Today's newsletter is coming late in the day, with very good reason. I spent today at the University of South Carolina School of Medicine Greenville (USCSOMG), talking with medical students about reproductive healthcare and the law in South Carolina. The room was full. Medical students were engaged, curious, and understandably worried. They gave me real hope about the doctors coming into the profession.
Here is the short version of what I walked them through: South Carolina’s law prohibits abortion once cardiac activity is detectable, with exceptions for medical emergencies, rape and incest up to 12 weeks, and fatal fetal anomalies (and those exceptions are narrower than they sound). The law protects contraception, and it exempts pregnant patients from prosecution. The legal risk lands on physicians, and it comes in three lanes: criminal, civil, and the medical board. My biggest takeaway for them was that charting is your best defense. Specific notes about your reasoning protect you. Vague ones do not.
I also warned them about a more practical risk. I know from working in a hospital for seven years and talking to physicians on a regular basis now, that sometimes when they feel unsure about the rules, they might hold back care they could safely give. Knowing exactly where the lines sit (as much as that is possible with the current state of affairs) helps you treat patients with confidence.
What's this mean for DPC practices?
A hospital doctor has a risk management office and a legal team down the hall. A DPC doctor is the office. You are also often the first call a patient makes about contraception, an early pregnancy, or a miscarriage. Your own policies and your own charting have to carry the weight.
Three questions worth asking yourself this week:
1. Does my membership agreement say clearly what I provide and what I refer out? This goes not only for reproductive healthcare, but all kinds of care.
2. Does my charting show my reasoning in specific terms?
3. Do I know a lawyer I would call before I need one?
The law in this area keeps moving, and I'll keep watching it for you.
Kim
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This newsletter is for general information only and is not legal advice. It does not create an attorney-client relationship.