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Duty to Inform

Occupational medicine physicians must inform patients fully about their medical conditions. While it is debatable whether a therapeutic exception (see Chapter 11) exists in general medical practice, there is no legal or ethical justification for withholding occupational medical information from an employee. This includes informing patients when they are being monitored for possible long-term toxic effects of known workplace exposures. Sharing information about monitoring with the patient will prevent allegations of cover-ups. It also allows an employee who retires or changes employers to ensure that necessary follow-up examinations or tests are performed. Although departing employees have a right to a copy of their medical records, few actually request the record and carry it to their next physician.

Occupational physicians should consider giving all departing employees a brief summary of information that they should provide to their next physician. Preemployment evaluations pose special problems because the patient may not be available for follow-up if they are not hired. Physicians must ensure they have enough information on each person they examine to allow them to contact the person later when test results become available.

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