Examples of badges with clear identification of titles presented by Pennsylvania dermatologist John J. Laskas Jr., MD, to the state Legislature when it was considering the new law.

New Pennsylvania law requires physicians to wear photo IDs

States are working to guarantee that patients know whom they are seeing and are not deceived by health professionals who misrepresent their training.

By Carolyne Krupa — Posted Dec. 20, 2010

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A new Pennsylvania law aims to make it clear for patients who is taking their blood pressure, giving them an injection or preparing to operate on a loved one.

Under the law signed Nov. 23 by Gov. Edward Rendell, physicians, nurses and other health care professionals soon will be required to wear photo identification badges that state their credentials in large block letters, with descriptions such as "physician" or "registered nurse."

"The idea is that you can read this instantly at a conversational distance," said John J. Laskas Jr., MD, a dermatologist in Glen Mills, Pa., and chair of the Pennsylvania Academy of Dermatology and Dermatologic Surgery's patient safety and scope of practice committee. "Then the patient knows and can make a judgment whether or not this is the level of expertise they need. We need to know and have a right to know the credentials of the person who is giving us care."

Beginning in January 2011, the state health department will have 90 days to develop interim regulations and then 18 months to finalize them. All Pennsylvania health care employers will need to comply by June 2015.

The Pennsylvania law is one example of how states are working to ensure that patients know whom they are seeing and are not misled by health professionals who misrepresent their level of training. At least two states -- California and Arizona -- have enacted laws requiring that any advertisements for medical services include the health professional's title and license type.

Illinois adopted its Truth in Health Care Professional Services Act in July, requiring health professionals to post their license when seeing patients in their office. They also must wear a visible badge stating their license credentials during all patient encounters.

Disclosing who the doctor is

The American Medical Association's Truth in Advertising campaign is designed to increase clarity and transparency in health care. The initiative encourages all states to enact laws mandating that all health care professionals disclose their training and qualifications.

Model legislation drafted by the AMA would require practitioners to identify their license type in advertisements, wear a clearly visible photo ID badge when seeing patients and post their type of license in their offices. The AMA further recommends that the rules apply in any practice setting, and that physicians who have collaborative agreements with nonphysicians post in each office a schedule of regular hours when they will be there.

"Research shows that patients can easily mistake the qualifications of health care professionals and often believe they are seeing a medical doctor when they are not," said Rebecca J. Patchin, MD, immediate past chair of the AMA Board of Trustees.

Ninety-six percent of U.S. adults believe that health care professionals should display both their level of training and their legal licensure, according to an AMA survey done in 2008 of 852 adults nationwide.

Pennsylvania's legislation is an issue of full disclosure and patient safety, said Bruce Brod, MD, clinical associate professor of dermatology at the University of Pennsylvania School of Medicine.

"When you're a patient, you're in a very vulnerable position," said Dr. Brod, chair of the Pennsylvania Academy of Dermatology and Dermatologic Surgery's political advocacy committee. "A lot of patients feel timid about asking the person [for] their credentials. They are concerned the person will take it as an insult or that it will affect the care they receive."

Lead bill sponsor Pennsylvania State Rep. Jennifer Mann was inspired to pursue the measure after visiting with a senior citizen constituent. The woman complained that while her cable man wore a photo ID when he came to her house, the people hired to provide her home health care had no such identification.

The woman was concerned about letting strangers into her home to provide sometimes-intimate health services when she did not know if they were who they claimed to be, said Mann's chief of staff, Rich Pronesti.

Dr. Laskas said he pushed for the legislation after seeing a resident and medical student from an area children's hospital with badges displaying their titles in big, bold letters.

"The problem is that since physicians don't necessarily wear their white coats and nurses don't necessarily wear their caps anymore, the patients can't really tell who is taking care of them," he said.

Though many hospitals in the state require name tags, they are often hard to read, with small lettering and abbreviations for degrees that some patients can't decipher, said Scot Chadwick, vice president for governmental affairs for the Pennsylvania Medical Society. "The genesis of it has been the increase in doctorates being offered and obtained by nonphysician health care providers who use the term 'doctor' in referring to themselves," he said. "That has led to a growing concern about possible patient confusion."

Dr. Brod has received inquiries from physicians across the country who are interested in supporting similar legislation. "We're hoping that this serves as a bellwether for other states," he said.

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