Consider Liability Risks Before Permitting Individuals to “Shadow” Physicians

A recent news report indicated that a physician at a New York hospital allowed a college student to insert a tube down an anesthetized patient’s throat to help the patient breathe, even though the student had no training to perform the procedure. The student, who was considering going to medical school, was “shadowing” the physician.  An operating room employee reported the incident to management, but the hospital did nothing about it until state inspectors showed up to investigate a complaint about the event on behalf of the federal Centers for Medicare and Medicaid Services. Inspectors categorized the incident as “immediate jeopardy,” the most serious type of deficiency that can cause serious injury or death to patients.

Therefore, when responding to a request to allow a high school or college student shadow you at an office or facility, consider the following:

• High school and college students may not understand state and federal patient privacy laws, and there is an increased risk that they will share their experiences with friends and family, as well as in college and on job applications.  You must ensure HIPAA compliance for any person who is permitted to access patient health information.
• You must be fully aware of the student’s medical history/status, including his/her vaccination record.
• Patients must understand and agree to have an unlicensed individual in the room during their encounter with you, and their consent should be clearly documented in the medical record.
• There are liability risks associated with allowing untrained, unlicensed persons to assist in patient care.  The “shadowed” physician would likely be held responsible for any injury caused by a student. Likewise, you cannot allow an unlicensed, untrained person to perform tasks that require a license.  Improper delegation of tasks may subject the supervising physician to action by the Office of Professional Medical Conduct (OPMC).
• In addition to the potential harm to patients, students and other unlicensed persons are also at risk for personal injury when using equipment that is unfamiliar to them.

Considering the above risks, it is recommended that physicians should only permit individuals such as medical, physician assistant or nursing students in an established training program to “shadow” them.  These programs should provide documentation of adequate liability insurance for their students. The programs must also delineate in writing those specific tasks which the students have been credentialed to perform.  They may perform those credentialed tasks only if the patient’s consent has previously been obtained.