A reader asked me a question the other day:
If I have warrant out for my arrest, can my doctor or hospital turn me in to the police?
Great question. Here's a recent example. I heard about an unusual story a few months ago on one of those Dateline type television shows. His name was Roger Gamblin. He was a Florida fugitive who skipped town after he allegedly defrauded his title company clients of ten million dollars. How was he found? From what I remember hearing, Mr Gamblin showed up in a Colorado ER with signs of progressive heart failure. Unfortunately for Roger, and fortunately for the FBI, who had been looking for him for over two years, Mr Gamblin had a pacemaker.
And supposedly, during a routine evaluation of Mr Gamblin's cardiac condition, a pacemaker check was performed. And wouldn't you know, the name attached to the unique pacemaker identification number did not match the name Mr Gamblin gave when he was admitted to the hospital. At that point, someone (perhaps even his physician), decided to investigate the background of the real Mr Gamblin and discovered he was a fugitive on the run. When he was discharged from the hospital, the FBI was there to pick him up. Someone turned him in to the authorities. Of course, you might be wondering what the duty of the physician is in this case. Should physicians turn in their patients to authorities if they know they have a criminal warrant out for their arrest? The internet is filled with public warrant data bases for anyone to search.
Physicians are part of the public. I suspect they have an obligation, as does anyone in the public, to notify authorities if they find out one of their patients have a warrant out for their arrest. Now, does that mean they should actively be searching the data base while their patients are being treated? Perhaps. Perhaps not. Physicians don't clock in and out and if they want to do a public search while at work, they don't need permission. If hospitals choose to ban websites, wireless technologies are there to pick up where the censorship of left off. There might even be an app for that. And if there isn't an app now, there eventually will be. You can count on that.
I know some medical school doctor friends of mine who routinely cross reference the public warrant site with their patients while at work. I'm not sure who they decide to check out and who they don't. Maybe they profile their patients based on their medical condition or the number of readmissions they make to the hospital or how rude they are. Who knows. I suppose the public can profile a criminal search however they want.
I also don't have any idea how HIPAA plays into all this. I suppose having a warrant out for one's arrest has nothing to do with confidentiality of one's medical condition and any member of the public has a right to search a public data base. As a physician, is letting authorities know a wanted person is seeking medical care legally acceptable? I suspect it is, but I don't know the specific legalities of what is and isn't allowed. Heck, if the FBI was waiting for Mr Gamblin, the hospital and their lawyers must have felt it was acceptable and they aren't alone. In fact, because of devastating Medicare hospital margins in today's insurance environment, doctors and hospitals are rapidly expanding their pool of potential revenue streams by taking advantage of these fugitives. In just a few short weeks, a nationwide hospital bounty reward system is going to be implemented. You heard it here first.
As part of Obama's next stimulus of the month package, physician productivity based RVU payments will be banned and replaced with the captured fugitive quality score standard. The more dangerous the fugitive you catch, the greater your score and the larger the physician and hospital quality bonus. It will help doctors and hospitals work together toward a common goal. This should generate millions of jobs and put hundreds of thousands of prison guards back to work.
In addition to the carrots, sticks have also been built into the program. If fugitives escape from the hospital without being captured, hospitals and physicians will lose millions in escape fees. The more fugitives that escape, the larger the escape fees. No longer will take home pay be dependent on RVU benchmarks. No sir. You're going to get paid based on how many patients you bag for the poh-leece on any given night. Get ready hospitalists. You're going to be on the front lines of the next greatest stimulus package to hit our country since, well, last year, and the year before that, and the year before that...