Public Health Law Map - Beta 5 - Medical and Public Health Law Site

College physicians must respect the students’ confidentiality. The fact that a parent
may be paying the tuition or medical bills does not give the parent the right to
medical information about a child who is not a minor. At the same time, the parents
of a college student have the reasonable expectation that they will be contacted if the
student is in trouble or requires significant medical care. The university should
require students to sign a waiver that allows it to contact the student’s parents in such
circumstances. (The university should allow exceptions for students who are
estranged from their parents.) For certain kinds of care, such as treatment for drug
abuse or venereal disease, the information should be protected unless the student
requests that parents be notified. However, students must understand that they may
have to pay for the care if they want to keep it confidential. The physician should
explain to students who ask that something not appear on a bill that few parents and
no insurance company will pay for unspecified services.
6. Comprehensive Care
Many college physicians are caught in a dilemma between the medical needs and the
financial problems of students. With rising tuition and fees for education, many
administrators are loath to require all students to show that they are covered by
health insurance. The expectation of both students and administrators is that the
student health service will take care of most health problems. The student’s failure to
buy insurance does not relieve the physician of responsibility for providing quality
medical care. The student health service and the individual physicians should set
policies for dealing with students who are unable to pay for necessary medical care.
For residential students with major medical problems, physicians must consider
whether the student can stay in school. If the student is hospitalized or otherwise
completely unable to attend school, the decision is obvious. The issue becomes one
of where and when to transfer the patient for ongoing care.
For students with less severe problems, the decision is more difficult. Most people do
not choose a school based on the availability of medical care. However, if the student
has a major disease requiring care that is unavailable at or near the school, the
potential for crisis is great. Student health physicians should be cautious about
accepting responsibility for caring for students with problems that they would
consider beyond their skills in another setting. The presence of such disease in a
student constitutes a federally protected handicap. The school must make proper
accommodation for the student’s handicap, including arrangements for medical care,
or justify why providing that care is impossible.
E. References - Institutional Medicine
1. Schools
Bradford BJ, Benedum KJ, Heald PA, Petrie SE. Immunization status of children on
school entry: area analysis and recommendations 1991. Clin Pediatr (Phila.).
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