Act on all suspected problems found in exam
Inform patients of any problems you discover
At his clinic in Toledo, OH, Charles Prezzia, MD, MPH, FACPM, follows a standard procedure when he stumbles across a nonwork health problem during a pre-employment exam or other company-paid exam.
"We take the position that we have to notify the patient of what we’ve found and recommend that they have it looked at by their family physician," says the doctor, president of Occupational Care Consultants of Toledo. "Beyond that, it’s up to them to seek treatment for the problem. We do not feel like we’re obligated to treat everything we find, just to advise them to see their regular doctor."
To ensure the patient is notified and that a paper trail is left to protect against future accusations that the health problem was not brought to the patient’s attention, Prezzia’s clinic uses a form that lists the nonwork-related health problems and specifically says the patient should see a family practitioner. The patient signs the form, keeps one copy, and another copy is filed with the patient’s records.
"We use pretty broad criteria for determining when to note any problems on that list and recommend they see a doctor," he explains. "If we see a skin lesion, for instance, we may not examine the lesion itself, but if there is any suspicion at all that it could be serious, we recommend having it looked at."
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