Home Forums Discussions General Discussion Curbside Consent

Question: You have a 16 year old in your practice who presents complaining of fatigue. To keep this uncomplicated, all ROS are negative and the physical exam is normal. You order a CBC, TSH, FT4 and an EBV panel. The FT4 comes back 1.1 and the TSH is 9. So not knowing the answer for sure, you call pediatric endocrine, and they tell you just to observe and repeat the test in three months. They don't like to start treating a TSH below 10 if the FT4 is normal.

So:

1. Do you just consider this part of the patient's care and a curbside consult and do not ask for permission from the parents or a release?
2. Do you call the parents to get consent
3. Do you need a written consent?
4. What if the consultant asks the patient's name (as 80% of consultants here do so they can look up the labs or just have a general idea what is going on and the age of the child?
5. In the case, do you get a phone consent and release from the parent before you talk to the consultant.

You are, after all, doing this in the best interests of your patient.

I always thought discussing without using patients name or date of birth or other identifiers, with a consultant to help the patient, is not HIPAA violation. I only disclose patient demographics when the consultant is officially involved in patient care. Discussing clinical data without an identifier is not much different than a question on the board exam.

I see it the same way as Naeem. I wouldn't document the curbside consult unless I was going to do a referral to that consultant.

Thanks guys. Yes, I never write down the name of a specialist who does a CC as it wouldn't be fair to them if anything happened as they didn't really know the entire story.

However, more and more specialists, and I am thinking 80% will have their MA ask the name, dob and the story before they will call you back.

Now, you could say, then you need to get a release from the parent/patient but that just isn't practical. To make it even harder, you won't even know if you need a release until after you call the specialist.

Bump

I am still not sure you would need written consent. I would see it as a referral. I tell the pt I need to get them in to see a specialist and then refer with a verbal agreement. Could tell the parent I need to consult with a specialist and that the specialist might want a visit and if so write it up as a referral. If the specialist ask for a name DOB etc then seems to me you could then write that conversation in the chart. There is some give and take here if you want to document or not.