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My brother and I have a mother in an assisted living facility in Florida. A doctor made changes in our mother's medications without notifying us. We thought that perhaps the doctor might be legally bound to notify us about the changes he decided to make in her medications.

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Is your mother competent (in the legal sense)? Do you have healthcare POA (medical proxy)? Has mother signed a HIPAA waiver naming you as people the doctors are allowed to release information to?

Unless your mother has been declared incompetent to make her own decisions and you have authority to make her medical decisions, I doubt a doctor is legally obligated to inform you. It would be nice if you had a working relationship with her doctor such that he would let you know (assuming he has a HIPAA waiver from your mother allowing him to discuss confidential matters with you).
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Jeanne -- I thought my question made it clear that I do have POA. My brother and I are both Health Care Proxy for Mom. And yes, Mom has Alzheimer's and was declared legally incompetent in 2009. "It would be nice if....." YES--OF COURSE IT WOULD BE NICE! That's the problem--the Dr. made changes in Mom's rx's without notifying us, and we feel this may have caused some serious side-effects.
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Yes, you made it clear that you have POA, but that is not the same as MEDICAL POA, so it is good to know you have that, too. It does seem to me that since Mom is incompetent the doctor should work with the people who have authority to make decisions for her. That "should" is an opinion of the ethics of the situation. I don't know about the legal requirements. Does this doctor know that she is incompetent and that you are her proxy?
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I was actually seeking legal information. When you say, "seems to me that...." etc., you are clearly giving an off-the-cuff opinion that may be 100% correct. But I am asking this: do statutes exist that require the doctor to inform the health care proxy in the State of Florida about the patient's rx's and changes made in medications given?
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I personally can't find anything that legally binds a physician to consulting with healthcare proxy before making treatment decisions. He/she is bound to provide information about treatment when asked. As healthcare proxy, you can choose to not let your mother continue a drug or treatment if it is in her best interest, or you know it is what she would want. You can also choose to change doctors if you feel her doctor is not doing a good job. I can't find anything that states the doctor has to consult a proxy before writing a new prescription. Really, the doctor didn't sign anything when you became the proxy. There may be something out there somewhere about physicians being legally bound to notify a proxy about changes, but I wouldn't be surprised if there isn't for most states.
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Just Google searching Florida statues doesn't come up with anything. With me in two different states it was very hit or miss. I had both POAs, they were both in effect with incompetency letters, but somtimes I would get a call for topical antibiotics and sometimes I would not get a call on a psychotropic that had been tried already with bad effects. I once had to acctually present HIPAA papers and even then the nurse really did not want to give me the medication list; I uncovered a problem with a medication being inappropriately discontinued. Short answer is you can ask to be called with everything and graciously accept a few silly calls in the bargain, but still keep an eye out and periodically get a med list. The other thing to do is put bad adverse reactions inot their allergy list even if not true allergies...I hate to do that, but sometimes its the only way to make someone stop and think hey there might be a reason this person is not on _____ that is usually indicated in this situation.

How serious of a side effect are you writing about? Was it something you would have know to say no to if only you had been asked?
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Mark, I am a Guardian in NY. Anytime the MD needs prior consent, I have to sign for my sister. I have also notified her group home in writing that prior consent MUST be obtained before changing medications or times given. Note that a Guardian has more power than a POA in NY. Florida may have different rules. The key here is to clarify your position in writing to the facility and the MD.
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Mark,

Be Nice! You are angry at your doctor, and I don't blame you. But why lash out at a VOLUNTEER who is trying to help you?

If you want a 100% correct legal opinion, consider hiring a lawyer. Or look for a website that is focused on the law, like elderlawanswers or the NAELA website.

Individuals here share their knowledge based on their individual experience and expertise. We have plenty of legal experts, especially about elder abuse, Medicaid and veterans benefits. The focus of this website, however, is the emotional, physical, medical and financial aspects of caregiving. This is a support group. You are welcome to participate, and you will be amazed at how helpful we are.
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Each states have their own "legal" requirements by the medical community. Some states accept Medical POA, some don't. Those who don't, requires Another kind of document for the Medical aspects. I forgot the word of that document but I did read it here on AC by another poster who ran into problems with the hospital not accepting her Medical POA. Like above, you may need to check with an Elder care lawyer to make sure you have all your documents or maybe a new law was passed that requires additional documents, etc...
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I live in California and I called my mother's doctor in Florida to ask him about her condition. He refused to call me back because he said it was not legal for him to give out any information regarding my mother unless I was designated as the person to whom he could give this information. Is there a law in the State of Florida which says that doctor's cannot give their patient's family information unless that particular member of the family is designated legally to receive this information?
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that's the Federal HIPAA law that if you're not listed as someone to be allowed to receive her info then, yes, they are not supposed to; I ran into that with my mom with her being in Kentucky and me in Alabama.
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Thank you for your reply. Frustrating as this is, I'm glad to know my experience was on the up and up. Thanks!
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Health Insurance Portability and Accountability Act is a Federal Law that prevents doctors, nurses, psychologists, etc., from disclosing identifiable medical information about a patient to a third party if the patient has not signed a release HIPAA form or Medical Power of Attorney) indicating that they want that information released. Have your mom sign one the next time she's in the Dr's office, if she wants you to have information from the doctor.

Better yet, arrange to call in to the doctor's office next time she has an appointment .
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No.
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that's what finally got things going with my mom when she finally started getting appointments at a different doc, which she changed to in frustration with what was happening with the ones I was having trouble with, which she wasn't doing with them, she was going as walk-ins, which actually turned out to be the problem, which I realize is different, but it turned things around when she did start having them and telling me when they were so I could call while she was there
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If you do have the HIPAA release or medical POA you still have to ask to be notified. They tend to otherwise just not bother, and I would actually ask for an updated med list every so often just to make sure.
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Is it legal for a doctor's office in Upstate New York to hand write changes onto a Health Care Proxy that was intially prepared (typewritten; signed; witnessed) by an attorney? I have discovered a Health Care proxy for my Aunt that has been altered at the bottom in pen (illegible) which was filed electronically into file system of hospital and her doctor's office in year 2015; 8 months after my Mother's (her sister's death). They have both lived in NY; I have always lived in CA. Even though that document (Dr's. office doesn't know I've just retrieved it through request of medical records at the hospital as they brought it to my attention while I was filing the Health Proxy I have from lawyer on record. It is the very same document I have as her representative but it's been altered by someone. Doctor's office is being resistant saying there is another form that must be filled out to have access. I had to go around them to other locations to get the form as they would not send it to me. Meanwhile my name is on a document in their records? It's not the handwriting of my Aunt at bottom of Health Proxy document where changes occur. Seems suspect in its nature; why I do not know other than my Aunt is having her first medical problem at 84 years of age but she doesn't understand what that problem really is other than going for testing (blood lab & urine testing) for her kidneys. Alarming to me that this document has been altered by someone other than my Aunt; and it seems illegal to do so without the revisions being done by her attorney. I have asked my Aunt to send me a copy of her document so I can see if the one she has is altered but I don't believe so. I don't want to alarm her so I have not said anything yet until I receive her document. I can't believe that ANY doctor would ever have authority to discuss anyones wishes when it is already in writing from a lawyer's office. All I want to know is; is it legal for a doctor's office to alter a patient's health care proxy? My Aunt never signed anything at bottom of page.
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I made a request in writing when I placed mom in memory care that I must be consulted and I must authorize all medications unless there is an emergency. I have not had a problem and have been called or emailed on all medical issues with mom.

You can't go backwards but you can talk with facility director and find out what forms you can fill out or get on file that going forward you must be notified on all future medications. If u want you can ask about her current mess and review those that are necessary and those u don't want her to have.
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