Food Allergy Support

Discussion Boards => Schools and Food Allergies => Topic started by: lakeswimr on September 15, 2013, 05:01:01 PM

Title: Question--WWYD
Post by: lakeswimr on September 15, 2013, 05:01:01 PM
My child's school has asked for permission to talk directly with allergist.  How would you word your response to this request? 

Title: Re: Question--WWYD
Post by: twinturbo on September 15, 2013, 06:34:08 PM
What I would do --

All questions for the allergist re:patient (my child) should be finalized in a single page. Upon receipt I can schedule a consultation appointment with the allergist. This will set a dedicated time within a busy schedule to focus on the questions which will be discussed real time with patient's parents. The office will then know how to code it for insurance billing.
Title: Re: Question--WWYD
Post by: ajasfolks2 on September 15, 2013, 06:55:55 PM
Never, oh NEVER would I allow school (or any of their representatives, including nurse) to have DIRECT access to allergist or ANY other med provider.

Anything/everything that school may wish to ask or "clarify" may be put in writing and then be presented to the appropriate med care provider, IF I, as parent, deem the info necessary for the care and education of my child at that school . . . otherwise, I would politely decline.

We've (FAS and at previous pa dot com) had lots of discussions about giving carte blanche (which IS what a  permission to "talk to allergist" permission is ) . . . AND how important it is to NOT give that sort of access to the medical provider for child.

Many accounts through the years as to schools fishing for info to use against parents, info to use to attempt to refute the parents' requests for necessary and appropriate accommodations, and instances of damaging of parent/patient/doctor relationships.

Just no.  Politely but firmly, no.  (Word your response in terms of HIPPAA and medical privacy, as well as the patient/doctor relationship being one that does not include the school.)  And if you have any inkling that the school may try to go around you to contact med care providers, then be sure you've indicated (in writing) on forms at doc's office that there are specific NAMED individuals who may have access to child's med records (typically mom & dad) and NOBODY else.  Be sure that in the insurance pages (where you sigh to authorize the insurance co to have access to whatever) that there isn't some sort of other blanket authorization for others, including schools.


Lakeswimr, this is really important.

Protect your privacy and your child's privacy. 




(Edited for typos & brain fart!)
Title: Re: Question--WWYD
Post by: lakeswimr on September 15, 2013, 07:01:40 PM
Thank you both.  I'm wondering more if you would suggest how to word my reply.  I would like it to be as polite as possible but will decline this request. 
Title: Re: Question--WWYD
Post by: twinturbo on September 15, 2013, 07:17:47 PM
That is how I would word it. It lets them know the conditions that are to be met if they have questions "for the allergist". Most likely they'd never get to the point of writing it down. It's obvious what the purpose in a call to the allergist is but it also puts them on notice the allergist's time costs me money one way or another.

Our school is unlikely to do it since we all have the same allergist but I know SpEd is going to try. Ironic, eh?

I'm not sure how applicable my method is for anyone else though. It's my way of politely calling their bluff to be scheduled at my convenience. I do respect the allergist's time and would never assume a consult from ANYONE should be considered freebies on a whim.
Title: Re: Question--WWYD
Post by: lakeswimr on September 15, 2013, 07:39:17 PM
I could do that but I actually just want to say something more along the lines of asking them what they would like to know and telling them I will contact the allergist and get whatever info it is they are seeking.  I am NOT going to schedule an appointment for the sake of asking questions that I don't even have so calling a bluff or not, I'm not going to offer to do that.  But I do get you. 
Title: Re: Question--WWYD
Post by: twinturbo on September 15, 2013, 07:50:56 PM
^So wordsmith the above, right?

Please send me a written list of the questions you have so I may review them before consultation with the allergist. As parents have been designated experts in the management of child's allergies most will likely be answerable by us.

If my brain fires up later I'll add variations. Maybe one will click/feel more right. It admittedly reads awkward.

Perkier version

Yes, we can get that done. As soon as you can get the questions written up can you email in a word doc or PDF, please? That way I can review it for questions we already have the answer to. Anything beyond that I'll be able to contact the allergist about. A file allows us all to literally be on the same page to reduce communication errors. Please let me know if you have any other questions otherwise I will look for that list from you.

haha. Perky is so not me.

Resisting urge to write parody version.
Title: Re: Question--WWYD
Post by: me on September 15, 2013, 07:59:40 PM
It is good.  I just want it to be a bit more polite in tone.  But what you wrote isn't rude by any means. 
Title: Re: Question--WWYD
Post by: ajasfolks2 on September 15, 2013, 08:05:01 PM
I've used something along the lines of,

"If you'd like to put any questions/ concerns you may have -- that are directly related to the LTFA of our child -- in writing, we would be willing to convey those to our medical care provider in order to provide you with clarity."

and then if/when there is more push back and more strong wording is needed, we've had to go to something as follows:

"Our physician(s) are OUR medical care providers.  The relationship is doctor - patient!  In the interest of our child's/family's right to medical privacy (HIPAA), we will be the conduit of information sharing.  We have the relationship with the medical provider, not the school. . . "

And at some point along the road, in one instance we've had to finally and simply say, without tone or any explanation (and YOU have this right up front):


NO.

They have no right to any of the records or to direct Q&A with your physicians.

There is nothing wrong with a polite but direct NO.

If they persist, then request (in writing) that THEY put their request (including the whys) in writing.

A "no" is not impolite in and of itself.   :) 
Title: Re: Question--WWYD
Post by: LinksEtc on September 15, 2013, 08:08:49 PM
Quote from: ajasfolks2 on September 15, 2013, 06:55:55 PM
Links, this is really important.

Protect your privacy and your child's privacy.

For the 504 threads?  I was planning to restart those this week  :).

----------------------------------------

Lakeswimr,

Getting the kids to bed, will try to come back ... There might be some good wording in some existing threads.

----

These threads talk about the topic a bit, but I didn't see a lot about specific wording.

Authorization for the release of info waiver (http://foodallergysupport.olicentral.com/index.php/topic,2450.msg3630.html#msg3630)

Re: New here, but need help before meeting with principal (http://foodallergysupport.olicentral.com/index.php/topic,4619.msg22888.html#msg22888)
Quote from: CMdeux on January 12, 2012, 03:55:03 PM
They have documentation regarding his condition, his history, and the potential for fatal anaphylaxis.  They need NOTHING MORE.  No waiver, no discussion with your doc, nothing.  If they have questions for your doc, they can damned well put them in writing and include YOU in communications with your child's physician.  Anything else is "inappropriate" as it doesn't include you.  Trust me-- you do NOT want them to have unfettered access to your physician.

-----

I like Ajas's wording above

Quote from: ajasfolks2 on September 15, 2013, 08:05:01 PM
"If you'd like to put any questions/ concerns you may have -- that are directly related to the LTFA of our child -- in writing, we would be willing to convey those to our medical care provider in order to provide you with clarity."

:yes:
Title: Re: Question--WWYD
Post by: CMdeux on September 15, 2013, 08:16:09 PM
Quote
There might be some good wording in some existing threads.

Yes, and some of that probably even dates back to PA.com days.

I think that others are spot on--

a) WE are the ones paying our physicians, not the school.  Ergo, the doc works for us and the patient-family relationship.

b) HIPAA and FERPA are not =

c) anything they want to know, they ought to be able to put in writing.  If they have an URGENT need-- so urgent that it can't be put in writing, I mean-- then a phone call to the allergist isn't what they ought to be doing.  I want no confusion re: calling 911 or calling the doctor's office, and neither does my child's physician.

Title: Re: Question--WWYD
Post by: twinturbo on September 15, 2013, 08:25:42 PM
It's a good reminder to verify what all is the protocol with the doctors offices and what I signed with county services. I've got no one to blame but myself if I don't check.




One more reason to request all questions in writing to proactively (of course *wink*) discern if they are questions the allergist can and should answer, or best answered through technical assistance through OCR if it concerns the removal of a barrier to educational access. Not many questions regarding food are as allergy related as they are ADA matters.




Thumbs up or down? I think I may use that for sped.
Title: Re: Question--WWYD
Post by: Macabre on September 15, 2013, 11:11:07 PM
On the front end of our 504 process our Sped Director (who was totally on our side) wanted that permission granted. I said no way.  However, they did put DS' information in front of the district pediatrician--who has a private practice.  I said I also wanted to speak with her, and I did.  She said she saw nothing that would indicate he shouldn't have a 504 (and DS was the first in the district).  In fact, she said she wasn't really qualified to judge.  DS is not her patient. 

:thumbsup:

Later this doctor became involved in my nonprofit.  I haven't been in a position to relate that experience to her, nor would I.  But I think she's a pretty awesome person for many reasons.

Long personal story--but suffice it to say that before eligibility is granted (which is not the case for lakeswimmr), districts may want to contact the allergist to discuss the allergy itself, severity, etc. 

What we did instead (and at the very strong urging of our Sped Dir--along with some resistance from me): I got the record of all three allergists DS had seen.  It clearly demonstrated allergy.  I still resent having to do that, but once we got into the meeting, the Sped Dir basically directed things the way we wanted them, so no harm done.
Title: Re: Question--WWYD
Post by: lakeswimr on September 16, 2013, 08:17:08 AM
Thanks, all.  I replied a polite no.  I appreciate all your responses.  It helped me feel better about things!  :)
Title: Re: Question--WWYD
Post by: ajasfolks2 on September 16, 2013, 06:56:43 PM
Links, sorry!  I meant "Lakeswimr" -- I edited to fix.

I need to wear reading glasses when I'm on the boards . . . or else bump up the view size!  Gah!!!   :fishslap:
Title: Re: Question--WWYD
Post by: LinksEtc on September 16, 2013, 08:20:54 PM
I wasn't sure why you put that there, but hey, I was going with it ... it is a good subtopic.

There's no need for the fish  :)  :smooch:

----

Lakeswimr,

I hope everything works out for you & DS at school.
Title: Re: Question--WWYD
Post by: lakeswimr on September 17, 2013, 06:37:52 AM
Thank you!  I think it will but it stinks that I even have to worry at all about this.  Normally they are very good so I'm surprised by recent things.
Title: Re: Question--WWYD
Post by: CMdeux on September 18, 2013, 07:32:09 PM
It's a great reminder, though, about why seeking eligibility early is such a good idea-- you just never know when one of the players will go off the rails on you and get a wild hair or three about what "isn't working" or "can't be done" (anymore).


I'm glad that you're not in the position of SEEKING a new eligibility here.
Title: Re: Question--WWYD
Post by: LinksEtc on January 11, 2014, 02:23:10 PM
Bumping for the 504 index.

How much weight does letter from allergist hold in 504 planning? (http://foodallergysupport.olicentral.com/index.php/topic,5156.0.html)

Quote from: CMdeux on March 27, 2012, 04:41:42 PM
Honestly, I'd rescind any permission for them to talk DIRECTLY to your physician.

The reason is that YOU need to have a seat at the table any time your physician is involved.  S/He's not the SCHOOL's physician-- s/he's your child's physician.

Quote from: CMdeux on March 27, 2012, 04:41:42 PM
Schools have an unfortunate tendency to cut parents out of the loop once they have access to the doctor, and they often agree (between the two of them) to things that PARENTS, being experts in daily tactical management, would KNOW cannot work.  Oh, sure, they may be fine in "theory" but we as parents know when we've got a child that can't really be relied upon to, say... resist food trading.  Or to speak up assertively when not feeling well.  Some kids can handle some situations better than others.  Most of the time, allergists don't have a great handle on a child's relative sensitivity, either-- unless parents have told them about reactions, that is.  What is fine for one PA child (eating M&M's and bakery cupcakes) might be really, really dangerous for another child, even though both are patients of the same allergist.  KWIM?

 

That is why parents ARE experts who must have a place at the table when a plan is being discussed.

Secondarily, who is compensating the physician for his/her TIME in all this phone and fax and e-mail time with the school, hmmm?  Is it the school?  You?  Not cool-- s/he's YOUR physician, and needs to be acting in his/her PATIENT's best interests. 


Honestly, I'd rescind the permission.  I'd just explain that you have privacy concerns re: turning over that kind of access, and you are also concerned about the possibility of "confusion" during a reaction-- you DO NOT want the school to be calling your physician during a reaction.  Say it with a smile, and make it clear that you are HAPPY for them to have access to your physician-- but that ALL access needs to be in writing and go through you.