Safely Reporting Concerns

Health care workers do have other protected ways to report patient and employee safety concerns. There are federal and state laws that “prohibit employers from retaliating against employees who report practices by employers that threaten public health and safety, or violate the law . . . Although the laws vary from state to state, anti-retaliation laws generally prohibit adverse actions such as termination, layoff, demotion, suspension, denial of benefits, reduction in pay, and discipline, when the adverse action is taken in retaliation for employees’ reports of unsafe or unlawful practices.”⁷ In most situations this reporting can be done publicly or anonymously if a health care worker is concerned about retaliation from their employer. The state and federal government want to protect appropriate whistle blowers and encourage reporting of concerning events, even if after investigation found to be not significant or a violation of state or federal law.

I hope after reading this, emergency physicians understand there are multiple ways to report perceived unsafe practices to the local, state, and federal authorities. These include state and local health departments, state Medicaid officials, your state Medicare contracted BFCC-QIO contractor such as Livanta and Kepro, the Joint Commission, and OSHA to name just a handful. Many of these can be anonymous if that is your preferred way to report. Also, if you send emails/other correspondence, save them, and consider even sending things certified mail when needed. Your first step should not be social media. Familiarize yourself with all of these options, your contract terms, and your medical staff bylaws before you go to social media. The social media postings may get the most publicity, but may not always result in the desired outcome of increasing patient and employee safety efficiently and effectively. ACEP is helping move the protection of physicians forward through the AMA and local state ACEP Chapters. It is estimated that only 15 percent of practicing physicians belong to the AMA, so hard work at the state chapter level will be needed to move the Arizona concept forward to other states for adoption.

Dr. Naber is associate chief medical officer at UC Health, Drake Hospital in Cincinnati and associate professor of emergency medicine and medical director of UR/CDI at University of Cincinnati Medical Center.

References

1. Will Stone. The Coronavirus Crisis: An ER Doctor lost his job after criticizing his hospital on COVID-19. Now He’s suing. NPR news web site. Available at: https://www.npr.org/sections/healthshots/2020/05/29/865042307/an-er-doctor-lost-his-job-after-criticizing-his-hospital-on-covid-19-nowhes-sui. Published May 29, 2020. Accessed June 24, 2022.
2. Jamie Landers. “A slap in the face”: Yuma hospital fires ER doctor for talking about COVID-19 in Arizona. Azcentral web site. Available at: https://www.azcentral.com/story/news/local/arizona-health/2020/12/10/cleavon-gilman-fired-yuma-hospital-speaking-outcovid-19/3888981001/. Published December 10, 2020. Updated December 11, 2020. Accessed June 24, 2022.
3. Kara Grant. Fired Doc sues NYU for Discrimination, Defamation, and Retaliation. MedPage Today website. Available at https://www.medpagetoday.com/special-reports/exclusives/94989. Published October 12, 2021. Accessed June 24, 2022.
4. The US Constitution, Amendment 14.
5. Weiss, LD. AAEM white paper on due process rights for physicians. J Emerg Med. 2007; 33:439–440.
6. ACEP Council Resolution 31(21). Subject: Employment-Retaliation, Whistleblower, Wrongful Termination. Available at www.acep.org/globalassets/uploads/uploaded-files/acep/about-us/leadership/council/2021-resolutions-compendium.pdf. Accessed June 24, 2022.
7. National Nurses United. Whistleblower Protection Laws for Healthcare. National Nurses United website. Available at https://www.nationalnursesunited.org/whistleblower-protection-laws-for-healthcare-workers. Accessed June 24, 2022.