Yet another mode of communication to worry about

"If this is an emergency, hang up and dial 911."

Medical providers easily add the ubiquitous message to their voice mail outgoing message. Lawyers warn us to avoid texting and email with patients because we cannot add such a message, and judges and juries may hold us responsible if an emergency turns into a disaster when we have failed to respond in time.

Add another mode of communication to the list to worry about. Last week the relative of a prospective patient made a credit card payment for the patient's evaluation through a widget on my practice Web site. Unbeknownst to me, the payer can add a note to the payment. When we accessed the record of the transaction on the Web portal we saw the patient's entire psychiatric history detailed in the note.

Imagine the potential for disaster that could stem from assumption that I will read such a note immediately. A patient could make a payment and add a note describing chest pain preceding a fatal heart attack. A patient's relative could send the contents of a suicide note.

How long before courts will hold the sender responsible for knowing the limitations of each and every form of communication they choose? Can we not now reasonably expect that, absent a response within a few minutes, the sender might realize they must call 911 on their own?

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