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vostrum1206

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I work for a pediatric practice and the physicians have a policy that once a teenage girl becomes pregnant we dismiss her from the practice to transition to an adult care. Can anyone tell me if this violates any laws? I am just wondering if this can be considered discrimination in some way.

Thanks!
 
I guess I wouldn't use the word "dismiss". That sounds like you fired her.

What you're really doing is transferring her care to an OBGYN, because it is medically necessary from a care perspective. Just make sure you document why you transferred her care, arrange the transfer, contact the consulting OBGYN, and make sure the patient understands why her care is being transferred. It's not discriminatory just because of her age. Many providers transfer care to other specialists because the patient's condition is not within the scope of their practice.
 
Thank you for the response Pam. It makes sense in the way you are saying but in this situation should they then allow the patient to transfer back once she delivers?
 
vostrum1206 said:
Thank you for the response Pam. It makes sense in the way you are saying but in this situation should they then allow the patient to transfer back once she delivers?
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She would still be your patient for conditions that are not related to the pregnancy, correct? If that is the case, then she doesn't really need to "transfer back." Your practice only transferred the care for her pregnancy and related conditions to the OBGYN practice, if I am reading your posts correctly.
 
I'm sorry Lance for not being clear. The issue is that the pediatric practice I work for currently has a policy to dismiss pregnant teens after deliver of the infant. They now would like revise the policy to dismiss the child as soon as they find out they are pregnant. By dismiss I mean they completely discharge the patient from our care and advise them to find an adult doctor to continue their care in the future. They will provide emergency care for 30 days. We do not allow them to come back to the practice after delivery. Our owners feel that since the child is engaging in adult activities they should then begin to be followed by an adult doctor. I do not agree.

I am concerned because I don't think that we should dismiss a patient just because they are pregnant. I am not sure if this would violate any laws under the ADA since pregnancy is a protected class.
 
With this clarification, you probably would be wise to consult an attorney for the proper language to put into your patient acknowledgement forms so the patient and parents are aware of this policy.
 
I would agree with Marcus on this one to consult with an attorney for proper language in the appropriate forms. After the delivery, since the patient is no longer pregnant, I don't believe ADA would be in effect then.
 
I am not a lawyer, so this is not in any way legal advice, but here is my gut response:

The doctors are dismissing these girls for engaging in sexual activity (using the euphemism "adult activity.") Are they also dismissing teenage boys who engage in sexual activity?

Get my drift?
 
discrimination: the unjust or prejudicial treatment of different categories of people or things, especially on the grounds of race, age, or sex.
 
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That is my feeling too. They are dismissing the boys also but only if they are informed he is going to be a father. Just because they are having sex does not make them an adult. Plus we are not dismissing patients because they are having sex, just if they are pregnant. So the reason they are giving is not even consistent.

I have just started the training for the CPCO certification so I don't have the credentials to back me when I am telling the owner's that I do not agree with this policy. Thank you all for your help and opinions.
 
I didn't pick up on discrimination because we don't know about the boys (would they treat a boy with an STD?), but judgemental - oh, yes.
 
vostrum1206 said:
That is my feeling too. They are dismissing the boys also but only if they are informed he is going to be a father. Just because they are having sex does not make them an adult. Plus we are not dismissing patients because they are having sex, just if they are pregnant. So the reason they are giving is not even consistent.

I have just started the training for the CPCO certification so I don't have the credentials to back me when I am telling the owner's that I do not agree with this policy. Thank you all for your help and opinions.
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That just makes me shake my head. If they kept their "mouths" shut (meaning didn't have that type of official policy) and just referred the pregnant girls to an OB/GYN, that would not raise eyebrows - like my first post on this topic.
 
I used to work for a pediatric practice.

We had this same issue arise. The physician's rationale was that he did NOT do any type of GYN procedure and did not keep those types of supplies in his office.
Since the young lady--whatever her age, has now become pregnant/after the birth of the child--she will now NEED/REQUIRE routine GYN care; therefore, she would be better served by receiving her complete medical care through either a GYN practice OR a Family/General practice.

There was no judgemental/discriminatory behavior involved in the decision. A young man, in the same situation would not require specific specialty care
 
dismissing patients

I worked for a Pediatric Clinic. This same situation came up.

There was no Judmental/Discriminatory attitude on the physician/clinics part.
The Pediatrician's position was that he had elected to not perform any type of GYN procedures. He did not keep any of the necessary supplies for GYN procedures.

We generally referred the young lady to another practice when they began their periods, at whatever age that began, because they would need routine GYN care at that stage. If a young lady became pregnant, she was referred and encouraged to remain with the GYN or find an FP, because after giving birth, she would need/require routine GYN services, and as a Pediatrician, he did not do that and as stated didn't keep the required supplies for those procedures.

Young men in a similar situation do not require additional specific services. IF they presented with what 'might/could' have been a STD, they were referred to a urologist. For the same rationale. The Pediatrician treats infant/children.

There was no Discrimination or Judgement displayed. It was 'the policy of the clinic', for the reasons stated...and was listed as such in the Clinic Compliance Manual.

Not everyone sees 'discrimination' in every action!
 
texancoder01 said:
I worked for a Pediatric Clinic. This same situation came up.

There was no Judmental/Discriminatory attitude on the physician/clinics part.
The Pediatrician's position was that he had elected to not perform any type of GYN procedures. He did not keep any of the necessary supplies for GYN procedures.

We generally referred the young lady to another practice when they began their periods, at whatever age that began, because they would need routine GYN care at that stage. If a young lady became pregnant, she was referred and encouraged to remain with the GYN or find an FP, because after giving birth, she would need/require routine GYN services, and as a Pediatrician, he did not do that and as stated didn't keep the required supplies for those procedures.

Young men in a similar situation do not require additional specific services. IF they presented with what 'might/could' have been a STD, they were referred to a urologist. For the same rationale. The Pediatrician treats infant/children.

There was no Discrimination or Judgement displayed. It was 'the policy of the clinic', for the reasons stated...and was listed as such in the Clinic Compliance Manual.

Not everyone sees 'discrimination' in every action!
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There's the big difference between your fomer employer and the clinic that the initial post was about. Your former employer has stated clinical and professional reasons why they will not treat these conditions and made official policy. It has not been stated that this is an offical policy in their compliance manual/program.
 
MnTwins29 said:
There's the big difference between your fomer employer and the clinic that the initial post was about. Your former employer has stated clinical and professional reasons why they will not treat these conditions and made official policy. It has not been stated that this is an offical policy in their compliance manual/program.
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The intial poster said it was the office policy, she never mentioned a compliance manual or program, but she did state it was the policy. She wanted to know if this "policy" violated any laws.

Remember also that doctors are not slaves and they are not bound to patients forever. They can discharge a patient (with proper notice) for any reason they see fit. They can't dump patients who are in the midst of treatment, but they can discharge them if they allow time for emergency and non-emergeny care while the patient finds another provider.
 
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