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Ethical Considerations When Taking Time Away From Private Practice
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Ethical Considerations When Taking Time Away From Private Practice    

Anthony Zamudio, Ph.D.

 

Dr. X is planning a vacation and his officemate who is normally available for coverage is unavailable so Dr. Y agrees to cover his practice.  Upon Dr. X’s return, he receives a “Welcome Back!” note from Dr. Y with a billing statement for a psychotherapy session with one of his patients.  Dr. Y requests forwarding the statement to the patient.  Dr. X is surprised with the billing given that he and his officemate don’t normally bill for emergency sessions.  He also realizes that Dr. Y is not on the patient’s HMO insurance panel, so the patient is billed at a full-fee rate.

This hypothetical scenario highlights several important ethical considerations when making arrangements for time away from private practice and may help to avoid strained and broken clinical and professional relationships that result from being uninformed.   

 

For Psychologists Requesting or Providing Coverage:

Code 3.07, Third Party Request for Services states, “When psychologists agree to provide services to a person or entity at the request of a third party, psychologists attempt to clarify at the outset of the service the nature of the relationship with all individuals or organizations involved.”   Dr. Y is similar to a third party in agreeing to provide services for Dr. X’s practice so it would be important to not only clarify Dr. Y’s availability and clinical competency but also to review financial arrangements with insurance companies, employee assistance programs, and/or other private organizational contracts that exist within Dr. X’s practice. 

4.04 Minimizing Intrusions on Privacy (a) states, “Psychologists include in written and oral reports and consultations, only information germane to the purpose for which the communication is made.”  The code is a reminder that we want to focus only on relevant information that will help colleagues in managing emergency situations.  Information exchange that borders on “gossip” and is not clinically pertinent should be avoided.

6.04 Fees and Financial Arrangements (a2): states  “As early as is feasible in a professional or scientific relationship, psychologists and recipients of psychological services reach an agreement specifying compensation and billing arrangements.”  Dr. X needed to discuss financial arrangements with Dr. Y and his patients before his time away.  Dr. X and Dr. Y should agree on how sliding scale, pro bono, and insurance patients will be reimbursed, and how fee arrangements will be handled. 

 

For Patients Regarding Their Treating Psychologist’s Time Away:

3.10 Informed Consent (a) states, “When psychologists conduct research or provide assessment, therapy, counseling or consulting services in person or via electronic transmission or other forms of communication, they obtain the informed consent of the individual or individuals using language that is reasonably understandable to that person or person.” Clear language for patients on how fee arrangements for services provided with other clinicians during time away should be included in consent to treatment forms. 

4.02 Discussing the Limits of Confidentiality (a2):  The code addresses “the foreseeable uses of the [confidential] information generated through their psychological activities.” The code suggests informing patients that colleagues who provide coverage during your time away will receive only pertinent clinical and financial information to ensure adequate management.

Reference:

American Psychological Association (2010).  Ethical principles of psychologists and code of conduct.

     Retrieved from www.apa.org/ethics/code.

 

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