Tag Archive for: Missouri Professional Licensing Attorney

Kansas and Missouri Professional Licensing Attorney Discusses Ethical Considerations Of Online Therapy

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With so much of our lives entombed in computers, there is little surprise that therapy sessions are now available online. The American Psychological Association (APA) calls the trend “telepsychology.” Telepsychology, according to the APA is the general rubric for any therapy session that is conducted either online, via a web service, or over a telecommunications portal. Both Missouri and Kansas now authorize their licensed therapists to conduct online therapy sessions.

Telepsychology has a tremendous upside, but therapists must be aware of the potential ethical pitfalls. If you are a therapist who has encountered disciplinary action because of online therapy or for any other reason, Kansas and Missouri professional licensing attorney Danielle Sanger has over a decade of experience fighting to protect therapists from allegations of ethical violations.

Some therapists offer video sessions via an online portal like Skype. One company has advanced the idea and has created a computer platform dedicated to facilitating therapeutical appointments without the face to face interaction. The service boasts that use of its portal will reduce costs significantly for patients and be considerably more convenient.

The program works more like a dating service than a referral system. Prospective patients complete an assessment form. The form is analyzed and categorized by individual metrics based on how the patient answers questions on the evaluation form. Next, the patient is matched with a therapist if the patient enrolls in the service. The service plans begin at $32 per week. The patient is eligible to conduct online therapy sessions once the transaction is consummated.

Prospective patients should not be misled. The minimum service is $32 per week. This allows for unlimited text or email exchanges. The website marketing this service indicates that therapists will respond one to two times per day. If written responses are insufficient for the patient, then they can schedule an online chat through a portal like Skype. The service does not indicate what the costs are for a streaming conference session. The website does discuss that couples therapy costs $59 per week. Additionally, the website offers gift cards and corporate functions as well.

The therapeutic services available on the website are what one would expect a psychologist or therapist to provide. They want to attract people who are having relationship difficulties, job problems, feeling trapped, or unable to achieve their goals. The service does have emergency response resources available for individuals who are suicidal or homicidal. However, the website redirects people in crisis to call 911 or present to an emergency room.

One service it does boast is assistance with social media dependence. The service claims that people become depressed and anxious after looking at social media too long. Therefore, some people may require talk therapy to work out their problems caused by prolonged exposure to social media.

Many testimonials posted on the service’s website exclaim the virtue of texting their therapist instead of treating in a traditional setting. Some said that removing the discomfort of face-to-face interaction allowed them to express themselves more accurately. Some people claimed to like the convenience of texting their therapist whenever they wanted to do so.

Therapists who chose to treat their patients this way must be wary of maintaining confidences. Therapists must be aware of protecting privacy and securing privileged information that is stored electronically. Additionally, therapists must be careful not to mislead others while participating in this service.

For More Information

Many people, especially those folks who are busy or live in remote areas who simply do not have the time or the resources to attend regular appointments can benefit from online therapy. As time passes, more and more services will be hosted online. As a result, many ethical questions will need answers. You can turn to Kansas and Missouri Professional Licensing Attorney Danielle Sanger for representation if you are facing a disciplinary hearing or investigation. Call Attorney Sanger today at 785-979-4353 to schedule a consultation and learn how her years of experience and aggressive defense of professional licensees will benefit you.

Kansas And Missouri Licensing Attorney Discuss Tragedy

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A question of whether a boy should have received a second dose of sedative arose after a child passed away during a dental procedure. The child was only 4-years-old. According to Foxnews.com, the boy may have had autism. His mother indicated he was on the autism spectrum although it is unclear whether he was officially diagnosed with the disorder. The boy went to a dentist that has a practice restricted to handling difficult patients. The initial investigation reports suggest that the boy received an additional dose of a powerful sedative before the dental procedure. Kansas and Missouri professional licensing attorney Danielle Sanger has represented numerous dentists and other professionals under investigation for violations of ethical rules.

The four-year-old presented an interesting problem for the dentist: the boy simply refused to open his mouth for the procedure. Despite lesser intrusive techniques, the dentist decided that sedating him would give the dentist the best opportunity to complete the process. The dentist office employs a board certified anesthesiologist to assist with difficult patients. The sedatives help the children relax as well as be compliant and non-combative during the examination. Toward that end, the dentist’s office employs an anesthesiologist to administer the appropriate drug.

Office personnel went to talk to the boy’s mother when the procedure was over. The staff reported to the child’s mother that he was resting comfortably and that it was time to begin to rouse him. The boy did not wake, however. He was found unresponsive and not breathing. Staff immediately commenced CPR and called for an ambulance. The EMS quickly transported him to a local hospital, but it was too late. The child died.

The dentist’s office and practice group declined to comment on the situation specifically because it was under investigation by several authorities. They did comment that their office performed over 1,900 similar procedures over a three-year span without complication or complaint. Furthermore, the dental office stated that the anesthesiologist followed strict protocols and guidelines. To ensure safety, the dental staff consults with the patient’s treating physician to obtain permission to give the child a sedative as a critical component of its anesthesia protocols.

In the immediate aftermath of the boy’s death, the mother learned that the anesthesiologist gave him a second shot of sedative. The sedative used is a powerful drug called ketamine. The mother stated the doctor wanted to be certain the child would not wake up while the dentist was working on him. Had that happened, the dentist would not have been able to complete the procedure. Accordingly, the physician gave a second shot. The report was not clear whether the boy’s mother knew they were going to give him a second shot.

Properly obtaining informed consent is the obligation of every healthcare provider. This instance may present an issue of whether the appropriate informed consent was given by the child’s mother for the second shot a ketamine. This issue will be thoroughly vetted by any investigatory body looking into these events. Therefore, it is vital for every healthcare professional to be certain informed consent is properly given. The patient or their proxy must understand what will be administered and have the opportunity to ask questions about the process. There must be no surprises when it comes to getting consent to perform medical and dental procedures.

Even the most diligent and conscientious healthcare professionals make mistakes

Kansas and Missouri Professional Licensing Attorney Danielle Sanger understands that mistakes can and sometimes do happen. It is a part of life. That understanding may not prevent a state licensing board from undertaking an investigation for an ethics violation. If that happens, Attorney Sanger will fight to protect your livelihood and your personal life as well. Call 785-979-4353 today for a consultation.

Kansas And Missouri Professional Licensing Attorney Asks If A Misdiagnosis Lead To New Mother’s Death?

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Did doctors in a New York hospital miss a diagnosis that caused the death of a young mother during childbirth? The answer of the question remains to be seen. The New York Times reported that a 34-year-old woman died after giving birth to her second child. Childbirth-related deaths are rare in the United States, but they do happen. The burning question is whether this death could have been prevented. If so, the physicians could face professional discipline as well as facing a medical malpractice lawsuit filed by the grief-stricken husband of the deceased.

The stricken woman began experiencing contractions about one month before her due date. They contractions were severe, and she was having difficulty sleeping. Consequently, she went to the emergency room of a local hospital. There, the staff examined her and informed her that she was not ready to give birth. They advised her to go home and get some rest. She did and eventually fell asleep. The next morning, the expectant mother awoke with contractions and pain in her abdomen.

The contractions advanced, and the woman gave birth in her apartment. Her husband called EMS and a neighbor assisted with the delivery. The EMS responders took the mother and newborn child to the hospital for a routine examination. Everything appeared to be fine. Before leaving the hospital, the new mother, her husband, and the baby’s brother all took photographs. The woman did not appear to be in any distress whatsoever. That changed shortly after arriving at the hospital.

What was to be a routine examination of the mother took a tragic turn. The doctors determined that the mother’s placenta did not discharge along with the baby. Therefore, the attending physicians began a procedure designed to expel the placenta. The initial attempt failed. As a result, the physicians opted to remove the placenta surgically. Surgeons delayed the procedure for reasons that are not clear. The surgery yielded disastrous results.

As the surgery was almost complete, the woman’s blood pressure crashed. The woman went into shock due to blood loss during the placenta removal. The staff quickly transferred her to the intensive care unit for blood transfusions. She received several transfusions but would her blood pressure would not stabilize. Doctors contemplated exploratory surgery to determine the cause of the problem.

Even at that point, the doctors did not expect to lose her. They informed her husband that the procedure would take a little while. That gave the man time to go home to pick up his eldest son who was with a babysitter all day. By the time she reached his home, his phone had ringed. It was the hospital calling to tell him his wife died from the blood loss.

The man filed a medical malpractice action against the hospital and the numerous physicians who treated his wife the night before she died and the day she died. He is understandably heartbroken. The lawsuit is still pending in court.

The most careful, diligent, and circumspect physicians make mistakes. The question here though does not only be they negligent but did they commit an ethical violation? Whether this was just a tragic case that could not have been prevented or not remains to be seen.

Count On Zealous Representation If You Are Accused Of An Ethical Violation

If you are a medical professional or other professional licensee facing professional discipline, Attorney Danielle Sanger can help. Attorney Sanger has extensive experience representing various healthcare professionals as well as other professional licensees. Call Kansas and Missouri Professional Licensing Attorney Danielle Sanger today at 78-979-4353 to schedule a consultation.

Missouri and Kansas Professional Licensing Attorney Describes Ethical Duties Of Medical Personnel Related To Concussions In Youth Sports

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The recently released movie “Concussion” starring Will Smith as a retired professional football player whose life is destroyed because of traumatic brain injury from repeated concussions is a sad true-to-life story. The story told in “Concussion” is not an isolated incident. Many headlines are made these days from ex-football players such as Junior Seau, who committed suicide after his career, and Kevin Turner who succumbed to a disease similar to Amyotrophic Lateral Sclerosis (ALS, commonly referred to as “Lou Gehrig’s disease”) in 2016 from suffering too many hits to the head. While football garners the bulk of the headlines related to head injuries, with good reason, other sports have similar concussion dangers. Soccer players, for instance, are at risk to suffer a concussion. So too are hockey players. Medical personnel in both Kansas and Missouri must follow the state-established protocols before a student-athlete returns to competition. Following the concussion rules will not guarantee the future safety of the athlete.  Consequently, subsequent injuries could lead to claims of misdiagnosis, malpractice, and ethical violations in some circumstances. Professional licensing attorney Danielle Sanger is a zealous advocate for professional licensees and will fight to protect you from claims of ethical violations.

At the high school level, proper care and prevention start with awareness of the potential for injury. Gone are the days of dismissing a bump on the head as simply “getting your bell rung.” High school athletic trainers, who must be licensed in Kansas and Missouri, are the first line of intervention and treatment. Athletic trainers are always on the lookout for head injuries. Head injuries can be concealed and are not always obvious. Athletic trainers receive education on how to spot head injuries and what interventions are necessary. Appropriate responses include immediately removing a person from the game and commencing testing. The player may return to action if cleared by the trainer, if not, state-sanctioned concussion protocols take over.

Missouri has a seven-step program that an athlete must pass before returning to play. At the outset, a physician must sign a return to play form before playing again.  Each step of the seven must be completed before moving to the next step. First, the athlete must rest completely. That means no sports and no school or a reduced school schedule for a period that could last several days. The next step is returning to classes full time. Then, the student-athlete may begin light exercise. The athlete may not begin exercising until they are asymptomatic and a physician has authorized the student to do so. At this step, the student may walk or ride a bicycle with no exertion. The student may not begin lifting weights. Once that step is complete, then the student may begin running without equipment in the gym or on a track. After that, the athlete may participate in non-contact drills, followed by full practice. Assuming the student remains asymptomatic, then the athlete is allowed to return to play in a game.  The protocol advises that the student progress one step per day and not try to accelerate the process.

Unfortunately, following this protocol will not guarantee the player will remain healthy. Even one concussion can have serious effects going forward, and a clean bill of health based on diagnostic testing is no guarantee of safety. Therefore, doctors, athletic trainers, coaches, parents, and the student-athlete all bear the burden of making sure each player safely competes.

Consult With An Experienced Professional Licensing Attorney If You Have Questions About Potential Liability From Concussion Related Injuries

Kansas and Missouri Professional Licensing Attorney Danielle Sanger possesses vast experience in representing healthcare professionals. Call Attorney Sanger today at 785-979-4353 to schedule a consultation to learn your rights and responsibilities if you are involved in evaluating or treating student-athletes for concussions.

Kansas And Missouri Professional Licensing Attorney Discuss The Opioid Crisis In Dentistry

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The American Dental Association (ADA) takes an active role in bringing awareness to its members about treating dental pain with prescription painkillers. The ADA recently discussed dentists’ responsibility to uncover drug-seeking behavior as well as emerging trends on how to handle patients with a sensitivity to or a history of opioid addiction.  The failure to adequately address the potential for opioid addiction has the potential to create an ethical dilemma for the practitioner.  If you are a dentist encountering professional discipline in Kansas or Missouri for prescribing narcotics to patients, then you need to contact a seasoned professional licensing attorney to fight for you.

The ADA concisely set forth the role of the dental professional relative to pain management and the potential for addiction. Access to leftover causes a significant portion of the opioid epidemic or unused prescriptions are falling into the wrong hands. The ADA warns its members to avoid prescribing painkillers for a period longer than necessary. For instance, the ADA indicated that dentists should prescribe painkillers for 2 to 3 days after implant surgery. If possible, the precise dosage should be given. Studies have proved that some flexibility is required with the prescription dosages because some patients genuinely need the medicine, twenty-four percent (24%) of patients reported that they continued to take the painkillers for more than ten days after the surgery.

Overprescription is a problem as well. Some patients, as stated above, experience excessive pain and require a longer course of pain medication. Notwithstanding, prolonged pain is indicative of an underlying medical problem such as an infection. Infections can be treated with antibiotics and once alleviated; the pain should subside. Consequently, the patient no longer needs the painkiller. The ADA considers good dental practice to be one in which the dentist prescribes a short course of painkillers and carefully examines the patient and evaluates the need to prolong the course once the prescription has ended.

The ADA considers dentists to be in a unique position in their patients’ lives to assess drug abuse. Dentists should evaluate their patients’ behavior and determine whether the patient is actively seeking drugs. The dentist can educate their patient and help that person obtain necessary services to combat any addiction problem.  To that end, the ADA encourages its members to engage in a discourse designed to discuss the patient’s substance abuse history.  The ADA is advocating for dentists to receive remuneration for this service. Currently, dentists cannot bill for these interludes because they are not part of the dental hygiene regimen.  A recent survey showed that twenty-three percent of patients reported a history of substance abuse when screened during a visit. Practitioners then had the chance to refer their patients to other health care providers. The study proves that early intervention can prevent continued opioid dependence.

The ADA takes an unequivocal stance on drug seeking behavior. The ADA has opined that a dentist violates the dental code of conduct by prescribing opioid-based medication to an addicted patient. Additionally, the dentist has an ethical obligation to discuss the dentist’s suspicion of drug abuse and offer referrals for treatment. The ADA suggests that the dentist should be delicate when addressing this issue with their patient. Also, the ADA encourages its members to elicit help from their staff in identifying drug addicted patients. The ADA recognized that patients sometimes open up to staff more readily that to the dentist. Accordingly, the staff is in a unique position to inform the dentist of what they learned and determine the appropriate course of action.

Beware of the signs of addiction

If you or a member of your staff are facing professional discipline in Kansas or Missouri from prescribing painkillers, you need an experienced and dedicated professional licensing attorney to fight for you. Call Missouri Professional Licensing Attorney Danielle Sanger today at 785-979-4353 to schedule a consultation. Attorney Sanger has dedicated her professional life to protecting yours.

Missouri Professional Licensing Attorney Summarizes Notable Disciplinary Actions For Missouri Social Workers

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In Missouri, the Committee for Social Workers (the Committee) regulates the social worker profession. The Committee is a state agency that falls under the authority of the Missouri Division of Professional Registration. The Committee is responsible for issuing licenses to practice social work. Additionally, the Committee is charged with the duty of investigation ethical violations allegedly committed by social workers, similar to other professional licensing boards in the state. Licensed social workers practicing in Missouri should be aware of the Committee’s authority and should be aware of the recent disciplinary decisions issued as a result of the Committee’s investigations.

To this point in 2016, the Committee resolved approximately thirteen investigatory matters by way of agreement or a full hearing and disciplinary ruling by the Committee.  In one case, the social worker provided counseling services for two minor children. The social worker commenced a romantic relationship with the children’s mother while the social worker provided counseling services. The social worker stipulated that his conduct violated Missouri’s ethical standards by violating the public trust, exploiting clients for personal gain, and engaging in behavior that rendered him impartial to his clients’ best interests. The social worker agreed to a five-year probationary period, submit to a psychiatric evaluation, and find a social worker to supervise his practice. The disciplinary action did not end with the stipulation of sanction. The Committee ruled that the social worker violated the terms of his probationary period by failing to obtain the services of a supervisory social worker. Consequently, the Committee suspended the social worker’s licensed for a term of three years or until such time as he could obtain an appropriate supervisor. Thereafter, the social worker’s license is subject to a five-year probationary period once adequate supervision is in place.

In another 2016 decision, the Committee ruled on an application to become a licensed master social worker in Missouri by a master social worker already licensed in Kansas. The applicant answered truthfully whether she was arrested. The candidate revealed that a Kansas court convicted her of theft in 2015. The Committee, instead of denying the application, ruled that she be admitted to practice in Missouri subject to a two-year probationary period. The master social worker can only practice in Missouri during that probationary period if she has adequate supervision by another master social worker admitted in Missouri.

The Committee and a licensee reached an agreement as to disciplinary action in an investigation in which the licensee failed to attend continuing education classes. Also, the licensee failed to retain records evidencing her attendance at the continuing education. The Committee took exception to the fact that the social worker misrepresented satisfying her educational requirements. The social worker and licensee agreed that she would be placed on probation for one year and provide evidence that she attended the educational courses.

Two additional agreed-upon resolutions yielded vastly different results. In one case, the Committee agreed to dismiss its complaint against the licensee, resulting in no disciplinary action against the licensee. In another instance, the licensee practiced social work without a valid license for four years. The parties agreed that the social worker should surrender her license and agree not to practice social work or apply for a license in Missouri, instead of facing additional discipline.  In another decision in 2016, the Committee did revoke the license of a social worker who defaulted at the disciplinary hearing.

Get Immediate Help If You Are A Social Worker Facing Disciplinary Action

If you are a social worker facing professional discipline in Kansas or Missouri, you need an experienced and dedicated professional licensing attorney to fight for you. Call Missouri Professional Licensing Attorney Danielle Sanger today at 785-979-4353 to schedule a consultation. Attorney Sanger has vast experience fighting for professional licensees. Do not trust your future to anyone else.

 

Kansas Professional Licensing Attorney Reviews Recent Court Opinion Issued In Jernigan v. State of Kansas

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On September 9, 2016, the Court of Appeals for Kansas issued its ruling in the case of Jernigan v. State of Kansas. The decision is important to healthcare practitioners in Kansas because this case afforded the Court of Appeals an opportunity to review the 2015 amendments to K.S.A. 65-2839a(b)(1) and (3). These sections govern licensees’ rights to an administrative and judicial review of the Kansas Board of Healing Arts’ (the “Board”) subpoena power. The Jernigan court discussed whether the amendment was constitutional and whether the amendment had retroactive effect. The Court of Appeals then turned to the merits of the case. The panel also discussed the authority of the Board and its power to issue subpoenas for records.

David Jernigan, D.C. is the primary owner and healthcare provider at a chiropractic care center in Kansas. Dr. Jernigan fashioned his practice to include traditional methods of chiropractic care complimented with holistic methods as well. The Board received complaints from an individual claiming that Dr. Jernigan fraudulently provided therapeutic services from which his patients derived no clinical benefit.  Accordingly, the Board issued a subpoena to Dr. Jernigan compelling the production of five (5) patients’ records in furtherance of an investigation in Dr. Jernigan’s practice. Dr. Jernigan filed a motion to quash in the district court without first filing an objection with the Board or otherwise exhausting his administrative remedies.

The Court of Appeals reviewed the amendment to K.S.A 65-2839a(b)(3). The amended statute requires a person aggrieved by a subpoena to petition the district court for relief only after exhausting all administrative remedies. The amendment took effect while the case was pending in the courts. The Court of Appeals, noting that the amendment was procedural in nature and therefore would apply retroactively under Kansas law, stated that the new law required Dr. Jernigan to appeal to the Board first. Jernigan did not do that. However, because the person to whom the Board issued the subpoena has only five (5) days to file an objection or motion to quash with the Board, applying that time to Dr. Jernigan would deprive him of a valuable right.

The Court of Appeals took the opportunity to analyze whether the amendment survived constitutional scrutiny. The panel found that it did. The Court of Appeals held that the amendment provides an opportunity to seek redress for a wrongfully issued subpoena. The Court did, however, note that the five (5) day window of opportunity to file an appeal was very narrow, leaving open the possibility that a court may revisit the issue at another time.

The Court of Appeals undertook a determination of the case upon its merits. The Court of Appeals ultimately ruled that the case must be remanded to the district court for further findings. Before doing so, the Court of Appeals reviewed the Board’s authority.  The panel reiterated that the practice of medicine in Kansas (and elsewhere) is a privilege and not a right and the Board exists to protect the public from incompetent, unscrupulous, or unethical healthcare providers.  Accordingly, the Board enjoys the authority to take disciplinary action upon a medical license after an investigation if warranted by the inquiry. Consequently, the Board possesses the power to issue subpoenas it believes will advance their statutorily imposed obligation to investigate the unethical practice of medicine.  The Court of Appeals cautioned that the Board’s authority is not unfettered.  Subpoenas may lawfully issue when Board is making an inquiry it is authorized to make when the demand for production is not indefinite, and the information sought is relevant to the investigation at hand. The Court of Appeals sent the case back to the district court to make factual findings consistent with its opinion.

Do Not Delay Seeking Legal Assistance When Served With A Subpoena In Kansas

As discussed above, time is of the essence. If you were served with a subpoena to produce records, call Kansas and Missouri Professional Licensing Attorney Danielle Sanger. Rely on her vast experience and sterling reputation to protect your livelihood. Call 785-979-4353 to schedule a consultation with Attorney Sanger today.

Missouri Professional Licensing Attorney Discusses Ethical Complaints Against Nurses

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Missouri’s legislature enacted the Nurse Practice Act (“the Act”) designed to govern the practice of nursing in Missouri. The Act entrusts licensing and discipline of nurses to the Missouri State Board of Nursing (“the Board”).  The Missouri Legislature gave the Board rule-making authority, which authorizes the Board to pass regulations for the profession. Consequently, the Board issued regulations establishing the ethical responsibilities and minimum practice requirements for nurses. Additionally, the regulations establish the complaint procedure for alleged ethical violations. The regulations also establish the minimum educational, character, and ethical obligations for both registered nurses and licensed practical nurses. Missouri professional licensing attorney Danielle Sangerng understands that nurses are vital components of our health care system and a responsible for delivering a high standard of care to their patients.

The regulations issued by the Board prescribe the proper procedure for filing a complaint against a nurse for an ethical violation.  The regulations permit only complaints against nurses to be filed if there is evidence to investigate misconduct. Individuals who learn of or witness unethical behavior committed by a nurse are encouraged to notify the nurse and the administration of the medical facility as soon as possible to allow the facility to rectify the situation and immediately correct the nurse’s behavior.  Reporting unethical behavior to the facility also serves as an alternate dispute resolution process which has the potential to informally discipline the nurse while serving to correct the offending behaviors.

The Board received complaints filed against a nurse. The regulations establish a clear and concise procedure to investigate the allegations.  The Board has a gatekeeping obligation to screen out complaints which fail to allege a violation of the Act and also provide sufficient information to commence an investigation.  Anyone may file a complaint with the Board alleging misconduct.  The complaint must be in writing and may be on a form prescribed by the Board. The complaint and any information gathered as a result of the investigation is not a public record. The Board must notify the complainant in writing of receipt of the complaint, and the Board must also notify the complainant if the Board dismisses the complaint or, if not dismissed, the disposition of the complaint.  If the Board finds sufficient information to warrant a disciplinary action, then the Board will file a formal complaint with the Missouri Administrative Hearings Commission.

The regulations impose a duty upon certain health care organizations to report unethical behavior to the Board.  Hospitals, surgical centers, and nurse staffing agencies are mandatory reporters to the Board. Those agencies must report any disciplinary action taken by these agencies against a nurse. The agencies must also report any voluntary resignation by the nurse in the face of discipline or any reports of misconduct pending before the health care facility.  In this context, disciplinary action is any final action taken by the board of the listed agencies to discipline, reprimand, or restrict the practice of the nurse in a meaningful way.  However, disciplinary actions will be considered by the Board only if the actions complained of are also violations of the ethical rules and would warrant disciplinary action by the Board. The complaint in filed by a mandatory reporting agency must be filed within 15 days of the date of the disciplinary action.  Also, the complaint must be in writing and include specific facts which set forth the allegations.   Notwithstanding, if the nurse submits to an employee assistance program in an effort to treat a drug or alcohol addiction, then the agency should not report the nurse. However, the agency must report the nurse if the nurse violates the employee assistance program.

Nurses Need Help Too

Missouri Professional Licensing Attorney Danielle Sanger prides herself on zealously representing nurses, and other professional licensees, who face professional discipline.  Call Attorney Sanger today at 785-979-4353 to schedule your free consultation.

Kansas And Missouri Professional Licensing Attorney Discusses Ethical Teletherapy Practice

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Use of emerging technologies is increasing in many aspects of healthcare. Teletherapy has grown significantly in health care professions such as psychology and other disciplines such as speech therapy.  Teletherapy as a recognized tool for treating patients has become a widely accepted practice. Teletherapy helps deliver treatment to people who have difficulty ambulating, or have to commute long distances like people who reside in rural areas, with greater ease and frequency. Accordingly, ethical obligations such as protecting patient-therapist confidentiality and informed consent are of paramount concern to practitioners utilizing the latest technological advances.  Kansas and Missouri professional licensing attorney Danielle Sanger cautions healthcare professionals who use teletherapy as a component of their practice to maintain the highest levels of data security as well as obtaining the informed consent of the patient to preserve patient-therapist confidentiality and trust.

The American Psychological Association (“APA”) mandates that therapists strictly maintain patient-therapist confidentiality.  Therapists must take every reasonable precaution to guard against disclosure of confidential patient communications. Therapists are obligated not to disclose patient confidences and are further obligated to protect patient data, such as notes, reports, and the like, from disclosure as well. Additionally, the APA imposes an obligation on therapists to discuss the limits of confidentiality. In the context of teletherapy, the therapist must discuss the risks of loss of privacy and limits of confidentiality when using teletherapy as a means to deliver patient services.

Therapists must understand the technology before treating a patient remotely with teletherapy.  HIPPA rules also require therapists to protect confidential client information. The APA mandates that psychologists become knowledgeable about and competent in the technologies used in teletherapy. Treatment providers have to make certain that their patients know about the potential for data or security breach and the potential, if a breach occurs, for loss of confidentiality. Practitioners should consider using all of the security advances available to them such as encryption, use of firewalls, backup systems, password protection of computers and computer files, updated virus protection, as well as reputable third-party vendors who provide data security. Guarding against disclosure also means protecting the records when they are destroyed.  Practitioners must be aware of the proper means to destroy electronic data to prevent unwanted disclosure.

The threat of a data breach is real. Stories are legion about reputable firms, businesses, and government agencies getting hacked. In other words, internet security is illusory, and 100% internet safety cannot be guaranteed. The APA requires therapists to take reasonable steps to ensure confidentiality.  Reasonableness requires the licensee to become competent in the use of the technology and the means employed to secure it.  By way of example, a reasonable means to protect data is to update security software to the latest version and take other precautions that are currently in practice. Also, therapists must inform their patients about any potential data breaches.

Therapists in both Kansas and Missouri use teletherapy are a component of their practice. In theory, therapists can practice out of state because of internet technology. Practitioners must approach this prospect cautiously. Failure to adhere to each state’s out-of-state licensing requirements can result in the practitioner committing a misdemeanor.  Therefore, practitioners must be very careful when delivering services to clients who receive the services in another state.  The better practice for the psychologist and other therapists is to be licensed in the state in which they practice regularly and the state in which the patient receives their services.

For More Information

Kansas and Missouri Professional Licensing Attorney Danielle Sanger has vast experience representing psychologists and other therapeutic professionals facing licensing discipline. Attorney Sanger prides herself on zealously representing professional licensees against disciplinary action. Call Attorney Sanger today at 785-979-4353 to schedule a free consultation.

Kansas And Missouri Professional Licensing Attorney Warns Healthcare Practitioners of Potential Disciplinary Pitfalls

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Many healthcare professionals have formed the opinion that childhood vaccinations are detrimental to children. The debate has raged for some time now. For one California pediatrician who not only ascribes to the belief that children should not be vaccinated but is a vocal advocate for eliminating the practice, the specter of disciplinary action is quite real. The L.A. Times recently reported that Dr. Robert Sears could face disciplinary action from the Medical Board of California for his decision to discontinue vaccinating a school-aged boy.  The Board filed the complaint against Dr. Sears on September 2, 2016.   The case has the potential to set a precedent for other medical licensing authorities across the United States.  Kansas and Missouri professional licensing attorney Danielle Sanger zealously advocates for healthcare providers who face disciplinary action.

According to the L.A. Times article, “Dr. Sears is one of the leading voice in the anti-vaccination world.”  Many parents who do not want their children to be immunized go to Dr. Sears for advice. Dr. Sears faces disciplinary action for writing a medical note on behalf of a two-year-old boy who was entering daycare. The note specifically stated that the boy should not have any additional vaccinations while he is of school age.  Dr. Sears now faces discipline for that decision.

Consequently, the Medical Board of California filed an accusation seeking professional discipline against Dr. Sears. In its accusation, the Medical Board of California alleges that Dr. Sears committed gross negligence, repeated negligent acts, unprofessional conduct, and insufficient record keeping when writing the note for the boy without previously examining the child. The Board alleges that the doctor wrote the note for the child after only receiving an oral history about prior vaccinations and anecdotal information from the child’s mother concerning the child’s reaction to his previous vaccinations.  Additionally, the child’s mother sought treatment for her child regarding head trauma and a cold. Dr. Sears merely indicated in his records that the child had a mark on his head and treated the child’s cold with garlic without further testing.

According to the Medical Board of California, Dr. Sears actions require discipline.  The Medical Board of California seeks suspension or revocation of Dr. Sears’ license or, in the alternative, requests that Dr. Sears’ license be subject to probation. The Medical Board of California also requested that Dr. Sears no longer have authority to supervise subordinate healthcare providers. The Board alleges that Dr. Sears’ failure to fully examine the child before writing the note excusing the boy from further vaccination requirements was grossly negligent. The Board alleges that the standard of care in the profession obligates a physician to examine the child fully for possible adverse reactions to vaccinations. Additionally, the standard of care in the professional demands that a physician obtains a full medical history of the nature of the previous vaccinations as well as a detailed description of the physical reaction the child suffered.  More significantly, the failure to obtain a full medical history prevented Dr. Sears from having all of the critical information necessary to make an informed opinion regarding the decision to order no further vaccinations. The Board argued that the doctor’s failure to adhere to the standard of care in the profession potentially endangered the child and his mother from exposure to preventable communicable diseases.

While many applaud the California Medical Board’s decision to pursue disciplinary action against Dr. Sears, others fear that the pursuit could result in a “witch hunt” for other anti-vaccination doctors in the U.S.  Many criticize the decision as interfering with a physician’s ability to treat their patients properly.

Experienced Advocate For Healthcare Professionals

Missouri Professional Licensing Attorney Danielle Sanger vigorously defends healthcare professionals, as well as other professional licensees, against professional discipline.  Call Attorney Sanger today at 785-979-4353 for a free consultation and learn how Attorney Sanger’s experience will make the difference for you.