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It is a breach of professional privilege for a doctor
to disclose to an insurance company information
concerning a patient obtained as a result of a patient
and doctor relationship. The prohibition against
disclosing such information clearly applies to any
practitioner on the staff of a local authority or other
public or private hospital who obtains information
concerning a patient in the hospital either by casual
observation or in the course of treatment of the
patient by virtue of his position on the hospital staff,
just as it applies to a doctor who is engaged speci–
fically by the patient to make an examination and
report for that patient's use.
Where a doctor conducts an examination of an
injured person on behalf of an insurance company
for the benefit of the company and disclosed to the
patient or his advisers that he is acting in the interests
of the insurance company different considerations
naturally apply. In cases not within the Workman's
Compensation Act the patient's medical adviser will
be present at the examination. In examinations under
section 33 of the Workmen's Compensation Act,
1934, where the patient attends without his medical
adviser the following is a statement of what the
Association regard as the proper professional practice
(i) the duty a of medical practitioner who is in–
structed by an employer or an insurance company
under section 33 of the Workmen's Compensation
Act, 1934, is to ascertain the medical condition and
state of health of the workman, (2) the medical
practitioner should not accept instructions from the
employer or the insurance company which would
oblige him to exceed his professional duty under
head (i). (3) Questions put to the workman in the
course of the medical examination are in the discre–
tion of the medical practitioner but should be
restricted to the workman's physical condition and
state of health except inasmuch as it may be necessary
to ascertain the surrounding circumstances and
background for the purpose of forming an opinion
on his medical condition and state of health.
(4) Irrespective of any questions put to the work–
man in the course of the examination any written
or oral report by a medical practitioner to the em–
ployer or insurance company should be restricted to
the medical issue and any information on the issue
of legal liability ascertained in the course of the
examination should not be disclosed.
This statement was drawn up after consultation
with representatives of the Incorporated Law
Society."
Examining Medical Officers.
It often happens that a doctor's patient has to be
examined for some particular purpose by a medical
officer representing an interested third party. These
examinations may occur in connection with life
assurance or superannuation, entry into certain em–
ployment, litigation, or requests from the police.
The following ethical code governing special
situations was approved by the Representative Body
in 1957. It does not apply to examinations performed
under statutory requirements, and paragraphs (2)
and (3) do not apply to pre-employment examinations
or to those connected with superannuation, or with
proposals for life or sickness assurance. For the
purpose of this code an examining medical officer is
a practitioner undertaking the examination of a
patient of another practitioner at the request of a
third party with the exception of examinations under
statutory requirements.
(i) An examining practitioner must be satisfied
that the individual to be examined consents, person–
ally or through his legal representative, to submit to
medical examination, and understands the reason
for it. (2) When the individual to be examined is
under medical care, the examining practitioner shall
cause the attending practitioner to be given such
notice of the time, place and purpose of his exam–
ination as will enable the attending practitioner to
be present should he or the patient so desire.
(Preferably such notice should be sent to the
attending practitioner through the post, or by
telephone, but in certain circumstances a com–
munication might properly be conveyed by the
patient.)
Exceptions to this are :
(a)
When circumstances justify a surprise visit.
(b)
When circumstances necessitate a visit within
a period which does not afford time for notification.
Where the examining practitioner has acted under
(a)
or
(b)
he shall promptly inform the attending
practitioner of the fact of his visit and the reason for
his action.
3. If the attending practitioner fails to attend at
the time arranged the examining practitioner shall
be at liberty to proceed with the examination.
4. An examining practitioner must avoid any
word or action which might disturb the confidence
of the patient in the attending practitioner and must
not, without the consent of the attending practitioner,
do anything which involves interference with the
treatment of the patient.
5. An examining practitioner shall confine himself
strictly to such investigation and examination as are
necessary for the purpose of submitting an adequate
report.
6. Any proposal or suggestion which an examining
practitioner may wish to put forward regarding
treatment shall be first discussed with the attending
practitioner either personally or by correspondence.