Know Your Obligation to Report

October 18, 2019 4:17 PM | Sally Winkelman (Administrator)

Editor’s Note: This article appeared in the August 2018 issue of Medigram, a monthly publication of the Wisconsin Medical Society

Physicians are required by law to report information to entities or individuals such as county health officials or law enforcement in certain situations. Most recently, that includes threats of school violence, which was enacted as part of a school safety law earlier this year.

Both HIPAA and Wisconsin confidentiality laws allow disclosure of protected health information where such disclosure is required by law. Failure to report as required can result fines, civil or criminal liability and/or professional discipline. Physicians should check with their legal counsel or risk manager if they have questions about when they are required to report information to others and how to do so.

The following is a summary of some of the more common mandatory reporting obligations applicable to Wisconsin physicians.

Threats of School Violence—Physicians and other health care professionals who believe in good faith, based on a threat made by an individual seen in the course of professional duties regarding violence in or targeted at a school, that there is a serious and imminent threat to the health or safety of a student or school employee or the public must “immediately inform, by telephone or personally, a law enforcement agency of the facts and circumstances contributing to” that belief. (Wis. Stat. § 175.32)

Child Abuse and Neglect—Physicians and other health care professionals who have reasonable cause to suspect that a child seen by them in the course of professional duties has been abused or neglected or has been threatened with abuse or neglect must “immediately inform, by telephone or personally,” the county department or local law enforcement of the facts and circumstances giving rise to that suspicion. (Wis. Stat. § 48.981)

Conduct of Colleagues—Physicians must make a written report to the Wisconsin Medical Examining Board if they have reason to believe a Wisconsin licensed physician:

  • Has engaged in acts constituting a pattern of unprofessional conduct under Wis. Admin Code § MED 10.
  • Has engaged in acts that create an immediate or continuing danger to one or more parties or to the public.
  • Is medically incompetent.
  • Is or may be mentally or physically unable to safely to engage in the practice of medicine or surgery. (Wis. Stat. § 448.115)

Elder Abuse—Physicians and other health care professionals must file a report with the county department, elder-adult-at-risk agency, local law enforcement, the Department of Health Services or the state board of aging and long-term care if they have reasonable cause to believe that an individual over the age of 60 seen in the course of professional duties, or another elder-at-risk, is at imminent risk of serious bodily harm, death, sexual assault or significant property loss, or if requested to make such a report by the patient. (Wis. Stat. § 46.90)

Sexual Contact by a Therapist—A therapist who has reasonable cause to suspect a patient or client he or she has seen in the course of professional duties is a victim of sexual contact by another therapist must ask the patient if he or she wants them to report the information and must, if authorized by the patient, report the suspicion to the Department of Safety and Professional Services or the local district attorney within 30 days. (Wis. Stat. § 940.22)

Danger to Others—Physicians, like all individuals, have a duty of reasonable care in light of foreseeable harm. This may, under certain circumstances, require physicians to warn or take reasonable actions, such as notifying law enforcement or potential targets, if they believe a patient, individuals or the public is at risk of serious and imminent harm as a result of information obtained in the course of providing professional services. Where such a duty may exist, Wisconsin law specifies that it is satisfied by doing one or more of the following: contacting law enforcement, contacting the applicable county department or taking other action a reasonable health care professional would consider as fulfilling a duty to warn a third party of substantial probability of harm under the circumstances (Wis. Stat. § 51.17). Physicians are encouraged to discuss such matters with their legal counsel or risk manager.

Other—Physicians are required by law to report certain other events or acts to state or local officials, including the following: