RE: [Philmont]: Medication information and privacy

It is not your job to make medical decisions for someone who is not a
client. It is not your job to make medical decisions for people when you are
not an MD.

See the post I just sent out.

Nothing I have said implies any of the stuff you write below. I am saying it
is legally, morally and ethically not your job. It is the personal
physician's job. That personal physician then has the responsibility to make
sure the unit leader knows what they should know about the child on the
form.

I have the kids welfare in mind. I believe that the best person to make the
medical decisions about the kids is the kids personal physician. When/If the
youth needs assistance I am prepared, EMT instructor, attorney for the
Wilderness Medical Society, I have more CME's this year then most MD's. But
I do not decided who goes on any trip. (Besides BSA I am a professional
mountain and river guide.)

"The Philmont physical examination form is not a "1 page medical
questionnaire." It asks for a complete medical history and for a complete
accounting of all medications a Philmont participant is taking." You are
correct, the information is provided by the parent to the physician for the
physician to evaluate.

That was the issue brought up in the post that I responded to. Collecting
more medical information than is necessary and having no physician's review
that information.

I risk lawsuits everyday. But the BSA can't. (I base that on defending the
BSA for years.) What they cannot defend is when volunteers walk outside the
program BSA has set up and unknowingly causes a lawsuit. Remember, you
homeowners is primary, but the BSA always steps in and covers you with your
carrier.

Jim

-----Original Message-----
From: Shane Hoffman [mailto:mycales@comcast.net]
Sent: Sunday, December 04, 2005 7:08 PM
To: bsa.rec.law@gmail.com
Subject: Re: [Philmont]: Medication information and privacy

Jim,

I don't understand where you are coming from with this. Are you saying it
is better to be ignorant of one of your Scout's physical, medical, or
emotional problems, and then when that problem blows up on day 4 or 5 at
Philmont you can just put your hands and say "I didn't know, so I'm not
responsible?" If you had that attitude towards my "kids" I would not have
you in my crew. I understand that you are a lawyer and that every possible
misstep is a lawsuit waiting to happen, but if you are not willing to take
complete responsibility (whether you have to or not) for the Scouts or
Venturers under your authority, you are not yet ready to lead them.

The Philmont physical examination form is not a "1 page medical
questionnaire." It asks for a complete medical history and for a complete
accounting of all medications a Philmont participant is taking. The reason
for needing all of this knowledge is that Philmont will represent the most
challenging physical activity many participants have ever or will ever face.

The stress of the trek can bring out severe problems in even the least
serious medical conditions.

As a pharmacist, I have 5 years of college training and 16 years of
professional practice in reviewing medical records. My number one job is to
assist physicians in making proper medicinal decisions. My second job is to
counsel patients about their medications and medical conditions. If your
pharmacist is not performing these two tasks, find another pharmacist.

I understand that a vast majority of crews going to Philmont have no medial
professional as a member of the crew. That does not lessen the fact that
little "John Doe" has moderate asthma, and climbing up Mt. Phillips in a
rain storm brought on an acute asthma attack, and because Joe Bumpkin
advisor didn't take the time to find out he had an asthmatic in his crew he
didn't know to look for an inhaler, or to carry a backup. All advisors need
to know what the Scouts/Venturers under their care are taking and what kinds
of medical or emotional problems they may have.

I guess the question is just how much is a Scout's health at Philmont worth?

I'll take the live John Doe and risk the lawsuit when he gets home alive and
well. Like I stated previously, my brother watched a kid die at Philmont
from lack of inhalers - his ran out and his advisor didn't know he was
asthmatic and had no backup inhaler. I will not have that happen on my
watch.

I don't mean to flame, but your bold statements call for rebuttal.

Shane Hoffman
Advisor Crew 445 - www.crew445.org - SHoffman@crew445.org ASM Troop 445 -
www.troop445.org - SHoffman@troop445.org "We should all realize that every
right implies a responsibility, every opportunity an obligation, every
position a duty, and that the most effective sermon is expressed in deeds
instead of words." ~ Waite Phillips

----- Original Message -----
From: "James H. Moss" <bsa.rec.law@gmail.com>
To: "Multiple recipients of list philmont" <philmont@troop47.com>
Sent: Sunday, December 04, 2005 3:58 PM
Subject: RE: [Philmont]: Medication information and privacy

> WHY IS ANY PERSON IN THE BSA REVIEWING MEDICAL RECORDS?
>
> The reason why the BSA only uses a 1 page medical questionnaire is because
> to ask for any more information creates liability.
>
> Unless you are an MD, what medical training do you have to review a
> medical
> record? (That question is self answering so don't try!)
>
> Sorry folks, but this one sends me through the roof. You are not stopping
> liability by reviewing someone's medical history, you are creating
> liability.
>
> The BSA has more of a history on this than any other subject. If they
> wanted
> you to review someone's medical history, they would have given you a form
> to
> do it!
>
> Let me repeat IF YOU ARE REVIEWING MEDICAL HISTORY OTHER THAN WHAT IS ON
> THE
> BSA MEDICAL'S YOU ARE CREATING A LAWSUIT FOR YOURSELF.
>
> Jim Moss
>
> -----Original Message-----
> From: owner-philmont@troop47.com [mailto:owner-philmont@troop47.com] On
> Behalf Of robertktuck@cox.net
> Sent: Sunday, December 04, 2005 2:27 PM
> To: Multiple recipients of list philmont
> Subject: Re: [Philmont]: Medication information and privacy
>
> Get the consent of the parent, in writing, to review the medical history.
> This issue has come up dealing with COPE, where we are required to review
> medical records. If you have a release signed by the minors parents of
> guardians, then you will be able to legally review the records.
>
> Robert Tuck
> First Responder Instructor
> COPE & Climbing Director
>
> PS In Georgia, inhalers are available off the shelf at Walmart. (Their
> usage
> still requires a doctor)
>>
>> From: "Shane Hoffman" <mycales@comcast.net>
>> Date: 2005/12/04 Sun PM 03:57:06 EST
>> To: Multiple recipients of list philmont <philmont@troop47.com>
>> Subject: [Philmont]: Medication information and privacy
>>
>> Roy,
>>
>> You raise a bit of a conundrum here. With the HIPPA privacy laws that
>> medical professionals must now practice under it may be hard to get
>> information about an individual's medical conditions and medications
>> being taken. I am really surprised that this has not become an issue
>> with the Philmont physical form yet.
>>
>> I would like to suggest getting your crew's physical forms together at
>> least a month before departure, and then take the time to become
>> familiar with each person's conditions (but if I suggested this I
>> would be breaking HIPPA laws). Under HIPPA, unless you are a medical
>> professional overlooking that patient's care, you aren't even allowed to
> look at the physicals.
>>
>> That being said, when I collected our contingent physical exams in May
>> of this year, I crafted a little HIPPA release/signature form stating
>> that parents/adults were aware that a medical professional (myself)
>> would be reviewing their physical and medication history in order to
>> properly prepare the advisors in the crews with possible
>> medical/medication situations on the trail.
>>
>> I don't know if the little release I crafted would stand up, but all
>> of the parents knew I was a pharmacist and trusted me with the
>> information. As it turned out, one of our young men did not medicate
>> properly for a couple of days on the trail and the knowledge passed on
>> to the advisors about what to expect kept the young man on the trail
>> instead of at the med shack back down at base camp.
>>
>> You have opened a VERY touchy subject concerning patient privacy. I
>> would really like to know the BSA's stance on this issue.
>>
>> If you are given the medication information willingly, most of the
>> questions you raised (symptoms of over or underuse, side effects,
>> proper dosing times,
>> etc.) can be found on reputable websites.
>>
>> Shane Hoffman, R.Ph.
>> Advisor Crew 445 - www.crew445.org - SHoffman@crew445.org ASM Troop
>> 445 - www.troop445.org - SHoffman@troop445.org "We should all realize
>> that every right implies a responsibility, every opportunity an
>> obligation, every position a duty, and that the most effective sermon
>> is expressed in deeds instead of words." ~ Waite Phillips
>>
>>
>> ----- Original Message -----
>> From: "R Fisher" <ghotier@texas.net>
>> To: "Multiple recipients of list philmont" <philmont@troop47.com>
>> Sent: Sunday, December 04, 2005 1:51 PM
>> Subject: RE: [Philmont]: Peanuts, EpiPens, and Anaphylaxis
>>
>>
>> > Tom Lindtveit writes in part:
>> >
>> >> Shane made me think of something else too, Pharmacists can provide
>> >> valuable information on medications and the effects they will have.
>> >> If you have a youth or adult on your crew taking meds you know
>> >> nothing about, you might want to ask your local Pharmacist what
>> >> those drugs are, how they work, and what side effects they may have
>> >> paying particular attention to their effects under heavy exertion.
>> >
>> > I forget who it was, I think it was T.W. Cook, that had a crew
>> > member at Philmont that was taking a medication to control something
>> > that turned out to be a diuretic and the crew member got severely
>> > dehydrated as a result.
>> >
>> > I'm not a doctor or a pharmacist, but other questions I have on our
>> > med sheet are:
>> >
>> > What are the symptoms that the indicated medication might not have
>> > been taken?
>> > What other known medications, prescription and OTC, are
>> > contra-indicated or might have interaction problems?
>> > What conditions should the medications be taken, i.e. with food, X
>> > amount of time before/after meals, etc.
>> >
>> > Happy Trails,
>> >
>> > Roy Fisher
>> >
>> >
>> >
>> >
>> >
>> >
>> >
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>> > reverent.
>> > -------------------------------------------------------
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>> >
>> >
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>> As you gather around this virtual campfire with fellow Scouts and
>> Scouters, do your best to be trustworthy, loyal, helpful, friendly,
>> courteous, kind, obedient, cheerful, thrifty, brave, clean and
>> reverent.
>> -------------------------------------------------------
>>
>>
>>
>>
>>
>>
>>
>
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> -------------------------------------------------------
> As you gather around this virtual campfire with fellow Scouts and
> Scouters,
> do your best to be trustworthy, loyal, helpful, friendly, courteous, kind,
> obedient, cheerful, thrifty, brave, clean and reverent.
> -------------------------------------------------------
>
>
>
>
>
>
>
>
>
>
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> -------------------------------------------------------
> Scouting E-mail Discussion Lists @ usscouts.org
> Subscribe/Unsubscribe at http://usscouts.org/lists/
> Listserv Commands at http://usscouts.org/lists/lc.asp
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> Send listserv commands to: listserv@troop47.com
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> List FAQ found at: http://usscouts.org/lists/faq.asp
> List Administrator: philmont_owner@troop47.com
> -------------------------------------------------------
> As you gather around this virtual campfire with fellow
> Scouts and Scouters, do your best to be trustworthy,
> loyal, helpful, friendly, courteous, kind, obedient,
> cheerful, thrifty, brave, clean and reverent.
> -------------------------------------------------------
>
>
>
>
>
>
>

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Subscribe/Unsubscribe at http://usscouts.org/lists/
Listserv Commands at http://usscouts.org/lists/lc.asp
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Send listserv commands to: listserv@troop47.com
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-------------------------------------------------------
As you gather around this virtual campfire with fellow
Scouts and Scouters, do your best to be trustworthy,
loyal, helpful, friendly, courteous, kind, obedient,
cheerful, thrifty, brave, clean and reverent.
-------------------------------------------------------

 
Received on Sun Dec 4 21:42:44 2005