Doctors make changes to protect undocumented patients

Locked record
Worried about tougher immigration policies, doctors are using caution including information in medical records for undocumented patients.

President Donald Trump’s executive order to crack down on illegal immigrants has changed how some doctors are practicing medicine, including the information they are documenting in patient records.

One doctor said she has learned to leave information out of undocumented patients’ medical records so the record can’t be used against them.

“To protect those living without documents, I’ve had to learn to exercise caution about how I record a patient’s social history in our files,” wrote Jennifer Adaeze Okwerekwu, M.D., a first-year resident in psychiatry at Cambridge Health Alliance, in a column on STAT.

Trump’s executive order has fueled fears about deportation among illegal immigrants and doctors are getting schooled in how to help them, Okwerekwu said. At a recent seminar at her community healthcare system in Cambridge, Massachusetts, speakers offered clinicians some tips to protect undocumented patients:

  • Be careful what information you include in records, whether paper or electronic. If doctors don’t document information, it’s not discoverable in a legal case.
  • Counsel patients to memorize important phone numbers, such as family, friends and an immigration lawyer.
  • Advise patients to make sure their children know how to get help if parents are detained, and document emergency contacts.
  • Check in with patients if they do not show up for medical appointments. With the threat of deportation, some patients may be afraid to seek services.

The uncertainty created by the tougher immigration policies have also created fears among some medical students. Some of that anxiety may have been eased by memos from the Department of Homeland Security that left intact provisions that granted protection from prosecution for the so-called Dreamers—young immigrants who were brought to the U.S. as children.