Practicing Medicine Without a License - A Big No-N

I recently learned something I think everyone here needs to know. I was given wrong information in medical school, and I suspect this is pretty common. And potentially very hazardous.
What do you do at a party when somebody starts talking about their ailments or their loved ones ailments. Yes, this does happen to medical students and doctors. In medical school I was told that I should not give medical advice if approached, but that it was OK to say “Gee, I think you should talk to your doctor.”
This is dead wrong. If you are a medical student or a resident with a limited license, you are not allowed to say that. That is practicing medicine without a license. You can only talk to people about medicine in the context of medical school activities or residency duties. If someone starts to tell you about their ailments outside of those contacts, the only safe reply is “I’m sorry I can’t talk to you about that.” I strongly recommend you then stop talking to that person and start talking to someone else about something else.
Also, if someone trips and falls, you can’t help them, even if it’s as simple as first aid skills. If someone goes into cardiac arrest, you can’t start CPR – that’s practicing medicine without a license even though you may have a current CPR card. All you can do is yell for help and/or call 911. You can’t help them in any way unless you are willing to risk being accused of practicing medicine without a license. And if you do, the state licensing board can later deny you a full license. That’s why I am posting this. Your common sense has to be put on hold. Common sense might tell you that if someone says they are feeling faint, you should help them sit down, but helping them sit down can be construed by the law as practicing medicine.
I know this is pretty ridiculous, but there it is.

Betsy,
This is pretty ridiculous! Ironic and a sad thing…good citizen that I am, I've kept my CPR cert continually for the past 13 years and sporadically before that. If it were needed by someone, I'd be covered under good samaritan laws so long as I am currently certified and was following Amer. Red Cross/Amer. Heart Assoc. protocols for CPR. Even if the person died and the family wanted to sue… ARC/AHA's lawyers would be there. Any suit brought against a certified person who performed CPR has, historically, been thrown out of court…hard for the family to prove malice or assault was intended while you're trying to save their loved one's life.
Now, just as I'm/usoldgeezers are entering med schools and residencies, where being CPR certified is often a requirement for graduation, I'm not supposed to perform it!! Pretty ironic 'n' strange; good to know though. Thanks! — Mary (in PA)

Hmmmm…
We were taught that our state (ohio at the time) and virtually all states have what are called 'good samaritan laws', which absolve medical people from liability in the event of providing intervention in life threatening emergencies.
Thus, if an RN or a dermatologist is the first bystander to respond, s/he may assist to the point of reasonable necessity, up until the first responders are on site.
There was actually a similar case which we discussed at the time. A passenger on an airplane had difficulty breathing and collapsed. A pathologist and a dermatologist responded to paged calls for assistance. They decided to perform an emergency tracheotomy using instruments like pocketknives and ball point pens. Needless to say, it was a disaster, with a lot of uncontrolled bleeding and no controlled airway at the conclusion. I can't remember whether the person survived or not - I think not.
But, there were no liability issues there. They were found to have been acting in good faith and within reasonable limits of their medical training.

in Fla you are covered by “good samaritan” laws and are immune from legal action. Indeed, not to do so is grounds for civil action, but not criminal. There are several precedent cases in the US for assisting an injured/ill party with no first response persons present.
Of course, you are in Philly and you can’t fart w/o the union steward letting you, so YMMV.

could this be a difference in State statutes ?
I find it incredible that your SOM could misinform you on something that is so likely to come up over your 4 years in school
it could also be that the exposure mediated by good sam laws is entirely different than the exposure based on practicing w/out a license

No, folks, this is a separate issue. Good Sam laws protect from civil actions if things don’t turn out well and you acted in accordance with what a ‘reasonable person’ at your training level would have done. (This means if you are an MSI and you don’t know very much but did as well as any MSI could be expected, you’re covered by the Good Sam laws.) And Good Sam laws generally do apply to medical students (check in your particular state before trusting to that statement, but it is true in most of the USA).
But you will be in deep ca-ca with the state medical licensing board if you act as a Good Samaritan, because THAT IS PRACTICING MEDICINE WITHOUT A LICENSE according to them. according to them. No, the state board can’t arrest you. And no, they can’t sue you either. But they can choose to deny you a license. Permanently No appeals No legal protections Nada, So if you make this choice, you should do it knowing that you may have just ended your career if the state board wants to make an issue of it.
Please understand, I am not telling anyone not to act if they see someone dying and they know how to help. I would never give that advice. As a friend of mine once said, “Better to go down for having done the right thing and tried to save a life, then not to go down and know you didn’t try.” That is my philosophy. But in situations where no one is in immediate danger of dying, such as the conversation-at-a-barbeque situation, this info could save your career while not increasing the risk to the potential patient.
And yes, EVMS apparently hadn’t checked with the state medical licensing board about this issue. I was told by the state board that apparently almost no one in the medical profession knows this, and that they are planning to mount an educational campaign to make sure that medical schools and residency programs get the facts right.

Snafu…In some states you can be sued for NOT assisting a person if you have experience. In Idaho an off-duty EMT is required to render help until services arrive. The good sam laws protect from a poor outcome. If you assist within your scope you are fine. As a nurse, not a flight nurse, I certaining would not try to trach/crich someone. But, I would render help within my discipline. As for medical advice that is a hard one, too. A neighbor came to me last summer, “Johnny was hit in the head with a rock, he didn’t pass out and feels fine, what should I do?” I said," I can’t give medical advice, my suggestion as a mother would be to take my child to the doctor." The kid was fine. But, Is that a no-no, too?
Curious,
Brooke

When I was in nursing school (in IL), we had a law class that we had to take. We were told if we witnessed an accident we had to stop. Supposedly if we did not we could be found liable (and they caught you). The lawyer also said that as long as we did not go beyond our scope of normal practice that a plantiff would not have a case.
Therefore if you have a CPR card, I feel that you could use the skills that were given to you, no matter what your educational level.
Just my $.02
:p

I know some countries have a law where one can be charged with" failing to assist the injured", especially
if you have some form of medical training. Personally I know I would not be able to just stand by and do nothing,
if anything I would render basic first aid, try to control bleeding, cover the person to keep them warm, etc. I
couldn’t live with a preventable death on my conscience, i.e, I could have given at least some help but
instead I did nothing… And if the board tried to deny me a license I would put up one helluva fight!I think
the Good Samaritan law should apply everywhere to everyone. It’s terrible that conflicting laws exist, it may
put someone in a terribly awkward position of not knowing whether they can legally render assistance
or not, and when every second counts and someone is not breathing or is bleeding out, you don’t have
the time to think about what laws you may or may not be breaking. You just want to save a life!

After discussing this enough to raise a dead horse, I would like to add some current info. WE discussed this in ethics.
I thought Elizabeth was off her rocker. I was wr… hold on a second…I was wrrrrrrrr…rrrrrrrrr…rrrr…ok I didn't have it right entirely.
You can lose your ability to practice medicine if you treat someone on the scene and do so without any medical training and certification. Also applies to giving advice. For example, at a restaurant, Jeff sees someone choking, so he gets up and attempts to help via the Heimlich manuever. Fails. So he lays the person down and tries Heimlich via compressions on the chest. Fails. He whips out a pen and while the person is passed out and choking to death, inserts a pen into the trach to create and airway. STOP!!! He isn't certified to do so given only being an MS-2 (ignore the EMT thing). After being hailed as a hero he gets a summons from the AMA local board and is told he will be denied a license after treating someone without one. Why? he could have done more damage than good. He might have hit the jugular. He might have seen the trach performed on rotations, but was he qualified to do one given his limited training? No.
So you graduate, but have to go into research for some BioTech and make gazillions after discovering a cure for brain tumors. Or graduate and then work for MickeyD's trying to pay off your school loans on 6 bucks and hour…forever.