The scene
A consultant rheumatologist who occasionally provided medical reports in relation to insurance claims was asked by an insurance company to review video evidence, taken covertly, of a patient of his who had received compensation for a disability. The consultant had provided a report on the same patient five years earlier when the patient had appeared to have a significant disability. At the time, the doctor had consent from the patient to submit his report to the insurance company. The video surveillance evidence of the patient was not compatible with the disability the doctor had previously described. He had prepared a further report based on the surveillance material, as requested.
Before submitting this to the insurer, the doctor wondered if there were any medico-legal consequences he should consider and he called the MDU advice line for assistance.
MDU advice
The medico-legal adviser explained that GMC guidance states that a doctor should obtain written consent when disclosing information to third parties and she also advised that the patient's written consent would be required to disclose a new report based on the fresh evidence.
The adviser checked that the doctor was aware of the requirements of the Access to Medical Reports Act 1988. This requires that a patient must be given 21 days to review a report before it is submitted to an insurance company or employer.
The doctor was relieved to have avoided a potential breach of confidentiality.
The adviser suggested that the doctor might advise the insurance company to whom he had provided the original report that he wished to withdraw his original report as he now had reason to believe that it might not be accurate. She suggested that he could tell the insurer that he could not produce a new report on the video surveillance without additional consent from the patient.
Outcome
The doctor was relieved to have avoided a potential breach of confidentiality. He planned to change his practice and would in future obtain written consent for all such reports and would ask for additional consent if any further reports were sought.
Dr Kathryn Leask
Medico-legal adviser
This page was correct at publication on 04/12/2013. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.