Phony doc walks into ED — Could it happen to you?

Impostor enters patient’s room, reviews charts

A man walked into an ED, told several nurses he was a doctor, and asked for a patient’s room number. The nurses showed him the room, where he proceeded to look through the patient’s medical charts. There’s only one problem: The man wasn’t a doctor!

This real-life horror story occurred at Akron (OH) City Hospital this year. It ended when the man in question tried to stop ambulances from entering the hospital parking lot, and the police arrested him.

Could it really be that easy? "Unfortunately, yes," admits Grena Porto, who heads QRS Healthcare Consulting in Hockessin, DE. "People sometimes forget we are charged with the safety of people and not just their medical care."

Of course, in the Akron case, the risks went beyond safety. "For sure you have a HIPAA [Health Insurance Portability and Accountability Act] issue," notes Porto. Beyond that, you could certainly have a legal liability issue with the patient, she says. "They could independently sue you," Porto says.

However, there is a positive side to events like these, says Jeff Snyder, MD, FACEP, regional medical director of emergency services for Premier Healthcare Services in Omaha, NE, which provides emergency medicine services for Allegiant Healthcare. "This has happened on and off over the years in several places; and usually when it occurs, it stimulates the hospital to develop better policies and procedures," Snyder says.

That result certainly was the case in Akron. Heather Phillips, a spokeswoman for Akron City Hospital, says, that since the incident, they reviewed the functionality of all technological and security systems. 

"We have increased our security presence in the area to monitor and direct patient and family access into the emergency department, and we plan to lock down our ambulance bay doors 24 hours a day," she says.

Of course, it would have been better if the event had not occurred at all, and there’s a good deal that ED managers can do to help prevent similar events in their departments.

"Hospitals are required to have photo IDs for all staff, including physicians, and they should be required to show them on demand — any place, any time," Porto explains. In the ED, you are somewhat more vulnerable in that you may have a whole lot of people coming in you may not know, she says. "This makes [demanding ID] more imperative. If they can’t produce ID and show they are who they say they are, do not let them in." This policy should include voluntary attendings, she says.

In fact, Porto adds, if requiring IDs to be shown on demand is not a hospitalwide policy, "the ED manager can require it just for the ED."

Snyder’s facility requires name badges for everyone. "I’m talking about janitors — and including, for example, every physician who has privileges," he says. When you join the staff and are oriented, you receive an ID badge, as well as five-digit numbers that allow you to access the computers," Snyder says. "No nurse here would give a doctor any charts, or other patient information, without a badge," he says.

All new physicians have large (8-by-10 inch) photos of themselves posted in the medical staff lounge, he continues. "That works as a security measure as well, because everyone comes in and checks out the new people, so they have their images in their minds."

At Lakeside hospital, Allegiant’s new "smart" technology facility, security is even tighter. "You can’t open a door without swiping your name badge," notes Snyder. "Once in, you can’t gain access to the main hospital, or back to the ED, without it."

To ensure your all staff are on the same page, Porto says, "It is absolutely worth an inservice" to spread the word about security. "This involves a shifting of mindset among all of us," she says. In the old days when someone wanted to see a patient or provide a consult, they never were required to pass a screening, Porto notes.

Today, there is a completely new reality, she says. "We were not raised in this environment, but we can no longer assume people are safe and friendly. People you don’t know pose a potential risk, and you should proceed accordingly," Porto explains.

And the recent rash of individuals appearing at hospitals posing as accreditation surveyors is living proof "that this is not a far-fetched threat. It happens," she adds.

Sources

For more information, contact:

  • Heather L. Phillips, Summa Health System, 525 E. Market St., Akron, OH 44309. Phone: (330) 375-7930. Fax: (330) 375-7936. E-mail: philliph@summa-health.org.
  • Grena Porto, QRS Healthcare Consulting, 7454 Lan-caster Pike, No. 301, Hockessin, DE 19707. Phone: (302) 235-2363. E-mail: gporto@earthlink.net.
  • Jeff Snyder, MD, FACEP, Regional Medical Director, Emergency Services, Premier Healthcare Services, Omaha, NE. Phone: (712) 328-5230. E-mail: JSnyder@phcsday.com.