Doctors Q & A

Thoughtfully Responding to Your Discovery that a Patient is a Registered Sex Offender

Q. I am a New Jersey family physician. One of my nurses recently discovered that a patient of our practice is a registered sex offender. This patient has an appointment for next week and my office staff is very concerned. I am deciding how to respond. Is there anything that prevents me from terminating my relationship with this patient? If I decide not to terminate my relationship with this patient, what are my legal responsibilities concerning my staff?

A. There are more than 500,000 registered sex offenders in the United States and every state has a law requiring some form of sex offender registration. New Jersey is the birthplace of "Megan's Law" and it has been in the forefront of protecting the public from sex offenders. New Jersey's statute requires high risk sex offenders to register with the appropriate governmental authorities. In turn, the State directly notifies local residents regarding new registrants and also posts such information on a publicly accessible website. As such, the information is certainly in the public domain, but the question becomes what can and/or should you do with this information?

Terminating the Doctor-Patient Relationship

New Jersey law states that the "use of any of the information disclosed pursuant to [the sexual offender registry law] for the purpose of. denying. services provided by any business establishment" is unlawful unless the purpose of the denial is ".consistent with the enhancement of public safety." (N.J.S.A. 2C:7-16). As such, if you refuse to maintain a doctor-patient relationship with this individual based solely upon your discovery that he is a registered sex offender, you are likely violating the law. Such a violation could subject you to civil liability.

Other commitments may also limit your ability to terminate your relationship with this patient. Under the common law, if a physician is providing ongoing treatment to a patient, the patient must be given adequate advanced notice of the termination. The length of notice required will vary depending upon the nature of the treatment. Moreover, if you are participating with the patient's MCO, your ability to terminate this relationship may be limited

Protecting your Staff

You certainly feel a moral obligation to protect your staff. Moreover, in New Jersey and many other states, an employer can be held responsible for harm inflicted upon his staff by business associates or customers.

If you maintain a relationship with this patient, you must take reasonable steps to protect your staff and others at the office. These affirmative steps may include:

1. Develop a comprehensive, thoughtful plan for responding to these situations;
2. Instruct your staff to never remain alone with the patient;
3. Train your staff regarding the proper reporting of, and response to, sexual harassment and assault;
4. Develop a patient file coding system that alerts the office staff to the fact that a particular patient is a registered offender;
5. Advise your staff that they should not publicly disseminate this information inasmuch as it may, in some situations, raise concerns regarding defamation and HIPAA.

Other States

While most commentators agree that New Jersey has the most elaborate sex registration statute, every state requires some form of registration for certain offenders. A survey of numerous state statutes reveals that there is a tremendous lack of uniformity from one statute to another. For instance, while some states do not distinguish between nude sunbathing and violent rape, other states (like New Jersey) have established a tiered system.

Many states do not explicitly prohibit discrimination against sexual offenders. Therefore, physicians in these states would not be violating the relevant registration law by terminating a doctor-patient relationship with an offender based solely upon his status. However, given the great variety of statutes, it is important for a physician to obtain the facts regarding his or her state's registration statute prior to terminating a relationship

Other States Summary

In summary, you probably cannot terminate the doctor-patient relationship solely because the patient's name is contained on New Jersey's registered list of sex offenders. Nevertheless, there are reasonable steps you should take to protect your staff and thus mitigate the possible harm to your practice.

Stephen A. Snyder, Esq.
Vice President/General Counsel

Disclaimer: The information contained within the MTBC^® Legal Corner is provided for general educational and informational purposes only and should not be construed as legal advice. The author of the Legal Corner does not represent the Web site user or the individual submitting a particular question. Please seek the advice of legal counsel to address any specific questions you may have regarding your particular facts or circumstances