Practical Guidance on Medicare Physician Signature Requirements

I was recently researching the physician signature requirements under the Medicare program and found this resource outlining some of key questions and answers around the requirements.

The Centers for Medicare & Medicaid Services Medicare Learning Network has issued a fact sheet on Comprehensive Error Rate Testing (CERT) Signature Requirements with the Q and A. Also mentioned in the guidance as a resourceis the Medicare Learning Network's MLN Matters Article MM6698, "Signature Guidelines for Medical Review Purposes."

AMA Issues New Policy To Guide Physicians’ Use of Social Media

Today the American Medical Association announced that it has adopted and issued a new policy offering guidance to physicians on the use of social media. The new policy focuses on helping physicians to "maintain a positive online presence and preserve the integrity of the patient-physician relationship."

The press release indicates that the policy encourages physicians to:

• Use privacy settings to safeguard personal information and content to the fullest extent possible on social networking sites.
• Routinely monitor their own Internet presence to ensure that the personal and professional information on their own sites and content posted about them by others, is accurate and appropriate.
• Maintain appropriate boundaries of the patient-physician relationship when interacting with patients online and ensure patient privacy and confidentiality is maintained.
• Consider separating personal and professional content online.
• Recognize that actions online and content posted can negatively affect their reputations among patients and colleagues, and may even have consequences for their medical careers.

UPDATE (11/10/10): Below is a copy of the complete AMA Policy on Professionalism in the Use of Social Media that Jane Sarasohn-Kahn obtained from Katherine Hatwell, AMA Media Relations.

AMA POLICY: PROFESSIONALISM IN THE USE OF SOCIAL MEDIA

The Internet has created the ability for medical students and physicians to communicate and share information quickly and to reach millions of people easily. Participating in social networking and other similar Internet opportunities can support physicians’ personal expression, enable individual physicians to have a professional presence online, foster collegiality and camaraderie within the profession, provide opportunity to widely disseminate public health messages and other health communication. Social networks, blogs, and other forms of communication online also create new challenges to the patient-physician relationship. Physicians should weigh a number of considerations when maintaining a presence online:

(a) Physicians should be cognizant of standards of patient privacy and confidentiality that must be maintained in all environments, including online, and must refrain from posting identifiable patient information online.

(b) When using the Internet for social networking, physicians should use privacy settings to safeguard personal information and content to the extent possible, but should realize that privacy settings are not absolute and that once on the Internet, content is likely there permanently. Thus, physicians should routinely monitor their own Internet presence to ensure that the personal and professional information on their own sites and, to the extent possible, content posted about them by others, is accurate and appropriate.

(c) If they interact with patients on the Internet, physicians must maintain appropriate boundaries of the patient-physician relationship in accordance with professional ethical guidelines just, as they would in any other context.

(d) To maintain appropriate professional boundaries physicians should consider separating personal and professional content online.

(e) When physicians see content posted by colleagues that appears unprofessional they have a responsibility to bring that content to the attention of the individual, so that he or she can remove it and/or take other appropriate actions. If the behavior significantly violates professional norms and the individual does not take appropriate action to resolve the situation, the physician should report the matter to appropriate authorities.

(f) Physicians must recognize that actions online and content posted may negatively affect their reputations among patients and colleagues, may have consequences for their medical careers (particularly for physicians-in-training and medical students), and can undermine public trust in the medical profession.

Educating Physicians About Social Media

Great insight and advice from Bryan Vartabedian, M.D., the author of 33 Charts on "How to Speak to Physicians About Social Media."

Dr. V was responding to a request from Susannah Fox, Associate Director - Digital Strategy at Pew Internet & American Life Project, who will be speaking on a panel at the American College of Surgeons 96th Annual Clinical Congress next month. The session title is To Tweet or Become Extinct?: Why Surgeons Need to Understand Social Networking.

As someone who regularly speaks to groups of physicians I enjoy the opportunity every time (as long as I start off by saying I'm a health care defense attorney). As a group they are always engaging and inquisitive which leads to great discussions. As Dr. V points out the legal aspects and concerns over privacy and liability will be a topic not far below the surface. Like lawyers surgeons are trained to be skeptical technicians. I see that there is a lawyer, Rebekah A. Z. Monson, who is on the panel to cover the dos and don'ts. However, I hope you (Susannah) will weave into the legal discussion the consumer health and e-patient issues that often clash with the legal implications. Don't let the legal issues stand alone.

Dr. V's advice of ". . . discussion of patient-specific issues in public forums is off limits; discussion of patient non-specific issues is encouraged. Any attempt at patient-initiated discussion of specific medical issues immediately goes offline and onto the EMR for issues of record, liability and safety . . ." is excellent. I also like Dr. V's ethical dilemma recommendation for a possible case study approach during the discussion. One example you may want to explore using to address the clash between physician as authoritarian (transparency issue that Dr. V discusses) vs. patient as engaged consumer (e-patient) is the story of Johathan Zittrain's crowdsourcing his diagnosis. His story presents many great angles on social media's use in the health care environment by e-patients.

As for the legal implications of social media if you want to bone up on the topic take a look at the article I co-authored for AHLA earlier this year on the legal implications of health care social media, Risky Business: Treating Tweeting the Symptoms of Social Media.

Good luck Susannah and break a leg (no worries - there will be plenty of docs around to take care of you)!

WVHCA: Proposed Amendment to West Virginia CON Law Defintion of "Private Office Practice"

On June 15, 2010, the West Virginia Health Care Authority filed a Notice of a Comment Period on a Proposed Rule with the West Virginia Secretary of State amending West Virginia CSR 65-7, Certificate of Need Rule.

According to the Summary and Statement of Circumstances filed with the Proposed Rule the "amendment clarifies the definition of "private office practice" for purposes of administering the Certificate of Need Program. Those entities meeting this criteria may be eligible for an exemption from Certificate of Need review pursuant to West Virginia Code 16-2D-R(a)."

Written comments on the Proposed Rule are due on or before July 16, 2010.

WVBOM: Policy Statement - Guidelines for Physicians in Collaborative Relationships with Advanced Nurse Practitioners

On May 10, 2010, the West Virginia Board of Medicine has issued a new Policy Statement - Guidelines for Physicians in Collaborative Relationships with Advanced Nurse Practitioners or Certified Nurse Midwives; Standard of Practice.

The new Policy Statement provide West Virginia physicians with guidance on the role and responsibility they play in the collaborative relationship with advanced nurse practitioners and certified nurse-midwifes. In summary, the guidance provides:

A. The physician must be permanently and fully licensed in West Virginia without restriction or limitation.

B. There should be a written collaborative agreement should should include certain specific provisions as outlined in the Policy Statement.

C. Other considerations that are outlined in the Policy Statement

The Policy Statement indicates that the failure by a physician to adhere to these minimum requirements and guidelines may result in discipline by the Board of Medicine.

Credentialing and Privileging Telemedicine Physician and Practitioner

Last week the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule revising the conditions of participation (CoPs) for hospitals and critical access hospitals allowing for a new credentialing and privileging process for physicians and practitioners who provide telemedicine services. The proposed rule should make it easier on smaller hospital (especially critical access hospitals) who don't have the in-house medical staff to adequately evaluate and privilege a wide range of specialty physicians who provide services through telemedicine.

The proposed rule was published in the Federal Register on May 26, 2010, and titled, Credentialing and Privileging of Telemedicine Physicians and Practitioners, 75 Fed Reg 29479 (May 26, 2010). Comments on the proposed rule must be submitted by July 26, 2010.

Traditionally the CoPs have required the governing body of the hospital to make all privileging decisions based on the recommendations of its medical staff using specific criteria. Hospitals often use third-party credentialing verification services to assist in compiling the voluminous documents needed to verify credentialing and then have the governing body of the hospital review and sign off on the privileging decision.

The proposed rule points out that there has been a Joint Commission standard policy that allows "privileging by proxy," which has been in direct conflict with CoPs. "Privileging by proxy" allows Joint Commission accredited hospitals to utilize a different methodology to privilege"distant-site" physicians and practitioners. Basically, allowing one Joint Commissioned accredited hospital to accept the privileging decisions of another Joint Commissioned accredited hospital. In the past, hospitals were deemed (deemed status) to meet the CoPs if they were accredited by the Joint Commission. However, changes in the Medicare Improvement for Patients and Providers Act of 2008 (MIPPA) will halt (effective July 15, 2010) the statutory recognition of the Joint Commission's hospital accreditation program and now requires the Joint Commission to meet CMS standards in order to confer Medicare deemed status.

CMS has decided that requiring each hospital to independently privilege providers is a duplicative and burdensome process, especially for small hospitals who often use telemedicine services from larger academic medical centers and hospitals to provide access to needed specialty services. Thus, CMS is proposing in the rule to revise the hospital credentialing and privileging requirements to allow a hospital who obtains telemedicine services by agreement with another hospital that the agreement can specify that the hospital providing the telemedicine services is responsible for credentialing the telemedicine provider and can provide this information to the medical staff of the hospital receiving the telemedicine services who can then rely upon the credentialing and privileging decisions of the hospital providing the telemedicine services.

For a more detailed discussion and understanding of the proposed revisions read the proposed rule in the May 26, 2010, Federal Register.

2010 AHLA Hospitals and Health Systems Law Institute: Hot 2010 Health Law Legal Topics

Although it is cold today in West Virginia - I'm hoping it will be hot in Florida in February.

I thought I would take a moment on this cold wintry day to write about the hot health topics that will be discussed at the American Health Lawyers Association (AHLA) Hospitals and Health Systems Law Institute scheduled for February 25-26, 2010 at the Doral Golf Resort & Spa in Miami, Florida (Conference Brochure PDF).

I will be speaking at the Hospitals Law Institute along with my colleague, Jody Joiner, Assistant Operations Counsel at Sisters of Charity of Leavenworth Health System. Our topic scheduled for Friday, February 26 is Hospital’s Friend or Foe: The Age of Social Media and Health 2.0 where we plan to cover:

• The social media technology tools used by health care providers and hospitals
• Pros/cons and legal implications of social media and health 2.0 services such as blogs, wikis, social networking, podcasting, video sharing, etc.
• Best practices and development of policies and procedures which address staff and employees using social media

In addition to our session there will be variety of "hot" health law legal topic covered at the conference that will interest hospital administrators and their legal counsel, including sessions on government data mining to identify hospital compliance, understanding the recent ARRA HITECH developments impacting HIPAA and EHR, hospital/physician collaboration and relationships, best practices in hospital practitioner credentialing, peer review and privileging, voluntary disclosure strategies, hospital clinical research issues, and much more.

The AHLA Hospital and Health System Law Institute overlaps with the AHLA Physicians and Physician Organizations Law Insitute which will be held on February 24-25.The Physician Law Insitute will include "hot" physician topics on on call payments, Accountability Care Organizations, HITECH, disruptive physician behavior intervention, Stark issues for physicians, hospital/physician mergers, FMV for physician compensation and much more.

You can register for one or both. As an AHLA Member I regularly attend the Physician/Hospital Law Institutes every year or so because of quality and breadth of health law related materials for those who work in the health care industry. More information, along with how to register, can be found at the AHLA website:
Hospitals and Health Systems Law Institute
Physicians and Physician Organizations Law Insitute

A 1930 Medical Record

I was recently in my hometown of New Martinsville visiting my dad, a retired family physician. When I arrived he had waiting for me a copy of one of my grandfather's medical records from the 1930s. My grandfather, Dr. Albert Coffield, practiced rural medicine in Wetzel County, West Virginia from 1911 until his death in 1936.

My dad told me the following story about the medical record.

My dad was a doctor who practiced out of his house on Coffield Ridge in Wetzel County. After my dad died in 1936 our mother sold the household furnishing and his office equipment. I was 12 years old when he died and my older brother was a first year student at West Virginia University. Since my mother wasn't employed she decided to move us to Morgantown where the University was so that my older brother could continue his college education. As a way to continue the family income she rented rooms to college students - many who came to the University from Wetzel County.

Included in the sale of the household and office furnishing was a wooden credenza with metal alphabetized slides. Behind some of the slides were some old medical records that were left in the credenza.

Thirty years later a lady who was a patient of mine brought the wooden credenza to me and told me that she had bought the credenza at the auction of my family's household items in 1936. She told me that she thought I would appreciate having it.

Here are photos of the medical record of a patient from 1934. The medical record format is simple yet complete. It contains all the important demographic and clinical information - including the patient statement, habits, family history, past history, physician examination and diagnosis. On the back is additional space for notes and a drawing of the internal organs that I suspect was meant to be used with the patient for education and instruction. It even has a built in billing record section that even the change:healthcare crowd would love.

What can these photos tell us about the current health care reform debate. Compare these photos of a medical record from 1934 to those that cost .73 cents today. Could today's physician and his or her patient get "meaningful use" out of this record?

A close up of the billing section for the change:healthcare gang.

Physician Incentives Under HITECH Act

Fellow health care lawyer colleague, AHLA HIT member and friend, Jud DeLoss, provides an excellent overview of the Physician Incentives under the HITECH ACT.

The incentives focus on providing direct payment for the adoption, implementation and maintenance of electronic health records (EHRs) to "eligible professional" who establishes the "meaninful use" of an EHR.

Check out this post and others at Jud's Minnesota Health IT Blog.

dCard: Health 2.0 Group Releases Standard for Physician Information

My health colleagues over at change:health (Christopher and Robert) and Organized Wisdom (Steve and Unity) along with Within3, the founding members, have worked together to release a new open standard dCard (doctor card) to establish basic e-standards for the collecting, storing and sharing of physician information. The dCard is also designed as a central location for the physician to maintain their core data and information.

The dCard concept is being initially supported by a group of nine health care technology companies. As the change:health press release indicates, joining them are eight other companies working together to develop the dCard:

• Within3 (Online professional network for health science professionals and organizations)
• OrganizedWisdom Health (First human-powered, physician-reviewed search service for health information, products and services on the web)
  
• VerusMed (Providers of clinical briefs for 150,000+ physicians and healthcare professionals)
• Peerclip (Online tool that enables physicians to organize, share, discuss and discover relevant medical information)
• Ozmosis (Online platform that unites physicians and healthcare organizations in a collaborative environment to improve patient care)
  
• Enurgi (Online healthcare services company that connects families and patients-in-need with 1 million+ local, clinical caregivers across the country)
  
• J. Parkinson, M.D. (Leading healthcare consumerism advocate and New York-based family practice physician)
• ReliefInsite (Secure, online pain management services)

I'm looking forward to learning more about the format and concept as the work to define the standard continues. Read more about the development of the dCard effort via VentureBeat and the press (change:health blog post). More from Unity Stokes at Organized Wisdom here.

Note: Not to be confused with this D-Card - but the entire industry could learn a lot from the Big D (see this post). Great step forward by this group. Christopher, you understand - I'm just returning from the land of Animal Kingdom and Magical Kingdoms and still not back in reality.

CMS Releases New Physician Self Referral (Stark) FAQs

The Centers for Medicare & Medicaid Services (CMS) recently modified its website and included a new Frequently Asked Questions (FAQ) section under the Physician Self Referral (Stark) section. CMS added 12 new Stark FAQs on January 31, 2008. A number of these new FAQs relate to the new Stark III regulations.

The Return of Flea . . .

An interview with Dr. Flea (Robert Lindeman, MD) from Eric Turkewitz at the New York Personal Injury Law Blog.

Thanks to Mr. Turkewitz for taking the time and effort to approach Dr. Lindeman and for Dr. Lindeman for agreeing to be interviewed. A great series of questions and answers. There is a lesson in this for all of us -- lawyers (plaintiff and defense), physician, hospital CEOs, etc.

Mr. Turkewitz followed up with Dr. Lindeman after seeing that he was interviewed for an article on Canadian doctor blogs, Check my blog and call me in the morning, by the National Review of Medicine. More on the behind the scenes interview for the article at the Canadian Medicine blog.

For more information check out my past post, "The Flea Flicker" and a follow up post highlighting an article I assisted Fard Johnmar, including some basic legal tips for physician bloggers.

Thanks to KevinMD courtesy of Althouse for the tip.

Dr. Crounse Interviews Dr. Parkinson: A Look Into A New Generation of Physicians and Patients

Bill Crounse, MD of HealthBlog posts about his interview courtesy of ScribeMedia) with Jay Parkinson, MD about his unique business model for today and tomorrows health care delivery - part concierge medicine, part old-time house call infused with modern technology.

Dr Crounse on Dr. Parkinson:

. . . someone who I believe is setting the bar for a new generation of healthcare professionals and the patients they care for. Someone who isn't afraid to buck the system. Someone who says, "why not?" instead of "why?". Someone who just plain understands how to leverage the power of the Net in healthcare . . . he is doing exactly what needs to be done to better serve his patients. He is leading by example, and I have nothing but admiration for what he is doing.

Physician Liability: Was Accident Foreseeable By Treating Physician?

A colleague pointed out this WSJ Law Blog post via the WSJ Health Blog reporting on a ruling made by the Massachusetts's Supreme Judicial Court. The ruling found a physician liable for failing to warn his patient about the side effects of the medications and the potential danger of driving while taking them.

The Boston Globe reports on the case and a copy of the slip opinion in the decision of Lyn-Ann Coombes, administratix v. Roland J. Florio, SJC-09869 December 10, 2007 can be found on the Supreme Judicial Court of Massachusetts decision website.

Although I have not had a chance to read the full opinion, the legal question that comes to mind (and which depends upon the facts in each case) is whether it was foreseeable by the physician that the patient (tortfeasor driver) was likely to have an accident? Remember Palsgraff? Was a duty owed and how broad should that duty be?

The blog post indicates that Justice Cordy's dissent states that the ruling "introduces a new audience to which the physician must attend -- everyone who might come in contact with the patient."

New (Old) Physician Models: Dr. Parkinson and Doctokr

If you are interested in Dr. Parkinson's business model check out doctokr (doc-talker) based in Vienna, Virginia. For more what doctokr is and how Alan Dappen, MD. provides his unique service check out about/services.

Thanks to Dr. Val for the referral. I particularly like this quote from her post:

"The physical exam is a straw man for reimbursement. Doctors require people to appear in person at their offices so that they can bill for the time spent caring for them. But for longstanding adult patients, the physical exam rarely changes medical management of their condition. It simply allows physicians to be reimbursed for their time. Cutting the middle man (health insurance) out of the equation allows me to give patients what they need without wasting their time in unnecessary in-person visits."

PeerClip: physician social bookmarking and collaboration

I got the opportunity at Health 2.0 to learn about peerclip, a new social bookmarking tool, information rating and peer collaboration tool exclusively for physicians. I've not personally used the tool but saw this recent review by Shahid Shah, the Healthcare IT Guy. Here is ConnectivHealth's official press release on the new product.

Read the "about us" section for more about peerclip and how you might use the tool if you are an MD, DO, physician assistant or nurse practitioner. I plan to pass along some information about peerclip to my physician clients to gain further insight into the tool and its value. I'd be interested to hear from anyone out there using the tool - feel free to post your thoughts in the comments.

Health 2.0 Physician Model: House Calls and FICO

Just back from Health 2.0 and was reading about Dr. Parkinson who demonstrates his new (disruptive) model changing the way health care is provided. Don't miss the great discussion in the comments. Check out Dr. Parkinson's website Jay Parkinson, MD + MPH (and his blog).

Dr. Parkinson's approach also highlights something of value that I think has been missing from health care for years -- house calls. I had the chance to watch and go on house calls with my dad, a retired rural physician. There is incredible value in seeing the patient in his/her own environment.

Dr. Parkinson's response in the comments is a concrete example of Scott Shreeve's FICO concept discussed at Health 2.0. Dr. Parkinson comment:

"I’m also toying with the possibility of lowering the following year’s fee for each individual who utilizes my services less often than average. We’ll see."

Update: Catch an interview with Dr. Parkinson who explains his business mode on ABC News.

CMS Stark III Regulations Now Available

Today CMS released the final Stark III physician self-referral rule available on the Physician Self Referral section of the CMS website and will be published in the September 5 Federal Register. 516 pages of light health care regulatory reading for the Labor Day Holiday.

The Phase III Stark Final Rule (CMS-1810-F) is officially titled, "Medicare Program; Physicians' Referrals to Health Care Entities With Which They Have Financial Relationships (Phase III)". The regulations will be effective 90 days after the publication date which is expected to be September 5, 2007. Read the CMS press release.

UPDATE: CMS has also provided an unofficial redline version of the Stark regulations showing the existing regulations and incorporating in the new Stark III changes.

UPDATE (7/5/07): The official version was published in the Federal Register on September 5, 2007. A complete copy of the regulations can be found here. The effective date of Phase III Final Rule is December 4, 2007.

UPDATE (11/11/07): David Harlow reports that certain provisions of Stark III will be delayed for up to a year (December 4, 2008).

Below is a copy of the rule summary and the table of contents directly from the final rule:

Summary: This final rule is the third phase (Phase III) of a final rulemaking amending our regulations regarding the physician self-referral prohibition in section 1877 of the Social Security Act (the Act). Specifically, this rule finalizes, and responds to public comments regarding, the Phase II interim final rule with comment period published on March 26, 2004, which set forth the self-referral prohibition and applicable definitions, interpreted various statutory exceptions to the prohibition, and created additional regulatory exceptions for arrangements that do not pose a risk of program or patient abuse (69 FR 16054).

In general, in response to public comments, in this Phase III final rule, we have reduced the regulatory burden on the health care industry through the interpretation of statutory exceptions and modification of the exceptions that were created using the Secretary’s discretionary authority under section 1877(b)(4) of the Act to promulgate exceptions for financial relationships that pose no risk of program or patient abuse.

I. Background
II. General Comments
A. General
B. Compliance with the Anti-kickback Statute
III. Definitions--§411.351
A. Employee
B. Entity
C. Fair Market Value
D. “Incident to” Services
E. Physician in the Group Practice
F. Radiology and Certain Other Imaging Services and Radiation Therapy
G. Referral
H. Rural Area
IV. Group Practice--§411.352
V. Prohibition on Certain Referrals by Physicians and Limitations on Billing--§411.353
VI. Financial Relationship, Compensation, and Ownership or
Investment Interest--§411.354
A. Ownership
B. Compensation
C. Special Rules on Compensation
VII. General Exceptions to the Referral Prohibition Related
to Both Ownership/Investment and Compensation--
§411.355
A. Physician Services
B. In-office Ancillary Services
C. Services Furnished by an Organization (or Its Contractors or Subcontractors) to Enrollees
D. Reserved
E. Academic Medical Centers
F. Implants Furnished by an Ambulatory Surgical Center
G. EPO and Other Dialysis-related Drugs Furnished in or by an End-Stage Renal Dialysis Facility
H. Preventive Screening Tests, Immunizations, and Vaccines
I. Eyeglasses and Contact Lenses Following Cataract Surgery
J. Intra-family Rural Referrals
VIII. Exceptions to the Referral Prohibition Related to
Ownership or Investment Interests--§411.356
A. Publicly-traded Securities and Mutual Funds
B. Hospitals Located in Puerto Rico
C. Rural Providers
D. Ownership Interest in a Whole Hospital
IX. Exceptions to the Referral Prohibition Related to
Compensation Arrangements--§411.357
A. Rental of Office Space
B. Rental of Equipment
C. Bona Fide Employment Relationships
D. Personal Service Arrangements
E. Physician Recruitment
F. Isolated Transactions
G. Remuneration Unrelated to Designated Health Services
H. Group Practice Arrangements with a Hospital
I. Payments by a Physician
J. Charitable Donations by a Physician
K. Nonmonetary Compensation
L. Fair Market Value Compensation
M. Medical Staff Incidental Benefits
N. Risk-sharing Arrangements
O. Compliance Training
P. Indirect Compensation Arrangements
Q. Referral Services
R. Obstetrical Malpractice Insurance Subsidies
S. Professional Courtesy
T. Retention Payments in Underserved Areas
U. Community-wide Health Information Systems
X. Reporting Requirements--§411.361
XI. Miscellaneous (Other)
XII. Provisions of the Final Rule
XIII. Technical Corrections
XIV. Collection of Information Requirements
XV. Regulatory Impact Analysis
A. Overall Impact
B. Anticipated Effects
C. Alternatives Considered

Comments on the new regulations:

• Brian Peterson at his West Virginia Legal Weblog provides insight into the new regulations clarification of physician recruitment agreements and restrictive covenants in physician employment agreements.
  

Thanks to the AHLA Stark Law listserve for the tip on the final rule.

MD Net Guide Article: Are Physician Blogs in a Legal and Ethical Twilight Zone?

Last month I had the opportunity to collaborate with Fard Johnmar of Envision Solutions on an article for MD Net Guide, "Social Media Notebook: Are Physician Blogs in a Legal and Ethical Twilight Zone?" The article looks at the recent incident involving Dr. Lindeman, who blogged under the pseudonym "Flea," and the risks associated with physician blogging.

I shared some legal tips that physician bloggers should consider when blogging, including:

• Anonymous blogging does not guarantee your privacy
• Consider informing your employer about your blog
• Follow your HIPAA training
• Post a legal disclaimer
• Be cautious about giving advice to patients

Check out the current issue of MD Net Guide to read the complete article. Also, the complete article, "Social Media Notebook: Are Physician Blogs in a Legal and Ethical Twilight Zone?" can be accessed via the web (registration required).