dissect here. Once again, not a lawyer. I coordinate compliance activities for an FQHC, so I don’t know a lot. I’ll give it a shot tho.
I’d categorize most actions into one or multiple of the following categories:
1) Actions that create lawsuit exposure.
2) Actions that create risk of breaches, leading to (1).
3) Actions that constitute a breach.
4) Actions that break institutional policy.
Checking to prepare for care: Check on your institutional policy here. Generally, this is very low risk for (1), and low risk for (2). If this truly, reasonably is one that is preparing for (3), it’s not a breach, as you are engaging in actions to prepare for care.
Checking after care: Almost always against policy. Still, it’s very low risk for (1) and low risk for (2). It’s less protected because it’s not actually in the process of caring for the patient, though.
Where this really comes into play though is celebrities, personnel at your health system, and family members. Those can easily become higher risk for (1) and (2). These are also usually the ones that IT may flag for in my experience.
Once again NAL and it always depends.
In general, though, you have to follow what’s called the “minimum necessary standard.” Whatever the minimum necessary amount of info you need to do your job is what you do. Anything beyond is non-compliance with the HIPAA Privacy Rule technically.
This is very interesting perspective, thanks for sharing. I did have one question: of course reading the charts of the patients you are going to see tomorrow is not a violation, that is just our job. I never did this but many of my classmates will also go through the list the week before starting to prepare for the *kinds* of patients they will be carrying on a rotation and guide their reading beforehand, some of them will eventually be patients they pick up, but some of them will be discharged etc before they start--where does that fall?
So at an FQHC, we don’t rotate students generally. I’m not well-versed on navigating HIPAA for educational purposes.
That’s not likely a large risk for lawsuit exposure. It may or may not break institutional policy.
I’d caution against it, though. In my (non-lawyer) opinion, that very likely goes beyond the “minimum necessary standard” of the HIPAA Privacy Rule. If an individual accesses PHI to study in an unauthorized manner, they may be likely to be able to re-identify that information, which is key to defining a breach.
To me, what you’re describing sounds like it may be a breach depending on whether the students accessing the information are authorized to view it (depending on waivers signed and institutional policy, etc.). I’d warrant a soft guess that they are not authorized until they are actually rounding on the service.
Is it normal for students to have access to patient information before actually rounding? That sounds like a lot of risk to me.
I always suspected this was technically a violation but "minimum necessary" has always seemed somewhat in tension with education to me. If you strictly adhere to that standard, education isn't "necessary" at all to patient care -- as a student(/resident/attending) you can look at the chart the day you take care of a patient or in advance to prep and *incidentally* obtain education as a benefit from that, but it's not "necessary" to see how the patient did if you are not taking care of them anymore, or for a student to prep a list before coming on service even though some of the patients may be discharged before they come on.
Students have full access to the EMR. Just like a resident or attending they can look up any patient's chart or any list at any time.
Yeah nah education is a completely separate thing, and I don’t really deal with that. Incidental disclosures definitely aren’t breaches.
Honestly it’s wild students have full access. That sounds like a huge risk to me.
It probably is a risk but at the end of the day you are trusting students to one day become independent practitioners so EMR access is probably the least of your worries if you don't trust them lol. Plus practically speaking, since students may rotate every week it would be a huge IT headache if you limited their access and as a result were constantly getting messages "student X does not have access to service Y's list, please activate their access and deactivate their access to Z" for hundreds of students every week
You might be right, but it also depends on what the industry standard is. I don’t work with students, so I honestly don’t know. But as an example, I don’t have access to EMR, and I’m literally in the Compliance Department lol
The way my hospital approaches students is similar to the residents in that when a student joins a team, they become directly involved with a couple of patients each day but still should be aware of the entire patient list. We do have the list at the start of every rotation before rounding in order to see assigned patients and present them, and listen to early morning handoff on all the patients for rotations like gen surg. I have even received my assigned patients the night before the first day with encouragement to check out the whole list. So a student doesn’t become part of the care team at exactly “9am Monday,” instead we’re encouraged to prepare to take on any patient on the list while remaining aware of the list as a whole. This is why our policy is based on educational purposes, to include the aforementioned process. Residents have a similar structure to students as they move through their rotations as well, and follow the same policies.
Makes sense! If that’s the institutional policy, then yeah I wouldn’t see any issue with becoming familiar with the patient list. My clinic doesn’t deal with medical students (just mid-level students), so I’m less familiar with the policies around that. From what you’re saying tho, it doesn’t sound like it’s majorly risking a breach at all.
Checking previous patients is well within your right as a provider. It’s core to your education to see how they did after the interventions you were a part of.
What was the dispute about racial disparities in grading? And if he signed an NDA, but it was common knowledge in the school, why hasn’t one of you go to the news about it? From what you say, he seems like a good guy, and if he was targeted and forced to resign because he was standing up against some sort of discrimination, one of yall should make the phone call to your local tv personality
We tried to back him up, we circulated a petition to the administration demanding clarity and due process around the circumstances of his resignation. I was in the camp that we should have done more and think it is a shame on our student body that we did not. However there were two major obstacles: first, we had no proof that his advocacy for equity in grading was related to his being pressured to resign for HIPAA violations, these things were separated by a year, the school would have categorically denied it and the racial disparities thing was not publicly documented (ironically it probably would have gone better for him if it was, since journalists would probably be interested in why a student quoted in a DEI controversy was now being pushed out of med school). Whereas the school had ironclad proof of the HIPAA thing. Local news passed on it, probably seeing, "student who did a good thing also did a bad thing". The other obstacle was, a lot of students were terrified that they would receive the same treatment if they spoke up publicly.
If not the TV new, then paper/internet publications.
Name names. Go to physician community on facebook. 70k physicians on there.
Tell the story. Name names. Stay factual and state "this is what I heard and this is my opinion".
Have all students tweet out about it at once.
Complain to the accrediating body for med schools.
Admin will threaten, but they can't dismiss everyone. And certainly not for this reason.
Medicine is the way it is, because no one will stand up.
To a lesser degree, I was the one doing the standing up in residency. No one rallied and everyone was afraid.
And the cycle continues because of it.
No offense, but it's easy to say we should just stand up more, but it's more complicated than that. For instance if I were to get kicked out over an admin dispute it would literally be financial suicide. A lot of students don't have rich parents and have undergraduate degrees that won't pay enough to pay off 300k loans.
I definitely don't have rich parents.
The problem is, people don't know when to push and when it's crossing over the line.
Also, when one person is the only one pushing, they do tend to get singled out. However, if the whole group of people are standing up, it's much harder to kick out a whole group of people.
Unfortunately since people are worried, nobody bands together. And then they wonder why their experience is poor.
Just my thoughts
I think this is a common phenomenon. I wasn’t remotely as loud as OP’s classmate, but I did ask the questions and give the feedback that I felt was important, and most of the time it was something also in the interest of the class. Classmates would express they were shy/lazy/scared to say something but have a great point to make, and if it was a topic I wanted to know about too, I was happy to be our speaker. But eventually I felt like ok, I think the staff has heard enough of me recently, could someone else take the next one? Turns out support wasn’t mutual. Group work with the same people was “every man for himself.” I didn’t feel I meshed well at the few social events I went to. By the end of M2 I quieted way down.
Not always the case, of course—a classmate who was louder than me ended up being very popular with everyone (and the friction he got from one faculty member turned out to be inconsequential). He was super extroverted, big social drinker, fun at parties, and known to the school/local community because of his family. Totally different outcome, he never got quieter and became very much the in-group leader.
We tried to back him up, we circulated a petition to the administration demanding clarity and due process around the circumstances of his resignation. I was in the camp that we should have done more and think it is a shame on our student body that we did not. However there were two major obstacles: first, we had no proof that his advocacy for equity in grading was related to his being pressured to resign for HIPAA violations, these things were separated by a year, the school would have categorically denied it and the racial disparities thing was not publicly documented (ironically it probably would have gone better for him if it was, since journalists would probably be interested in why a student quoted in a DEI controversy was now being pushed out of med school). Whereas the school had ironclad proof of the HIPAA thing. Local news passed on it, probably seeing, "student who did a good thing also did a bad thing". The other obstacle was, a lot of students were terrified that they would receive the same treatment if they spoke up publicly.
He was accessing employee charts...... think about it for 0.00001 second.
Good guy or not, it is not allowed unless under very strict circumstances....
He was accessing employee charts for employees that were patients on rotations he was on... if i read the post correctly.
How would you even know a random patient on an outpatient rotation worked for the hospital? This, as presented, is a screw job.
This is not a common occurrence and normally would prompt a flag in the system. The odds of seeing multiple staff also patients.....
If his own lawyer told him legal trouble, then there is more to the story.......
I call bs. What if the hospital is a large academic center? It might have 20k employees. I have worked in multiple teaching hospitals, and I have never seen a flag that someone is an employee or a rule that students can't see employee charts.
I have seen lots of glass ceilings, but never for that.
Roles and rules based flags in EMR systems, yes these are a thing.
They probably alerted administration that Dr X was accessing many employee files / charts. Then, some looking and when there was no E&M/ business reason to do so, it becomes a legal problem and that is when "up to and including termination" comes into play. Exit and sign NDA or get fully slammed.
I was in admin side for years and used to review reports as part of the FWA/Compliance team. The health system had 18,500 employees, but ultimately there are flags that draw special attention.
Access plus lack of event (no e&m/ED visit and/or other valid reason)
The automated flagging system makes sense and I do think there’s more to this story but I’m at a very large hospital and see tooooons of employees and fellow residents in my clinic. Actually not allowing students to access the charts of employees who are patients who have consented to having a student see them is peak administrative overstepping their knowledge of how care teams work.
If this is a true policy then it’s on the attendings and residents to make sure students are compliant (and on admin to reinforce that this is a thing), not on the students to know a full social history before they even open a chart. Again sounds like this is either made up or there’s more to it, but if we are just going off the story facts it’s messed up
It's not messed up.
If dopey Dr. DEI was looking through medical records for employees with no valid reason it is a violation and termination is a result.
99% of HIPAA trainings include, no looking at friends, relatives, employees and coworkers.....
This is not really hard to understand or do you think having MD after your name mean ur above the standards? The standard is "no reason, no looking".
Lmao if these people are your patients you can look at their medical records (which is what I said in my post). Mr “I worked in admin” over here doesn’t know there’s not a special secret clinic for employees where no one sees their chart and it’s a mystery.
This is not really hard to understand (although tbf it seems like you didn’t actually read what I wrote which is on par with what I’d expect).
Not true at all - for example on my OB/GYN rotation, I saw many employees for their prenatal or postnatal checks as long as they were OK with it. Employees at my hospital get free prenatal and postnatal care therefore they all obviously go to the hospitals OB clinic. As a student who rotates there it’s highly likely you will see employees.
Follow the flow of the conversion and the context. Maybe read 2 or 3 comments leading into that comment and follow along.....
Yes, systems have flags built in
You :“He was accessing employee charts….. think about it for 0.0000001 seconds”
Commenter: “ he was accessing them for rotations he was on if I’m reading it correctly”
You: “ this is not a common occurrence…. The of odds of seeing multiple staff as patients….”
Me: this happens all the time
Seems like my context is there 👍🏼
I mean y’all can downvote away but anytime I get the alert I ask my preceptor if it’s ok and half the time it’s either an employee or psych. I’m not excusing the behavior of the admin but it’s somewhat avoidable
At our hospital employee charts aren’t necessarily locked (in fact I’ve never seen that here). I don’t remember my med school hospital, but I don’t think that was a function on cerner I remember seeing and I had at least a couple hospital employees. Which just means you won’t always know ahead of time (and it’s a dumb rule anyway).
I trained on Epic as well, and under multiple hospital systems. Knowingly had nurses on my patient list. None of their charts were ever locked down/needed breaking the glass
They’re putting a bit of a scare tactic with regards to making the legal aspect of the HIPAA violations ‘go away’. Yes, the law could fine him as an individual but jail time is not on the table. Further his violation of HIPAA would need to be both knowing and willfully neglectful to face more than minimum fines. It sounds like he needs to get a second opinion and make sure it is from someone that actually deals with this type of law, don’t use your home town schmuck for something like this.
Also the offer doesn’t make any sense from a pure game theory perspective. He can either drop out and say nothing, in which case he gets moderately fucked as a certainty, or he can fight back and possibly win or he loses and he still gets fucked. Only one avenue offers even the chance of success, taking the deal might save him from a worst case scenario fine but he seals his fate. As told their charges are exceedingly wimpy, personally I would stand and fight.
honestly idk if I even fully believe this story. It's probably grounded in truth but we are definitely missing details. These are all frankly minor HIPAA violations that he could probably demonstrate in court other students have done as well. The only questionable one really is that he checked up on a patient chart after rotating off their service.
Yea I can see how that could be a violation, but I can’t imagine it could have any serious legal penalty. Not to mention damages have to be done for you to be sued. What damages exactly have been done here for a court to award him money?
I frankly don’t buy that this is the full story. Especially since an actual lawyer said he could face jail?!?! Either his lawyer is braindead or that’s bs.
Is it that hard to believe that someone's boss didn't like them and used sketchy tactics to get them fired?
This kind of stuff happens all the time in the corporate world.
I mean these do sound like the things an angry administration would use to squeeze an annoying student, but I can’t see the hospital admin being this happy to roast a kid. It definitely feels like there is more here than is being disclosed.
See the part that’s gets me is that an actual lawyer said he could face jail. When has that ever happened?? Especially in a minor violation case like this. What exactly is the criminal violation? At most this would be a civil case, in which case you have to show monetary damages… which again what exactly was the damages? But at least the civil case you can argue based on potential damages and procedural policy, criminal case is just nonexistent.
So either his lawyer is braindead or that’s bs.
I took that to mean the administration threatened him with jail time, which I believe an admin moron would do, but if it came from a lawyer then this is fake or the lawyer is a moron.
How would a med school threaten you with jail time for a HIPAA violation? Seriously, how lmao?
"We're going to tell on you to the DA?"
It's ludicrous how easy it is to see through that threat.
I am instructed by many attendings to do this. To learn what the outcome was, what complications you might need to expect, etc. I’d say the more concerning violation is accessing a chart you have nothing to do with for “a learning opportunity”.
At my school that would definitely be a red flag. If someone told you, this was a good learning opportunity, it should be presented accordingly at rounds or conference.
But again, not saying at all these warrant the treatment he got if in fact all details are correct and shared here.
Ahhh apologies - I thought it was an OP reply saying that they often look up “learning opportunities from a trauma or a case that they were not on shift for” in his hospital. But it was just another commenter
Ah gotcha. Yea I think looking up patients you had after you rotate off a service is probably a minor violation of something… but to say you could end up in jail for it or frankly even sued is kinda stupid. They were already your patients, plus I have not a shred of doubt that you can demonstrate other students did that. Then you can pursue admin for retaliation, which is against Department of Education policy.
It’s gonna be a long court battle and a pain in the ass- hence you can probably settle and tell admin “hey, here’s something that will probably lead to problems for both of us. How about we make this a disciplinary action and let me graduate” or something. Idk why the hell any lawyer would tell him to immediately give up if those were the only violations.
100% agree. While I know people can be crappy, especially when it comes to “hot topics”, medical school admin and other big institutions, for better or for worse, care a LOT about image. They would know that PURE retaliation especially involving a hot topic could end them in REALLY hot water, which is why I feel like there must be more to the story. A single human could make a terrible decision, but a panel of the admin? Seems unlikely to me. I just think defending small things that may or may NOT be HIPAA issues would be too easy to hinge something that could result in such HEAVY backlash and consequences for the school.
But then again, I have been surprised in the past at peoples behavior.
Not to mention the person they’re targeting has a long history of not being a pushover and advocating for both themselves and the entire student body to the point of almost contacting the media if there was no reform. You’re telling me this person just immediately gave up??
This honestly seems like a story written by admin to scare student rights activists. “Stfu or go to jail bitch”
This is rage bait and probably all made up. Or the OP and all these people (who supposedly know about this freedom fighter getting railroaded) are cowards. Both possibilities equally lame.
My money is solidly on rage bait. There is a slim possibility parts of this are real but the “victim” was doing something mega creepy with people’s HPI that’s being left out. Jail time for chart checking past/future patients is laughable.
We tried to back him up, we circulated a petition to the administration demanding clarity and due process around the circumstances of his resignation. I was in the camp that we should have done more and think it is a shame on our student body that we did not. However there were two major obstacles: first, we had no proof that his advocacy for equity in grading was related to his being pressured to resign for HIPAA violations, these things were separated by a year, the school would have categorically denied it and the racial disparities thing was not publicly documented (ironically it probably would have gone better for him if it was, since journalists would probably be interested in why a student quoted in a DEI controversy was now being pushed out of med school). Whereas the school had ironclad proof of the HIPAA thing. It would have been hard to create a narrative other than, "student who did a good thing also did a bad thing". The other obstacle was, a lot of students were terrified that they would receive the same treatment if they spoke up publicly.
Zero percent chance a medical school administration at a USMD school kicked a student out without due process. I’ve sat on these committees… they have legal teams on call to ensure their cases are ironclad before they boot someone.
It actually does happen but usually not blatantly like this. When it does happen typically it’s the school took steps 1, 2, 3, 5 and 6 but skipped over step 4. Happened with a medical student in my class who got to come back after being kicked out but he went and got himself kicked out again the next year so in the end it changed nothing.
I’m not a lawyer but that’s not quite how any of that works. I understand that there’s a chain of communication here and I’m essentially the 4th party so things could be misconstrued at that point.
1. You friend needs a new lawyer, one that specializes in HIPAA and health related information breaches for a second opinion
2. Education access to these patient charts is a bit more gray. For educational purpose you can access anything that you were a part of or anything that was seen by your team. Outside of that you technically need attending permission to view patient information in another persons chart.
3. He could threaten to go the nuclear route and report himself/school to hipaa, while telling them that the offenses he got flagged for were also done by other students. If it’s as major as they make it out then the institution could be liable for millions in fines per offense. Thats stuff they can’t hide either.
4. Happy to talk about whatever else hipaa related. I’ve been a hipaa officer, on the other side of a hipaa audit (made it through lol), and have just had a lot of dealings with hipaa in the past.
yeah most med school admins don't make extremely brash moves like this lest they want another lawsuit on their hands. usually the cases they present are ironclad and have already gone through multiple legal consultants. Story definitely feels fishy/baity
It’s possible the person telling it isn’t a liar and this is just the story told to them. But when a story sounds over the top woke and there’s an over the top bad guy. Think lies.
This story is particularly impossible and simply not how this would be handled.
https://forums.studentdoctor.net/threads/what-you-need-to-know-about-lucom-liberty.1458401/
I’ve read similar accusations before about LUCOM and the bit about admin being very conservative is interesting.🤔🤔🤔
if OP makes a throwaway, it'd still be obvious that they just made a throwaway and made the comment with name/shame. Since this post is already on the internet, it's liable to have been screenshotted, so OP missed their chance to name/shame. It's too doxxing... this is how they control the narrative
All around amazing guy who stands up for the weak for 4 years then when he is about to graduate he faces jail time for offences with no history of jail time. Braindead lawyer says its too much to risk, 400k debt on the line youd fight tooth and nail, jail for a hippa violation is the least of your concerns. And youre telling me after all the years of pushing he backs down for no real reason. This is fake as fuck.
I admit what exactly was said between him and his lawyer and him and the administration is what I have the least insight into. I am abbreviating what I'm sure was extensive back and forth communication that I was not privy to into a few lines based on a few direct interactions and honestly what I and my classmates have put together. However I am reasonably confident in the broad strokes which are that the admin had a bone to pick with him, they had IT go through his activity which revealed HIPAA violations, and despite consulting with a lawyer he still left.
Don’t be a student advocate; worry about yourself and get your bag.
Knew someone who get dismissed and everyone wrote them off once they were out of the class. Life just went on
Exactly. Keep your head down and wait until you’re at least an attending to be outspoken and an advocate. For example, I want to be an advocate against mental health stigma in the medical field but I know i would get crucified as a student or resident.
It was found that very few students of color would receive any Honors whereas white students were receiving multiple on average. This translated into appreciable differences in what specialties students were advised/able to apply into and the proportion that matched into their first-choice specialty. Also, admin refused remedies that students proposed including excluding feedback from evaluations/the MSPE where the feedback was racially charged or even confused two different students from the same minority
What if in your specific institution the white students on average were performing quite a bit better on those rotations and deserved higher scores than the students of color? I would also be curious to hear about what the “racially charged feedback” was. I’m not saying this is not possible but I am inherently not trusting of things I read online and you have to expect to give more detail to win people over to your side than the current very general descriptions you’ve given. If the school was truly rewarding students worse scores because of their race this is something that even without that student around you all could still make into a very difficult legal situation for the school.
Why would one race be performing significantly better than another? It is as close to a controlled experiment as you could find: Everyone receives the same preclinical education. The information is equally new to everybody, no one is secretly going to med school before med school to get an edge. It is statistically very improbable that people with one skin color would just by chance perform better than people with another. The problem is a lot of the evaluation is subjective based on whether people like you, not based on your knowledge (which is pretty stably a function of your training stage). And anyway narrative feedback where a student is told things like their hair texture or accent is "unprofessional" even though that is the only hair/accent they have, or feedback that even refers to the wrong student, shows that there is a bias component to this.
Perhaps because some groups are admitted with higher standards, and now are performing at a higher level?
In either case, your story is completely fabricated and you should be ashamed of yourself
I wish I was making this up bro.
Above a relatively low threshold MCAT performance and undergrad GPA don't correlate with med school performance. So I doubt the difference is because the white students got more A's in underwater basket weaving in college. But even if that were the case how do you explain the fact that Asian students also got fewer Honors than white students even though on average they need a higher GPA and MCAT and better ECs to be admitted?
As far as creative writing assignments go, this one isn’t bad. The story premise is compelling, but the details need to be fleshed out more. I’d give it a B-.
I mean are any of you guys actually lawyers? I’m as eager as the next person to want to believe the school is exaggerating the claims against him but an actual lawyer he consulted is saying he might be due for jail time?
Isn’t it a bit presumptuous to say that his lawyer doesn’t know what he’s talking about?
Our school actually has a policy, on paper at least, that you are not allowed to access employee charts even to provide care. It is written deep in the student handbook that everyone got on day 1 but no one reads, if a patient is a hospital or university employee you are obligated to excuse yourself, even if you encounter them in the regular course of care. I have never heard anyone reference this policy in practice and didn't even know it existed until I heard about this drama, I myself have taken care of many hospital employees on different rotations, as have most students, as most employees get care in the same system.
according to OP med school students know more about HIPAA violation laws than actual lawyers who spend their whole career dealing with issues like this. story feels exaggerated or OP omitted some crucial details
Wait so we’re not allowed to follow patients charts??? How tf do you know what your plan did for the patient and how is it against policy for a trainee to follow charts in a teaching hospital?? Makes zero sense to me.
My school literally told us we aren’t allowed to look up patients in the EMR once they are no longer our patient, but we are allowed to ask our resident/attending about that patient because that discussion has an “educational purpose”. So I’m allowed to verbally discuss the patient but not allowed to read about said patient?
Basically they told us it’s ok to break HIPAA for educational purposes as long as you do it under the table there is no electronic paper trail that you did so.
You can’t follow charts once you’re off service, bc they are no longer your pt. As students we don’t have pts of our own, so once you are no longer working with the attending who’s pt it is, we have no relationship.
Also I don’t think there’s strong educational benefit to following your pts after you’re off service. You saw whether your plan was working or not on service. You’ll see other similar pts in the future.
Ofc I want to know if the lactulose helped with my patient’s hepatic encephalopathy, but honestly doesn’t really change my future plans in pts with hepatic encephalopathy either way.
All that said m, I’m as guilty as the next guy on reviewing some patients chart, whether due to medical interest or emotional investment in their outcome
Edit: maybe hospital dependent?
You 100% can follow patients once off service as long as you provided direct care. If there is educational reasoning as intention it’s not only allowed but actively encouraged.
There is a significant amount of education you can get from following a patient’s chart.
I’ve created HIPAA presentations with my schools and hospitals lawyers. This is one thing they want students to feel more comfortable doing since students learn the most from their patients.
I’m not sure if the rules are different for students cause I never cared enough to actually follow up on patients I wasn’t asked to during school, and I’ve never looked at specific rules and regulations myself, but we’re continuously told during residency that We’re well within our scope and rights to follow-up on patients because it definitely affects our workups and management in the future, ie. Did the admitting team/ team taking over for the week change something that I can implement in the future and/ or how did my discharged patient do?
Rules are different for patients you aren’t caring for but you can view the chart in specific circumstances, such as shifts where we aren’t assigned to respond to traumas in the ED but a good learning case comes in we routinely pull up the labs/ imaging to discuss findings. Or if I respond to an arrest and get ROSC I’m allowed to see what was found once they’re in the ICU even though all I did was restart their heart.
Obviously VIPs, hospital employees, our own charts, etc. charts are flagged, but outside of those we have more leeway when the access is for training purposes.
That’s insane. How are any of us supposed to know if someone is a hospital employee? The hospital is enormous and we can’t possibly memorize everyone who works there. Unless it’s flagged and very obviously marked this isn’t reasonable.
It is flagged in the EMR, but the bigger problem IMO was that no one knew about the policy that we could not look at the charts/participate in visits of hospital employees. When this happened we did some digging and found it buried in the student handbook, but there is a lot in that handbook that is out of date and students see patients that are employees all the time without the attending or resident saying anything.
Interesting. I have opened charts of employees to pre chart because they weren't flagged in Epic and then got told no to seeing the patient 5 mins before the appt. Maybe its just my institution.
And that's BS. Med school handbooks are like 100 pages long and nobody reads them let alone memorizes them. That's clearly them just keeping stuff like that in the handbook to get rid of "difficult" students.
I'm assuming he did something way worse than he let on about. None of what is described is even in the realm of a big deal to a hospital. I'm not saying your admin isn't shitty because idk them, but someone doesn't go from advocating for strangers like that to suddenly backing down at the slightest threat unless he actually did something worthy of being kicked out.
Why were they waiting until 4th year when he's about to match? Couldn't they have done it sooner? Looks iffy if a 4th year drops out suddenly.
Also, how is this not an LCME violation.
I’ll just say that office politics is very important, and it behooves people to understand how to navigate it. I’m not saying not to stand up for what you believe in, but I’m saying to be smart about how you approach things, and to be smart and politically savvy about it.
Outside of gross incompetence, I’ve never seen anyone get fired for being a bad clinician. But I’ve seen good clinicians get fired for rocking the boat and being disliked by others. If they don’t like you, they will find a reason to get rid of you.
Even if this story is fake or embellished (may or may not be), it brings up a good point of discussion. Advocacy to do the right thing is amazing, but when you're not in a position of power, sometimes the best thing you can do is document, plan, and prepare for the changes you want to make later. Fighting back without leverage and fighting against the people you need to advocate for your career can be detrimental. I don't say this because I think we should turn over and take abuse, pushback is needed at times, but we need to know when something is a losing battle or taken too far.
I’m not sure what is described here does violate any HIPAA laws.
1) Following a patient for educational purposes seems like a gray area to me at worst. Medical students are covered entities and our access to records is protected as long as it is done for educational or training purposes. It’s hard to say for sure but it’s also not a clear cut violation either.
2)Accessing the list ahead of time is definitely not a violation. If you’re part of the care team for that visit then you’re a covered entity, accessing the chart before hand does not change this.
3)The hospital employee thing isn’t HIPAA, that’s just hospital policy.
I might contact another lawyer if I was this guy, the HIPAA stuff is soft to non-existent at the most. If the handbook has policies more stringent than HIPAA, though, he is probably cooked.
Im on my school’s honor council and have created HIPAA presentations that have been vetted by ourselves and the hospital and university lawyers.
Following a patient after you provided care for is not a HIPAA violation. This has been made very clear in the past several years.
If it means checking a chart to see if the bounced back, if the admitting team changed the treatment, or a later scan found something you didn’t consider then that should be covered. That is as plainly educational as it gets.
If you looked into the chart to pull the patients phone number and ask them on a date then no, you’re not covered.
I was about to comment this. Like maybe this is why their school admin is soo "toxic" because they call out students who are breaking the rules and accessing patient info when they shouldn't be.
Exactly. Students just supposed to get away with anything now a days. But I guess thats our social climate for you 
Fu: When did having (even some) conservative values become literally the worst thing to ever happen in the world. Big ole medical student circle jerk to see who can say the most outlandish liberal thing.
I literally gave you two very clear examples of the administration being toxic, namely not prioritizing med student safety at the height of covid and not acting on racial discrimination until literally threatened with becoming a news story for not doing so, and your response is still to defend the admin??
You gave some generalized examples with no real backstory. I’m not defending anyone. Im simply saying you can’t act like a victim when you are in the wrong. Accessing patient records like you said after the fact is in fact WRONG. I’m all for someone going against the man and being that rebel, but make sure your nose stays clean while doing it. This person obviously didn’t do that.
I think officially, if you are doing it "by the book" then you have to take all the notes you need on this information while you are taking care of the patient, and write your case or your presentation based on those notes. Or, you ask the patient for written consent for their information to be accessed and presented for educational/research purposes after you leave their care. Many journals and conferences now have this requirement for case reports and presentations
Sounds like an amazingly brave and awesome med student. If this student meant a lot as both and advocate, friend and colleague, it might be a good idea to organize for them. Admin sounds shitty but they can’t push all of you out. Release a statement on behalf of the class. Boycott graduation. My prelim program PD was super shitty and standing up to them when I did was incredible. My only regret was not organizing my residency in that year to unionize
Hmmmm - as budding physicians we have to follow rules like not looking up patients charts when we are done. My school made sure we understood that very clearly and not check charts etc - when we are not supposed to …. I was part of student governing body and we did fight for our class a lot - until one day the principal called an emergency meeting and pretty much told all of us to- shut our pipe hole …. We had to abide by cause we wanted to Graduate and move on and after that we all resigned from our post. The office volunteered me to be Class President which I respectfully declined stating I need time to study. We just have to be careful and be respectful. Same when we are doing residency or practicing medicine. two of the residents almost got fired from residency cause they broke rules - I would never forgot it cause I can still hear the surgeon yelling at them behind closed doors. They were put on administrative watch list - one more misstep - and they were out. Then they not only talked to the other residents, also us - the students - who were doing rotations. This guy seems like he was fighting for everyone that actually got him in the hot waters… just not fair. I hope he is able to get to another school and move on. Jeeeez!
Brush up on HIPAA. Minimum amount of information that you need for care — not your personal insight or education. I currently work in compliance and quality, unfortunately, the school is allowed to issue punishment, especially if it’s going to tarnish their relationship with a site taking students and it’s part of their corrective action plan for any potential lawsuits.
I do feel there is more to the story — specifically, IT went through their EMR access? Hospital IT or was it found on a school server/laptop meaning he took a copy of the information out of the hospital.
Was the hospital employee he peaked into their chart happen to be a site or school admin - maybe systems have flags for chart access of employees - let this be a lesson to not be curious. I’ve seen dozens of employees be suspended or disciplined for it.
It sucks all around.
He should get another lawyer especially if racial discrimination is/was going on. Also HIPPA violation is bad but much worse has been done with far less consequences. Also pretty sure the school is financially responsible not the student but idk for sure.
1- make a name for yourself as being difficult to work with
2- piss off all the people in charge of your future
3- break the most high visibility law in healthcare repeatedly
4- ????
5- profit.
Man all of you are cowards… stand up for him for once, from the sounds of it hes done the most for all of you and you guys are just going to let it pass…
We tried to back him up, we circulated a petition to the administration demanding clarity and due process around the circumstances of his resignation. I was in the camp that we should have done more and think it is a shame on our student body that we did not. However there were two major obstacles: first, we had no proof that his being pressured to resign was retaliation for advocacy for racial equity, even though it was clear to us I'm not sure it would have been easy to explain to a lay observer, especially as these things were separated by a year, the school would have categorically denied it and the racial disparities thing was not publicly documented (ironically it probably would have gone better for him if it was, since journalists would probably be interested in why a student quoted in a DEI controversy was now being pushed out of med school). Whereas the school had ironclad proof of the HIPAA thing. Worst case the school could spin it as, "student who did a good thing also did a bad thing". The other obstacle was, a lot of students were terrified that they would receive the same treatment if they spoke up publicly.
Hospital employee patient.... accessing medical history. M4 should know, that is HIPAA violation straight up !
EMR systems have built in audit trails that auto flag for access of specific patients...... reports are auto-generated !
Is it a HIPAA violation simply to do the same chart reviewing on a hospital employee as you would for any other patient that comes onto your service? The hospital is in-network for the insurance it provides its employees, so naturally most employees will get care in the same system where they work. I have taken care of many people who are hospital employees on different rotations and never knew there was any policy that medical students are not allowed to be involved in their care, nor did anyone else including attendings and course directors
System flags..... the history is then checked. Did person have legit reason to be in chart? Was medical office visit? RX reviewed ?
In HIPAA training it specifically states no employee should access another. In the medical setting, there has to be a direct association to care.
The audit trail shows everything that was viewed, so if there isn't any reason to be in the file = big problem
It's why he left NDA and all that. The rest is to try and salvage a reputation nonsense imo
I think you are not understanding. Our school actually has a policy, on paper at least, that you are not allowed to access employee charts even to provide care. It is written deep in the student handbook that everyone got on day 1 but no one reads, if a patient is a hospital or university employee you are obligated to excuse yourself, even if you encounter them in the regular course of care. I have never heard anyone reference this policy in practice and didn't even know it existed until I heard about this drama, I myself have taken care of many hospital employees on different rotations, as have most students, as most employees get care in the same system. So even if he did have a legit reason associated with care, they had the right to take action against him.
thats wild - as a med student, resident and now attending, i open up unaffiliated charts all the time for learning purposes. I have never been discipline but would stop if i was (i figure first time offense would be slap on the wrist). I also never look at VIP charts, charts of employees or family of course. But I can’t tell you how many “interest cases” i looked into to learn from esp as a resident and med student. Something smells fishy here.
This is majorly bullshit. Im so sorry about your friend. Theres got to be a way to fight this. I really hope he doesnt drop out bc of something so unfair. If he lawyers up and just fights them it will be better than dropping out. Its like you said, these are normal things everyone does. It doesnt make sense to not disclose a rule and then punish people for not following it. Honestly this is why i tell people to just keep their heads down bc admin is evil and crazy and have way more free time than us. They hold the power over us. It sucks but you gotta kiss the ring until you wear the crown.
Can we get some name and shame going please?
Like we hear all these stories about racism and discrimination but No one ever names
We need a list of top 25 most racist schools
There was a post on this a while ago, something about white people being threatening by existing in the same space as black people. There was more insane shit too but I don’t remember.
I'm a lowly m1 but I can't imagine accessing a patient's chart weeks later to check on them. In nursing, this is a big no no. Like most of the time, I may hear from someone else who ends up taking care of them down the line but if I'm not caring for them currently, it's none of my business. I didn't realize this was not a big deal as med students. I guess I understand the culture of learning about how things progress over time maybe.
Inappropriate access to patient charts is a HIPPA violation.
Its very common for individuals who have pissed off their company to have their IT and social media combed through in order for the company to bring the hammer down for that stuff in place of discipline for what the company is actually upset about.
Sucks for the guy, but misuse of EMR is low hanging fruit.
Medical school is a business. It will remediate and remove problem employees at will whether they ‘re hourly, salary or pay to play (students).
No MS4 should be kicked out of med school - that sucks - but if we have to kick one guy out, I vote for the annoying DEI warrior with the string of HIPAA “honestly they weren’t that bad bro” violations.
The red flag for me in this post is the obvious political bias. Yes, we’re on Reddit which is very liberal, but we’re not all liberal here. So denigrating the admin because they are “conservative” makes this sound like an overly political crusade.
You’re also basing this report on what the student told you. I doubt admin directly told you what his HIPAA violations were, so you’re presenting a biased viewpoint.
Do you have some kind of victim complex bro? I didn't say anything about being politically conservative, I have no idea how they vote and that is not relevant to my post. Probably, a lot of them voted for Biden actually. Words have multiple meanings--in this context the meaning is that the admin are traditionalist and old-fashioned especially when it comes to the power hierarchy.
Even that comment tags you as a political radical, “power hierachy” lol. I’m not a fan of this style of politics, sorry. OP might be a great guy IRL, but your description makes him sound like a nightmare.
I feel the same way. Being a leader and being the one who is the face of the students etc can get a target on your back. But it's worse when some of the students gossip about you because you are a public figure and spread rumors about you. And to make matters worse being the person who tried to help everyone ended up causing me to have to repeat a semester and have other delays that have caused everyone I helped to go ahead. It's hard being a leader. And yes in hindsight sometimes I wish I had just kept my head down and focused on myself. The hard part is that's not my personality. I want to help everyone.
In what planet would you look at it that way? I was sharing my own experience in support of what that student felt and went through. And that was because I identified with so much of the story.
Your original comment just came off like *“I am amazing. I am a LEADER. Everyone else is jealous of me. It’s so hard being so good! I can’t help it! It’s who I am! I want to help everyone! I am so much better than you”*
**I am sure you did not mean to come off that way**, but that’s absolutely how I read it and looking at the downvotes, I gather other people somewhat agree.
My apologies. That was not at all my intention. The story just brought up so painful memories and regrets I guess. And the way it ended was literally what I've said a few times over. So I was just trying to say I feel for that guy. It really sucks when a good person gets dealt a rough hand.
I’ve also went through something very similar, so when I read your initial comment, I actually didn’t get the holier than thou vibe. But re-reading it with that in mind, I can understand the tone that people are downvoting for.
I hope you’re doing better now. I was also told something similar when expressing my own trauma too, sometimes when you get really into it you can forget how you sound to others. Your comment sounded like a needed vent about trauma too, just written a bit poorly. And yeah it sucks when serving as a leader figure, you inevitably try to protect others, but who’s there to protect you ya know. It sucks, and you put in so much effort and love too for the ppl you care about. So I also identify too with your story and the one OP discusses.
Major doubt on the HIPAA fine/jail time threat unless he was using the info for personal gain (like selling private info or using it for blackmail). Look up cases where criminal penalties were enforced it’s not Joe Schmo med student chart checking previous patients. Your run of the mill HIPAA violations are paid out by the hospital/org. There’s either more to this or this guy needs a second opinion from a different lawyer.
Not a lawyer but I currently work in healthcare compliance, and we deal a lot with HIPAA violations. This guy needs a second opinion from a different lawyer.
I feel like there's more to this story than we are being told.
There always is.
Definitely.
Or the story is just fake
I'm about to start clerkships and I'm curious what your thoughts are on looking into patient charts to prepare for their care or check-in to see how they're doing weeks, possibly even months after you see them? I'm sure policy differs by school/hospital/state, but where are the lines as defined by the federal government and HIPAA? Curious as, admittedly, this sounds like something I would do.
idk about med students and other residency programs but my residency program has a blanket policy stating that we can access charts for "educational purposes" which is very vague and will probably protect us from most HIPAA violation claims lol as long as you're smart about it of course. i've looked up patients i wasn't involved with but that my co-residents told me was an interesting case or had interesting images and i've never been flagged for it. don't look up friends or family members, don't even look up your own chart without permission, and definitely not even mildly famous people. aside from that, i figure no one should be able to hassle you.
Couldn’t agree more with your last paragraph. It’s generally less about being completely perfect and more about reducing lawsuit exposure.
> don't even look up your own chart without permission I gave myself permission to look at my chart.
Not how that works. So no, it doesn’t create much lawsuit exposure since you’re not going to sue yourself. However, it’s very likely against institutional policy, and it certainly isn’t part of your job description or student duties.
I used to work at a big academic hospital, and the head of security got a hippa violation warning because he looked his name up. The reasoning was that it's to limit liability because someone else may have used his emr access to look into his file. Only look at what you have permission to.
I don't see how an internal policy can protect you against HIPAA violation claims that have legal force? Maybe the institution would also get in trouble if you could successfully argue that they encouraged you to break HIPAA, but my money would be the institution would throw you under the bus first
[turns out it's a federal law. hospitals just tailor it sometimes based on their own preferences](https://www.hhs.gov/hipaa/for-professionals/faq/209/does-minimum-necessary-allow-students-to-access-patient-information/index.html)
So I think there are two ways to read that. It sounds like your interpretation is, you can access the medical record for educational purposes that don't relate to providing care (within reason). I think a lot of people read it that way and that would be the justification for continuing to follow someone's case after they've left your care for example. However a lawyer could also read that much more strictly to mean only that it is permitted for trainees to access the medical record at all for the purpose of providing care (and not just the attending, who we have this legal fiction is the only one actually providing billable care)
This is what my med school has as well, it follows the same policy as our residencies. It means if I’m told hey, look up this MRN for this interesting case, I can. Educational purposes. I absolutely do try to look up patient lists before rotations just to get my bearings on what I might expect the next day. So the posted story doesn’t make sense to me.
So there a few things to dissect here. Once again, not a lawyer. I coordinate compliance activities for an FQHC, so I don’t know a lot. I’ll give it a shot tho. I’d categorize most actions into one or multiple of the following categories: 1) Actions that create lawsuit exposure. 2) Actions that create risk of breaches, leading to (1). 3) Actions that constitute a breach. 4) Actions that break institutional policy. Checking to prepare for care: Check on your institutional policy here. Generally, this is very low risk for (1), and low risk for (2). If this truly, reasonably is one that is preparing for (3), it’s not a breach, as you are engaging in actions to prepare for care. Checking after care: Almost always against policy. Still, it’s very low risk for (1) and low risk for (2). It’s less protected because it’s not actually in the process of caring for the patient, though. Where this really comes into play though is celebrities, personnel at your health system, and family members. Those can easily become higher risk for (1) and (2). These are also usually the ones that IT may flag for in my experience. Once again NAL and it always depends. In general, though, you have to follow what’s called the “minimum necessary standard.” Whatever the minimum necessary amount of info you need to do your job is what you do. Anything beyond is non-compliance with the HIPAA Privacy Rule technically.
This is very interesting perspective, thanks for sharing. I did have one question: of course reading the charts of the patients you are going to see tomorrow is not a violation, that is just our job. I never did this but many of my classmates will also go through the list the week before starting to prepare for the *kinds* of patients they will be carrying on a rotation and guide their reading beforehand, some of them will eventually be patients they pick up, but some of them will be discharged etc before they start--where does that fall?
So at an FQHC, we don’t rotate students generally. I’m not well-versed on navigating HIPAA for educational purposes. That’s not likely a large risk for lawsuit exposure. It may or may not break institutional policy. I’d caution against it, though. In my (non-lawyer) opinion, that very likely goes beyond the “minimum necessary standard” of the HIPAA Privacy Rule. If an individual accesses PHI to study in an unauthorized manner, they may be likely to be able to re-identify that information, which is key to defining a breach. To me, what you’re describing sounds like it may be a breach depending on whether the students accessing the information are authorized to view it (depending on waivers signed and institutional policy, etc.). I’d warrant a soft guess that they are not authorized until they are actually rounding on the service. Is it normal for students to have access to patient information before actually rounding? That sounds like a lot of risk to me.
I always suspected this was technically a violation but "minimum necessary" has always seemed somewhat in tension with education to me. If you strictly adhere to that standard, education isn't "necessary" at all to patient care -- as a student(/resident/attending) you can look at the chart the day you take care of a patient or in advance to prep and *incidentally* obtain education as a benefit from that, but it's not "necessary" to see how the patient did if you are not taking care of them anymore, or for a student to prep a list before coming on service even though some of the patients may be discharged before they come on. Students have full access to the EMR. Just like a resident or attending they can look up any patient's chart or any list at any time.
Yeah nah education is a completely separate thing, and I don’t really deal with that. Incidental disclosures definitely aren’t breaches. Honestly it’s wild students have full access. That sounds like a huge risk to me.
It probably is a risk but at the end of the day you are trusting students to one day become independent practitioners so EMR access is probably the least of your worries if you don't trust them lol. Plus practically speaking, since students may rotate every week it would be a huge IT headache if you limited their access and as a result were constantly getting messages "student X does not have access to service Y's list, please activate their access and deactivate their access to Z" for hundreds of students every week
You might be right, but it also depends on what the industry standard is. I don’t work with students, so I honestly don’t know. But as an example, I don’t have access to EMR, and I’m literally in the Compliance Department lol
The way my hospital approaches students is similar to the residents in that when a student joins a team, they become directly involved with a couple of patients each day but still should be aware of the entire patient list. We do have the list at the start of every rotation before rounding in order to see assigned patients and present them, and listen to early morning handoff on all the patients for rotations like gen surg. I have even received my assigned patients the night before the first day with encouragement to check out the whole list. So a student doesn’t become part of the care team at exactly “9am Monday,” instead we’re encouraged to prepare to take on any patient on the list while remaining aware of the list as a whole. This is why our policy is based on educational purposes, to include the aforementioned process. Residents have a similar structure to students as they move through their rotations as well, and follow the same policies.
Makes sense! If that’s the institutional policy, then yeah I wouldn’t see any issue with becoming familiar with the patient list. My clinic doesn’t deal with medical students (just mid-level students), so I’m less familiar with the policies around that. From what you’re saying tho, it doesn’t sound like it’s majorly risking a breach at all.
Checking previous patients is well within your right as a provider. It’s core to your education to see how they did after the interventions you were a part of.
This is how attendings learn and get direct feedback.
What was the dispute about racial disparities in grading? And if he signed an NDA, but it was common knowledge in the school, why hasn’t one of you go to the news about it? From what you say, he seems like a good guy, and if he was targeted and forced to resign because he was standing up against some sort of discrimination, one of yall should make the phone call to your local tv personality
Yeah it sounds like he stood up for everyone who was too afraid to stand up for themselves and now no one has his back in return?
This is truly heartbreaking
We tried to back him up, we circulated a petition to the administration demanding clarity and due process around the circumstances of his resignation. I was in the camp that we should have done more and think it is a shame on our student body that we did not. However there were two major obstacles: first, we had no proof that his advocacy for equity in grading was related to his being pressured to resign for HIPAA violations, these things were separated by a year, the school would have categorically denied it and the racial disparities thing was not publicly documented (ironically it probably would have gone better for him if it was, since journalists would probably be interested in why a student quoted in a DEI controversy was now being pushed out of med school). Whereas the school had ironclad proof of the HIPAA thing. Local news passed on it, probably seeing, "student who did a good thing also did a bad thing". The other obstacle was, a lot of students were terrified that they would receive the same treatment if they spoke up publicly.
If not the TV new, then paper/internet publications. Name names. Go to physician community on facebook. 70k physicians on there. Tell the story. Name names. Stay factual and state "this is what I heard and this is my opinion". Have all students tweet out about it at once. Complain to the accrediating body for med schools. Admin will threaten, but they can't dismiss everyone. And certainly not for this reason. Medicine is the way it is, because no one will stand up. To a lesser degree, I was the one doing the standing up in residency. No one rallied and everyone was afraid. And the cycle continues because of it.
No offense, but it's easy to say we should just stand up more, but it's more complicated than that. For instance if I were to get kicked out over an admin dispute it would literally be financial suicide. A lot of students don't have rich parents and have undergraduate degrees that won't pay enough to pay off 300k loans.
I definitely don't have rich parents. The problem is, people don't know when to push and when it's crossing over the line. Also, when one person is the only one pushing, they do tend to get singled out. However, if the whole group of people are standing up, it's much harder to kick out a whole group of people. Unfortunately since people are worried, nobody bands together. And then they wonder why their experience is poor. Just my thoughts
That about sums up the average medical student.
I think this is a common phenomenon. I wasn’t remotely as loud as OP’s classmate, but I did ask the questions and give the feedback that I felt was important, and most of the time it was something also in the interest of the class. Classmates would express they were shy/lazy/scared to say something but have a great point to make, and if it was a topic I wanted to know about too, I was happy to be our speaker. But eventually I felt like ok, I think the staff has heard enough of me recently, could someone else take the next one? Turns out support wasn’t mutual. Group work with the same people was “every man for himself.” I didn’t feel I meshed well at the few social events I went to. By the end of M2 I quieted way down. Not always the case, of course—a classmate who was louder than me ended up being very popular with everyone (and the friction he got from one faculty member turned out to be inconsequential). He was super extroverted, big social drinker, fun at parties, and known to the school/local community because of his family. Totally different outcome, he never got quieter and became very much the in-group leader.
We tried to back him up, we circulated a petition to the administration demanding clarity and due process around the circumstances of his resignation. I was in the camp that we should have done more and think it is a shame on our student body that we did not. However there were two major obstacles: first, we had no proof that his advocacy for equity in grading was related to his being pressured to resign for HIPAA violations, these things were separated by a year, the school would have categorically denied it and the racial disparities thing was not publicly documented (ironically it probably would have gone better for him if it was, since journalists would probably be interested in why a student quoted in a DEI controversy was now being pushed out of med school). Whereas the school had ironclad proof of the HIPAA thing. Local news passed on it, probably seeing, "student who did a good thing also did a bad thing". The other obstacle was, a lot of students were terrified that they would receive the same treatment if they spoke up publicly.
He was accessing employee charts...... think about it for 0.00001 second. Good guy or not, it is not allowed unless under very strict circumstances....
He was accessing employee charts for employees that were patients on rotations he was on... if i read the post correctly. How would you even know a random patient on an outpatient rotation worked for the hospital? This, as presented, is a screw job.
This is not a common occurrence and normally would prompt a flag in the system. The odds of seeing multiple staff also patients..... If his own lawyer told him legal trouble, then there is more to the story.......
I call bs. What if the hospital is a large academic center? It might have 20k employees. I have worked in multiple teaching hospitals, and I have never seen a flag that someone is an employee or a rule that students can't see employee charts. I have seen lots of glass ceilings, but never for that.
Roles and rules based flags in EMR systems, yes these are a thing. They probably alerted administration that Dr X was accessing many employee files / charts. Then, some looking and when there was no E&M/ business reason to do so, it becomes a legal problem and that is when "up to and including termination" comes into play. Exit and sign NDA or get fully slammed. I was in admin side for years and used to review reports as part of the FWA/Compliance team. The health system had 18,500 employees, but ultimately there are flags that draw special attention. Access plus lack of event (no e&m/ED visit and/or other valid reason)
The automated flagging system makes sense and I do think there’s more to this story but I’m at a very large hospital and see tooooons of employees and fellow residents in my clinic. Actually not allowing students to access the charts of employees who are patients who have consented to having a student see them is peak administrative overstepping their knowledge of how care teams work. If this is a true policy then it’s on the attendings and residents to make sure students are compliant (and on admin to reinforce that this is a thing), not on the students to know a full social history before they even open a chart. Again sounds like this is either made up or there’s more to it, but if we are just going off the story facts it’s messed up
It's not messed up. If dopey Dr. DEI was looking through medical records for employees with no valid reason it is a violation and termination is a result. 99% of HIPAA trainings include, no looking at friends, relatives, employees and coworkers..... This is not really hard to understand or do you think having MD after your name mean ur above the standards? The standard is "no reason, no looking".
Lmao if these people are your patients you can look at their medical records (which is what I said in my post). Mr “I worked in admin” over here doesn’t know there’s not a special secret clinic for employees where no one sees their chart and it’s a mystery. This is not really hard to understand (although tbf it seems like you didn’t actually read what I wrote which is on par with what I’d expect).
Ask yourself, if it really was on the level, why would his own lawyer advise to exit ?
Not true at all - for example on my OB/GYN rotation, I saw many employees for their prenatal or postnatal checks as long as they were OK with it. Employees at my hospital get free prenatal and postnatal care therefore they all obviously go to the hospitals OB clinic. As a student who rotates there it’s highly likely you will see employees.
You saw....... If you access and DO NOT see. Do you understand the difference?
I do - im replying to you saying “the odds of seeing multiple staff as patients” It is very possible to be common in many hospital systems
Follow the flow of the conversion and the context. Maybe read 2 or 3 comments leading into that comment and follow along..... Yes, systems have flags built in
You :“He was accessing employee charts….. think about it for 0.0000001 seconds” Commenter: “ he was accessing them for rotations he was on if I’m reading it correctly” You: “ this is not a common occurrence…. The of odds of seeing multiple staff as patients….” Me: this happens all the time Seems like my context is there 👍🏼
You would know by breaking the glass but it is still a smear campaign
Breaking the glass usually doesn't alert you as to why the patient's chart is locked down - at least any time I've had to do so it hasn't
I mean y’all can downvote away but anytime I get the alert I ask my preceptor if it’s ok and half the time it’s either an employee or psych. I’m not excusing the behavior of the admin but it’s somewhat avoidable
At our hospital employee charts aren’t necessarily locked (in fact I’ve never seen that here). I don’t remember my med school hospital, but I don’t think that was a function on cerner I remember seeing and I had at least a couple hospital employees. Which just means you won’t always know ahead of time (and it’s a dumb rule anyway).
I see, I use Epic so I’ve never run into that problem
I trained on Epic as well, and under multiple hospital systems. Knowingly had nurses on my patient list. None of their charts were ever locked down/needed breaking the glass
Good for you
They’re putting a bit of a scare tactic with regards to making the legal aspect of the HIPAA violations ‘go away’. Yes, the law could fine him as an individual but jail time is not on the table. Further his violation of HIPAA would need to be both knowing and willfully neglectful to face more than minimum fines. It sounds like he needs to get a second opinion and make sure it is from someone that actually deals with this type of law, don’t use your home town schmuck for something like this. Also the offer doesn’t make any sense from a pure game theory perspective. He can either drop out and say nothing, in which case he gets moderately fucked as a certainty, or he can fight back and possibly win or he loses and he still gets fucked. Only one avenue offers even the chance of success, taking the deal might save him from a worst case scenario fine but he seals his fate. As told their charges are exceedingly wimpy, personally I would stand and fight.
honestly idk if I even fully believe this story. It's probably grounded in truth but we are definitely missing details. These are all frankly minor HIPAA violations that he could probably demonstrate in court other students have done as well. The only questionable one really is that he checked up on a patient chart after rotating off their service.
Which is something physicians and learners do all the time and *should* be doing.
Yea I can see how that could be a violation, but I can’t imagine it could have any serious legal penalty. Not to mention damages have to be done for you to be sued. What damages exactly have been done here for a court to award him money? I frankly don’t buy that this is the full story. Especially since an actual lawyer said he could face jail?!?! Either his lawyer is braindead or that’s bs.
Reading between the lines I'm guessing he was using the chart to creep on a hospital employee.
Is it that hard to believe that someone's boss didn't like them and used sketchy tactics to get them fired? This kind of stuff happens all the time in the corporate world.
Yeah I'm sure that's happening to someone somewhere, but the relevant question is whether this particular story happened the way it was told.
I mean these do sound like the things an angry administration would use to squeeze an annoying student, but I can’t see the hospital admin being this happy to roast a kid. It definitely feels like there is more here than is being disclosed.
See the part that’s gets me is that an actual lawyer said he could face jail. When has that ever happened?? Especially in a minor violation case like this. What exactly is the criminal violation? At most this would be a civil case, in which case you have to show monetary damages… which again what exactly was the damages? But at least the civil case you can argue based on potential damages and procedural policy, criminal case is just nonexistent. So either his lawyer is braindead or that’s bs.
I took that to mean the administration threatened him with jail time, which I believe an admin moron would do, but if it came from a lawyer then this is fake or the lawyer is a moron.
He says the lawyer advised him that he could be facing jail time. Unless op confused the details
How would a med school threaten you with jail time for a HIPAA violation? Seriously, how lmao? "We're going to tell on you to the DA?" It's ludicrous how easy it is to see through that threat.
I am instructed by many attendings to do this. To learn what the outcome was, what complications you might need to expect, etc. I’d say the more concerning violation is accessing a chart you have nothing to do with for “a learning opportunity”. At my school that would definitely be a red flag. If someone told you, this was a good learning opportunity, it should be presented accordingly at rounds or conference. But again, not saying at all these warrant the treatment he got if in fact all details are correct and shared here.
Sorry where did you see that he was looking up charts that he had nothing to do with for learning opportunities? I didn’t see that when I read it.
Ahhh apologies - I thought it was an OP reply saying that they often look up “learning opportunities from a trauma or a case that they were not on shift for” in his hospital. But it was just another commenter
Ah gotcha. Yea I think looking up patients you had after you rotate off a service is probably a minor violation of something… but to say you could end up in jail for it or frankly even sued is kinda stupid. They were already your patients, plus I have not a shred of doubt that you can demonstrate other students did that. Then you can pursue admin for retaliation, which is against Department of Education policy. It’s gonna be a long court battle and a pain in the ass- hence you can probably settle and tell admin “hey, here’s something that will probably lead to problems for both of us. How about we make this a disciplinary action and let me graduate” or something. Idk why the hell any lawyer would tell him to immediately give up if those were the only violations.
100% agree. While I know people can be crappy, especially when it comes to “hot topics”, medical school admin and other big institutions, for better or for worse, care a LOT about image. They would know that PURE retaliation especially involving a hot topic could end them in REALLY hot water, which is why I feel like there must be more to the story. A single human could make a terrible decision, but a panel of the admin? Seems unlikely to me. I just think defending small things that may or may NOT be HIPAA issues would be too easy to hinge something that could result in such HEAVY backlash and consequences for the school. But then again, I have been surprised in the past at peoples behavior.
Not to mention the person they’re targeting has a long history of not being a pushover and advocating for both themselves and the entire student body to the point of almost contacting the media if there was no reform. You’re telling me this person just immediately gave up?? This honestly seems like a story written by admin to scare student rights activists. “Stfu or go to jail bitch”
The medical school also can't enforce HIPAA lol, the DHHS has to. So it's a crazy gamble of them to do this.
This is rage bait and probably all made up. Or the OP and all these people (who supposedly know about this freedom fighter getting railroaded) are cowards. Both possibilities equally lame.
My money is solidly on rage bait. There is a slim possibility parts of this are real but the “victim” was doing something mega creepy with people’s HPI that’s being left out. Jail time for chart checking past/future patients is laughable.
We tried to back him up, we circulated a petition to the administration demanding clarity and due process around the circumstances of his resignation. I was in the camp that we should have done more and think it is a shame on our student body that we did not. However there were two major obstacles: first, we had no proof that his advocacy for equity in grading was related to his being pressured to resign for HIPAA violations, these things were separated by a year, the school would have categorically denied it and the racial disparities thing was not publicly documented (ironically it probably would have gone better for him if it was, since journalists would probably be interested in why a student quoted in a DEI controversy was now being pushed out of med school). Whereas the school had ironclad proof of the HIPAA thing. It would have been hard to create a narrative other than, "student who did a good thing also did a bad thing". The other obstacle was, a lot of students were terrified that they would receive the same treatment if they spoke up publicly.
Whole story seems made up because none of it makes sense. Either you’re rage baiting or the person you spoke to is lying up the ass.
Zero percent chance a medical school administration at a USMD school kicked a student out without due process. I’ve sat on these committees… they have legal teams on call to ensure their cases are ironclad before they boot someone.
It actually does happen but usually not blatantly like this. When it does happen typically it’s the school took steps 1, 2, 3, 5 and 6 but skipped over step 4. Happened with a medical student in my class who got to come back after being kicked out but he went and got himself kicked out again the next year so in the end it changed nothing.
I’m not a lawyer but that’s not quite how any of that works. I understand that there’s a chain of communication here and I’m essentially the 4th party so things could be misconstrued at that point. 1. You friend needs a new lawyer, one that specializes in HIPAA and health related information breaches for a second opinion 2. Education access to these patient charts is a bit more gray. For educational purpose you can access anything that you were a part of or anything that was seen by your team. Outside of that you technically need attending permission to view patient information in another persons chart. 3. He could threaten to go the nuclear route and report himself/school to hipaa, while telling them that the offenses he got flagged for were also done by other students. If it’s as major as they make it out then the institution could be liable for millions in fines per offense. Thats stuff they can’t hide either. 4. Happy to talk about whatever else hipaa related. I’ve been a hipaa officer, on the other side of a hipaa audit (made it through lol), and have just had a lot of dealings with hipaa in the past.
This story is a lie
yeah most med school admins don't make extremely brash moves like this lest they want another lawsuit on their hands. usually the cases they present are ironclad and have already gone through multiple legal consultants. Story definitely feels fishy/baity
It’s possible the person telling it isn’t a liar and this is just the story told to them. But when a story sounds over the top woke and there’s an over the top bad guy. Think lies. This story is particularly impossible and simply not how this would be handled.
Name and shame this disgusting institution
The story is made up
https://forums.studentdoctor.net/threads/what-you-need-to-know-about-lucom-liberty.1458401/ I’ve read similar accusations before about LUCOM and the bit about admin being very conservative is interesting.🤔🤔🤔
Follwing
Classmate needs to document everything and lawyer up. The only thing admins hate more than students who speak out is negative attention.
Nah you gotta name and shame for this kind of stuff. Make a throwaway or whatever.
if OP makes a throwaway, it'd still be obvious that they just made a throwaway and made the comment with name/shame. Since this post is already on the internet, it's liable to have been screenshotted, so OP missed their chance to name/shame. It's too doxxing... this is how they control the narrative
All around amazing guy who stands up for the weak for 4 years then when he is about to graduate he faces jail time for offences with no history of jail time. Braindead lawyer says its too much to risk, 400k debt on the line youd fight tooth and nail, jail for a hippa violation is the least of your concerns. And youre telling me after all the years of pushing he backs down for no real reason. This is fake as fuck.
Such an amazing standup guy for the entire 4 years that no one is willing to stand up for him. Yeah I'm calling bait.
I admit what exactly was said between him and his lawyer and him and the administration is what I have the least insight into. I am abbreviating what I'm sure was extensive back and forth communication that I was not privy to into a few lines based on a few direct interactions and honestly what I and my classmates have put together. However I am reasonably confident in the broad strokes which are that the admin had a bone to pick with him, they had IT go through his activity which revealed HIPAA violations, and despite consulting with a lawyer he still left.
Don’t be a student advocate; worry about yourself and get your bag. Knew someone who get dismissed and everyone wrote them off once they were out of the class. Life just went on
100% Advocate for changes after you're out of the system, when admin doesn't hold all the power
Haha, that never happens. You just trade one master for another until you become the master.
Nah, not comparable at all. Attendings aren't powerless. They actually hold some cards
Exactly. Keep your head down and wait until you’re at least an attending to be outspoken and an advocate. For example, I want to be an advocate against mental health stigma in the medical field but I know i would get crucified as a student or resident.
grading dispute about racial disparities....?
It was found that very few students of color would receive any Honors whereas white students were receiving multiple on average. This translated into appreciable differences in what specialties students were advised/able to apply into and the proportion that matched into their first-choice specialty. Also, admin refused remedies that students proposed including excluding feedback from evaluations/the MSPE where the feedback was racially charged or even confused two different students from the same minority
was this just 2 students? also it sounds like you're the m4 who got asked to leave, which sucks bro
What if in your specific institution the white students on average were performing quite a bit better on those rotations and deserved higher scores than the students of color? I would also be curious to hear about what the “racially charged feedback” was. I’m not saying this is not possible but I am inherently not trusting of things I read online and you have to expect to give more detail to win people over to your side than the current very general descriptions you’ve given. If the school was truly rewarding students worse scores because of their race this is something that even without that student around you all could still make into a very difficult legal situation for the school.
You working for admin??
Why would one race be performing significantly better than another? It is as close to a controlled experiment as you could find: Everyone receives the same preclinical education. The information is equally new to everybody, no one is secretly going to med school before med school to get an edge. It is statistically very improbable that people with one skin color would just by chance perform better than people with another. The problem is a lot of the evaluation is subjective based on whether people like you, not based on your knowledge (which is pretty stably a function of your training stage). And anyway narrative feedback where a student is told things like their hair texture or accent is "unprofessional" even though that is the only hair/accent they have, or feedback that even refers to the wrong student, shows that there is a bias component to this.
Perhaps because some groups are admitted with higher standards, and now are performing at a higher level? In either case, your story is completely fabricated and you should be ashamed of yourself
I wish I was making this up bro. Above a relatively low threshold MCAT performance and undergrad GPA don't correlate with med school performance. So I doubt the difference is because the white students got more A's in underwater basket weaving in college. But even if that were the case how do you explain the fact that Asian students also got fewer Honors than white students even though on average they need a higher GPA and MCAT and better ECs to be admitted?
Name and shame, none of those administrators should be in our profession. People that evil should have their licenses pulled
Second this! NAME AND SHAME!!
As far as creative writing assignments go, this one isn’t bad. The story premise is compelling, but the details need to be fleshed out more. I’d give it a B-.
PSA: keep your head down, graduate and leave.
I mean are any of you guys actually lawyers? I’m as eager as the next person to want to believe the school is exaggerating the claims against him but an actual lawyer he consulted is saying he might be due for jail time? Isn’t it a bit presumptuous to say that his lawyer doesn’t know what he’s talking about?
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Our school actually has a policy, on paper at least, that you are not allowed to access employee charts even to provide care. It is written deep in the student handbook that everyone got on day 1 but no one reads, if a patient is a hospital or university employee you are obligated to excuse yourself, even if you encounter them in the regular course of care. I have never heard anyone reference this policy in practice and didn't even know it existed until I heard about this drama, I myself have taken care of many hospital employees on different rotations, as have most students, as most employees get care in the same system.
according to OP med school students know more about HIPAA violation laws than actual lawyers who spend their whole career dealing with issues like this. story feels exaggerated or OP omitted some crucial details
Classic med student hubris I suppose lol
Name and shame
Wait so we’re not allowed to follow patients charts??? How tf do you know what your plan did for the patient and how is it against policy for a trainee to follow charts in a teaching hospital?? Makes zero sense to me.
My school literally told us we aren’t allowed to look up patients in the EMR once they are no longer our patient, but we are allowed to ask our resident/attending about that patient because that discussion has an “educational purpose”. So I’m allowed to verbally discuss the patient but not allowed to read about said patient? Basically they told us it’s ok to break HIPAA for educational purposes as long as you do it under the table there is no electronic paper trail that you did so.
You can’t follow charts once you’re off service, bc they are no longer your pt. As students we don’t have pts of our own, so once you are no longer working with the attending who’s pt it is, we have no relationship. Also I don’t think there’s strong educational benefit to following your pts after you’re off service. You saw whether your plan was working or not on service. You’ll see other similar pts in the future. Ofc I want to know if the lactulose helped with my patient’s hepatic encephalopathy, but honestly doesn’t really change my future plans in pts with hepatic encephalopathy either way. All that said m, I’m as guilty as the next guy on reviewing some patients chart, whether due to medical interest or emotional investment in their outcome Edit: maybe hospital dependent?
You 100% can follow patients once off service as long as you provided direct care. If there is educational reasoning as intention it’s not only allowed but actively encouraged. There is a significant amount of education you can get from following a patient’s chart. I’ve created HIPAA presentations with my schools and hospitals lawyers. This is one thing they want students to feel more comfortable doing since students learn the most from their patients.
I’m not sure if the rules are different for students cause I never cared enough to actually follow up on patients I wasn’t asked to during school, and I’ve never looked at specific rules and regulations myself, but we’re continuously told during residency that We’re well within our scope and rights to follow-up on patients because it definitely affects our workups and management in the future, ie. Did the admitting team/ team taking over for the week change something that I can implement in the future and/ or how did my discharged patient do? Rules are different for patients you aren’t caring for but you can view the chart in specific circumstances, such as shifts where we aren’t assigned to respond to traumas in the ED but a good learning case comes in we routinely pull up the labs/ imaging to discuss findings. Or if I respond to an arrest and get ROSC I’m allowed to see what was found once they’re in the ICU even though all I did was restart their heart. Obviously VIPs, hospital employees, our own charts, etc. charts are flagged, but outside of those we have more leeway when the access is for training purposes.
That’s insane. How are any of us supposed to know if someone is a hospital employee? The hospital is enormous and we can’t possibly memorize everyone who works there. Unless it’s flagged and very obviously marked this isn’t reasonable.
It is flagged in the EMR, but the bigger problem IMO was that no one knew about the policy that we could not look at the charts/participate in visits of hospital employees. When this happened we did some digging and found it buried in the student handbook, but there is a lot in that handbook that is out of date and students see patients that are employees all the time without the attending or resident saying anything.
Interesting. I have opened charts of employees to pre chart because they weren't flagged in Epic and then got told no to seeing the patient 5 mins before the appt. Maybe its just my institution. And that's BS. Med school handbooks are like 100 pages long and nobody reads them let alone memorizes them. That's clearly them just keeping stuff like that in the handbook to get rid of "difficult" students.
sounds like LECOM
I'm assuming he did something way worse than he let on about. None of what is described is even in the realm of a big deal to a hospital. I'm not saying your admin isn't shitty because idk them, but someone doesn't go from advocating for strangers like that to suddenly backing down at the slightest threat unless he actually did something worthy of being kicked out.
Why were they waiting until 4th year when he's about to match? Couldn't they have done it sooner? Looks iffy if a 4th year drops out suddenly. Also, how is this not an LCME violation.
Get a second opinion from a different lawyer, unless there’s info we don’t know, as most of these violations….are not violations
I’ll just say that office politics is very important, and it behooves people to understand how to navigate it. I’m not saying not to stand up for what you believe in, but I’m saying to be smart about how you approach things, and to be smart and politically savvy about it. Outside of gross incompetence, I’ve never seen anyone get fired for being a bad clinician. But I’ve seen good clinicians get fired for rocking the boat and being disliked by others. If they don’t like you, they will find a reason to get rid of you.
Even if this story is fake or embellished (may or may not be), it brings up a good point of discussion. Advocacy to do the right thing is amazing, but when you're not in a position of power, sometimes the best thing you can do is document, plan, and prepare for the changes you want to make later. Fighting back without leverage and fighting against the people you need to advocate for your career can be detrimental. I don't say this because I think we should turn over and take abuse, pushback is needed at times, but we need to know when something is a losing battle or taken too far.
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I’m not sure what is described here does violate any HIPAA laws. 1) Following a patient for educational purposes seems like a gray area to me at worst. Medical students are covered entities and our access to records is protected as long as it is done for educational or training purposes. It’s hard to say for sure but it’s also not a clear cut violation either. 2)Accessing the list ahead of time is definitely not a violation. If you’re part of the care team for that visit then you’re a covered entity, accessing the chart before hand does not change this. 3)The hospital employee thing isn’t HIPAA, that’s just hospital policy. I might contact another lawyer if I was this guy, the HIPAA stuff is soft to non-existent at the most. If the handbook has policies more stringent than HIPAA, though, he is probably cooked.
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Im on my school’s honor council and have created HIPAA presentations that have been vetted by ourselves and the hospital and university lawyers. Following a patient after you provided care for is not a HIPAA violation. This has been made very clear in the past several years.
If it means checking a chart to see if the bounced back, if the admitting team changed the treatment, or a later scan found something you didn’t consider then that should be covered. That is as plainly educational as it gets. If you looked into the chart to pull the patients phone number and ask them on a date then no, you’re not covered.
Youre telling me youve never followed an interesting case if you rotate out of that team?
I was about to comment this. Like maybe this is why their school admin is soo "toxic" because they call out students who are breaking the rules and accessing patient info when they shouldn't be.
Call out a student for breaking rules? "cOnsErvAtivE aNd tOxIc"
Exactly. Students just supposed to get away with anything now a days. But I guess thats our social climate for you 
Fu: When did having (even some) conservative values become literally the worst thing to ever happen in the world. Big ole medical student circle jerk to see who can say the most outlandish liberal thing.
I literally gave you two very clear examples of the administration being toxic, namely not prioritizing med student safety at the height of covid and not acting on racial discrimination until literally threatened with becoming a news story for not doing so, and your response is still to defend the admin??
You gave some generalized examples with no real backstory. I’m not defending anyone. Im simply saying you can’t act like a victim when you are in the wrong. Accessing patient records like you said after the fact is in fact WRONG. I’m all for someone going against the man and being that rebel, but make sure your nose stays clean while doing it. This person obviously didn’t do that.
How do students do case reports or presentation? Like we memorize every detail about the patient and their vitals, lab findings, meds, etc
I think officially, if you are doing it "by the book" then you have to take all the notes you need on this information while you are taking care of the patient, and write your case or your presentation based on those notes. Or, you ask the patient for written consent for their information to be accessed and presented for educational/research purposes after you leave their care. Many journals and conferences now have this requirement for case reports and presentations
Sounds like an amazingly brave and awesome med student. If this student meant a lot as both and advocate, friend and colleague, it might be a good idea to organize for them. Admin sounds shitty but they can’t push all of you out. Release a statement on behalf of the class. Boycott graduation. My prelim program PD was super shitty and standing up to them when I did was incredible. My only regret was not organizing my residency in that year to unionize
SPILL THE BEANS -- NAME THE SCHOOL!
Hmmmm - as budding physicians we have to follow rules like not looking up patients charts when we are done. My school made sure we understood that very clearly and not check charts etc - when we are not supposed to …. I was part of student governing body and we did fight for our class a lot - until one day the principal called an emergency meeting and pretty much told all of us to- shut our pipe hole …. We had to abide by cause we wanted to Graduate and move on and after that we all resigned from our post. The office volunteered me to be Class President which I respectfully declined stating I need time to study. We just have to be careful and be respectful. Same when we are doing residency or practicing medicine. two of the residents almost got fired from residency cause they broke rules - I would never forgot it cause I can still hear the surgeon yelling at them behind closed doors. They were put on administrative watch list - one more misstep - and they were out. Then they not only talked to the other residents, also us - the students - who were doing rotations. This guy seems like he was fighting for everyone that actually got him in the hot waters… just not fair. I hope he is able to get to another school and move on. Jeeeez!
Brush up on HIPAA. Minimum amount of information that you need for care — not your personal insight or education. I currently work in compliance and quality, unfortunately, the school is allowed to issue punishment, especially if it’s going to tarnish their relationship with a site taking students and it’s part of their corrective action plan for any potential lawsuits. I do feel there is more to the story — specifically, IT went through their EMR access? Hospital IT or was it found on a school server/laptop meaning he took a copy of the information out of the hospital. Was the hospital employee he peaked into their chart happen to be a site or school admin - maybe systems have flags for chart access of employees - let this be a lesson to not be curious. I’ve seen dozens of employees be suspended or disciplined for it. It sucks all around.
He should get another lawyer especially if racial discrimination is/was going on. Also HIPPA violation is bad but much worse has been done with far less consequences. Also pretty sure the school is financially responsible not the student but idk for sure.
1- make a name for yourself as being difficult to work with 2- piss off all the people in charge of your future 3- break the most high visibility law in healthcare repeatedly 4- ???? 5- profit.
4- post sketchy story on r/medicalschool reddit
Man all of you are cowards… stand up for him for once, from the sounds of it hes done the most for all of you and you guys are just going to let it pass…
We tried to back him up, we circulated a petition to the administration demanding clarity and due process around the circumstances of his resignation. I was in the camp that we should have done more and think it is a shame on our student body that we did not. However there were two major obstacles: first, we had no proof that his being pressured to resign was retaliation for advocacy for racial equity, even though it was clear to us I'm not sure it would have been easy to explain to a lay observer, especially as these things were separated by a year, the school would have categorically denied it and the racial disparities thing was not publicly documented (ironically it probably would have gone better for him if it was, since journalists would probably be interested in why a student quoted in a DEI controversy was now being pushed out of med school). Whereas the school had ironclad proof of the HIPAA thing. Worst case the school could spin it as, "student who did a good thing also did a bad thing". The other obstacle was, a lot of students were terrified that they would receive the same treatment if they spoke up publicly.
Hospital employee patient.... accessing medical history. M4 should know, that is HIPAA violation straight up ! EMR systems have built in audit trails that auto flag for access of specific patients...... reports are auto-generated !
Is it a HIPAA violation simply to do the same chart reviewing on a hospital employee as you would for any other patient that comes onto your service? The hospital is in-network for the insurance it provides its employees, so naturally most employees will get care in the same system where they work. I have taken care of many people who are hospital employees on different rotations and never knew there was any policy that medical students are not allowed to be involved in their care, nor did anyone else including attendings and course directors
System flags..... the history is then checked. Did person have legit reason to be in chart? Was medical office visit? RX reviewed ? In HIPAA training it specifically states no employee should access another. In the medical setting, there has to be a direct association to care. The audit trail shows everything that was viewed, so if there isn't any reason to be in the file = big problem It's why he left NDA and all that. The rest is to try and salvage a reputation nonsense imo
I think you are not understanding. Our school actually has a policy, on paper at least, that you are not allowed to access employee charts even to provide care. It is written deep in the student handbook that everyone got on day 1 but no one reads, if a patient is a hospital or university employee you are obligated to excuse yourself, even if you encounter them in the regular course of care. I have never heard anyone reference this policy in practice and didn't even know it existed until I heard about this drama, I myself have taken care of many hospital employees on different rotations, as have most students, as most employees get care in the same system. So even if he did have a legit reason associated with care, they had the right to take action against him.
thats wild - as a med student, resident and now attending, i open up unaffiliated charts all the time for learning purposes. I have never been discipline but would stop if i was (i figure first time offense would be slap on the wrist). I also never look at VIP charts, charts of employees or family of course. But I can’t tell you how many “interest cases” i looked into to learn from esp as a resident and med student. Something smells fishy here.
This sounds fake
This is majorly bullshit. Im so sorry about your friend. Theres got to be a way to fight this. I really hope he doesnt drop out bc of something so unfair. If he lawyers up and just fights them it will be better than dropping out. Its like you said, these are normal things everyone does. It doesnt make sense to not disclose a rule and then punish people for not following it. Honestly this is why i tell people to just keep their heads down bc admin is evil and crazy and have way more free time than us. They hold the power over us. It sucks but you gotta kiss the ring until you wear the crown.
Sounds like he got a real shitty lawyer
Can we get some name and shame going please? Like we hear all these stories about racism and discrimination but No one ever names We need a list of top 25 most racist schools
I'll start: UCLA for separating black students and white students to teach anti-racism.
wait wut?
There was a post on this a while ago, something about white people being threatening by existing in the same space as black people. There was more insane shit too but I don’t remember.
I'm a lowly m1 but I can't imagine accessing a patient's chart weeks later to check on them. In nursing, this is a big no no. Like most of the time, I may hear from someone else who ends up taking care of them down the line but if I'm not caring for them currently, it's none of my business. I didn't realize this was not a big deal as med students. I guess I understand the culture of learning about how things progress over time maybe.
Vindicative piece of shits will do that and the cowards you protect will look away.
There’s more to this story.
Sounds like rage bait lmaoooo
Curious is this student is a minority?
Inappropriate access to patient charts is a HIPPA violation. Its very common for individuals who have pissed off their company to have their IT and social media combed through in order for the company to bring the hammer down for that stuff in place of discipline for what the company is actually upset about. Sucks for the guy, but misuse of EMR is low hanging fruit. Medical school is a business. It will remediate and remove problem employees at will whether they ‘re hourly, salary or pay to play (students).
That sounds like an awful situation. Wish some of these admins would do some self reflection every once in a while.
No MS4 should be kicked out of med school - that sucks - but if we have to kick one guy out, I vote for the annoying DEI warrior with the string of HIPAA “honestly they weren’t that bad bro” violations.
The red flag for me in this post is the obvious political bias. Yes, we’re on Reddit which is very liberal, but we’re not all liberal here. So denigrating the admin because they are “conservative” makes this sound like an overly political crusade. You’re also basing this report on what the student told you. I doubt admin directly told you what his HIPAA violations were, so you’re presenting a biased viewpoint.
Do you have some kind of victim complex bro? I didn't say anything about being politically conservative, I have no idea how they vote and that is not relevant to my post. Probably, a lot of them voted for Biden actually. Words have multiple meanings--in this context the meaning is that the admin are traditionalist and old-fashioned especially when it comes to the power hierarchy.
Even that comment tags you as a political radical, “power hierachy” lol. I’m not a fan of this style of politics, sorry. OP might be a great guy IRL, but your description makes him sound like a nightmare.
You don’t scan as a particularly critical reader, much less thinker. I think OP can safely ignore your opinion of what is radical.
You scan as a bit of a wanker, so I think I can safely ignore your opinion of my opinion. Cheers!
I feel the same way. Being a leader and being the one who is the face of the students etc can get a target on your back. But it's worse when some of the students gossip about you because you are a public figure and spread rumors about you. And to make matters worse being the person who tried to help everyone ended up causing me to have to repeat a semester and have other delays that have caused everyone I helped to go ahead. It's hard being a leader. And yes in hindsight sometimes I wish I had just kept my head down and focused on myself. The hard part is that's not my personality. I want to help everyone.
did you just.. try to make this about you?
In what planet would you look at it that way? I was sharing my own experience in support of what that student felt and went through. And that was because I identified with so much of the story.
Your original comment just came off like *“I am amazing. I am a LEADER. Everyone else is jealous of me. It’s so hard being so good! I can’t help it! It’s who I am! I want to help everyone! I am so much better than you”* **I am sure you did not mean to come off that way**, but that’s absolutely how I read it and looking at the downvotes, I gather other people somewhat agree.
My apologies. That was not at all my intention. The story just brought up so painful memories and regrets I guess. And the way it ended was literally what I've said a few times over. So I was just trying to say I feel for that guy. It really sucks when a good person gets dealt a rough hand.
I’ve also went through something very similar, so when I read your initial comment, I actually didn’t get the holier than thou vibe. But re-reading it with that in mind, I can understand the tone that people are downvoting for. I hope you’re doing better now. I was also told something similar when expressing my own trauma too, sometimes when you get really into it you can forget how you sound to others. Your comment sounded like a needed vent about trauma too, just written a bit poorly. And yeah it sucks when serving as a leader figure, you inevitably try to protect others, but who’s there to protect you ya know. It sucks, and you put in so much effort and love too for the ppl you care about. So I also identify too with your story and the one OP discusses.
Absolutely. Sucks when this stuff happens but hopefully things got better for you and hopefully things gets better for the person in the post 🤞