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INSTRUCTIONS FOR THE DOCTOR

This is a short case.

You have arranged a meeting with your receptionist, Stephanie Clark, to manage the following situation.

Scenario

Stephanie Clark works as a receptionist at your single-doctor practice. Her 3-year-old child, Letitia, attends the local childcare centre. Last week another child, Daisy, attended the practice because of diarrhoea. Daisy’s mum, Sally, was advised to keep Daisy at home until the results of the stool tests were available.

Sally brings Daisy to the practice today for a follow-up. Sally mentioned that she already knew that the stool test showed an infection that needed treatment, as Stephanie had told her when they met in the supermarket yesterday.

Breach of patient confidentiality is a reason for instant dismissal in all your staff contracts. Your practice manager is currently on leave and so you have to meet with Stephanie on your own.

INSTRUCTIONS FOR THE RECEPTIONIST, STEPHANIE CLARK

You work as a receptionist at the local general practice. Your 3-year-old daughter, Letitia, attends the local childcare centre.

Children at the childcare centre have had a ‘run’ of diarrhoea. You have been hoping that Letitia would not catch the infection as you would have to take time-off work to care for her.

Letitia’s best friend is Daisy. Last week Daisy attended the practice because of diarrhoea. Daisy’s mum Sally was advised to keep Daisy at home until the results of the stool tests were available. When you chatted with Sally at the supermarket yesterday you told her the result showed Daisy needed treatment. Sally was happy to know this, as she could then reschedule her work.

You are a bit surprised that the GP has asked to see you this morning.

When the GP tells you about the breach of confidentiality and implications for your job, you react defensively. You consider that the rules are ‘over-the-top’ and stupid—Sally is your friend and you have a right to tell her what you know about her own child.

You show no appreciation of the seriousness of your error.

SUGGESTED APPROACH TO THE CASE

Arrange the meeting in a quiet, private office and ask Stephanie if she wishes to bring a support person

Explain the reason for meeting—Sally knew the results of Daisy’s stool test prior to seeing the doctor

Sensitively ask for Stephanie’s side of the story

Demonstrate active listening to Stephanie

Explore Stephanie’s understanding and response to a reminder of the rules of patient confidentiality

Remind Stephanie that her employment can be terminated immediately if a breach of confidentiality occurs

State that Stephanie has breached confidentiality based on information from Sally and herself

Tell Stephanie that ...

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