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CAREGIVER ID BADGES
In an attempt to minimize patient confusion over the levels of training of heath care providers, Pennsylvania will be requiring all physicians and employees who provide direct patient care to wear photo identification badges.
The law will be rolled out in two phases: 1.) physicians and their employees in private medical practices and required to wear these badges as of December 10, 2011. 2.) Employees in hospital settings will be required to do so starting in June 2015.
According to the interim regulations, all badges must contain:
- A photograph taken within the last four years;
- An employees’ full name;
- The title in which the employee is licensed or certified by;
- The name of the health care facility or employment agency.
The Pennsylvania Academy of Dermatology and Dermatologic Surgery (PAD) has received both positive and negative feedback on this new regulations. Below is an explanation from John Laskas, MD, chair of PAD’s Patient Safety and Scope of Practice Committee, about why he feels these new regulations will serve an important purpose:
Section Index
Intro
Statement of Problem
Why Do We Patients Just Not Ask?
The Solution
As the author of this legislative concept, it is my duty and privilege to explain the rationale behind the Identification Badge Law. Please read the entirety below before concluding formulation of your opinion regarding it.
It is most unfortunate that in promulgating interim, temporary regulations, the Pennsylvania Department of Health has failed completely to explain or implement the basic reason for this law and failed to show how the law is intended to solve a problem that all of us, as physicians and patients, encounter every day with increasing frequency. Further, the DOH has failed to even mention, discuss, demonstrate, or require the most critical part of the badge, which the law requires. The law itself requires them to do so when they promulgate the final regulations. We beg that they do offer that communication immediately.
The badge is intended primarily to identify the CREDENTIAL of the caregiver in a standardized, predictable location on every badge, in a uniform type size, in order that every patient can tell immediately whether they are being treated by a PHYSICIAN, NURSE, NURSE PRACTITONER, PHYSICIAN ASSISTANT, PHYSICAL THERAPIST, DENTIST, DENTAL ASSISTANT, ETC.
At this point in the discussion, I ask that we put aside for the moment our viewpoint as physicians and consider these thoughts, as we are, indeed, patients and families of patients – parents, siblings, grandparents, etc.
When we are sick, we are privileged to have access to the finest medical care on the planet. There are many who serve as caregivers, including physicians, nurses, physician assistants, physical therapists, social workers, etc. The days are past when the only caregiver was the neighborhood doctor.
Today, many of these individuals serve as primary caregivers in individual settings, including private offices, hospitals, emergency rooms, and pharmacy clinics.
There is a wide spectrum of training and expertise among caregivers. In a clinical setting, it is often impossible for us to know whether the person offering care is a physician, nurse, physician assistant, pharmacist, dentist, dental hygienist, etc., in spite of the fact that some wear badges.
Many hospital identification badges have an institutional logo and photograph taking up most of the badge with the name of the caregiver and their license credential too small to read. There is no consistent design allowing a patient to read or search a badge for their credentials without physically grabbing hold of the badge.
Moreover, we patients often have no idea what the alphabet soup of credentialing designations means. What does Pa-C, MD, CRNP, DO, RN, LPN, etc. mean to us? Something official sounding, but what?
There are laws and regulations in Pennsylvania promulgated by the various licensure boards whereby nurses and physician assistants must identify their credentials when caring for patients. This is not the case for physicians. Patients often infer that when no badge appears the person in the white coat or scrub suit is a physician, when most often they are NOT.
Depending on our illness or other circumstances, we patients may prefer to see a physician, physician assistant, nurse practitioner, or physical therapist, etc.
More often than not, we do not know the credentials of the person providing care. Here is a person in a white coat or scrub suit literally holding our life in her hands.
WHY DO WE PATIENTS JUST NOT ASK?
Because by doing so we are afraid of insulting the caregiver in front of us by questioning his or her expertise. We are afraid of this because literally this person often holds in his or her hands our lives or that of our loved ones. We’re afraid to incite anger or resentment.
Patients have the absolute right to know the credentials of the person to whom they entrust their lives in each and every medical transaction.
Consider your three-year-old child develops a fever of 103 and a rash. Perhaps this a simple flu-like virus, but could it be meningitis? You take her to the local pharmacy clinic, where you are assured all is well and you are given Tylenol. In 18 hours, your child is dead of meningitis.
What were the credentials of the person in that white coat? Was it a physician, nurse, physician assistant, social worker, pharmacist, or what? Would you have chosen further consultation if you knew that this was not a physician? We have no way of knowing the credentials because identification was absent, obscured or too small to read.
After your heart attack, you awake 200 miles from home in a hospital unfamiliar to you. At midnight a person in a scrub suit arrives to inject an unknown substance intravenously. Wouldn’t you like to know immediately that this is a nurse and not the medical secretary who is helping the nurse who is too busy elsewhere “just this once?”
The critical piece of the required design is the licensure identification in the strip on the bottom of the badge. The law requires that the title “Physician,” “Nurse,” “Physician Assistant,” etc. appear in the one-half inch strip across the entire bottom of the badge in the largest typeface possible as shown below:
This solution to the identification problem is simple. The essence is that the license credential appears in a standard position, size, and typeface across the bottom of the badge. This will make it immediately accessible at a conversational distance.
This badge will enable all of us, as patients, parents, grandparents, and physicians to know the credential of every health care giver attending us, whether in a hospital, private office, pharmacy, or any other clinical setting. In this way, we patients and our families can have the information we need to decide whether or not to consent to trust our life to the person in the scrub suit who confronts us.
The Pennsylvania Department of Health must correctly inform everyone concerned about the one-half inch identification strip immediately.
John J. Laskas, Jr., MD
Media, Pennsylvania