These rules are directed at employers rather than medical care providers. The employer is expected to see that the medical care personnel follow the rules, and it is the employer that is subject to administrative sanctions if the rules are not followed. Physicians employed in a company occupational medicine department that does not comply with the rules may be subject to sanctions as company representatives. Nonemployee physicians may be subject to sanctions if they contractually accept the responsibility for maintaining employee medical information. This can become a problem if the employer goes out of business without arranging for an orderly transition in responsibility for the employees' medical information. An abrupt termination of business may leave the physician with the duty and financial responsibility to maintain the records or transfer them properly.OSHA clearly intended these rules to supplement, rather than replace, traditional practices: "Except as expressly provided, the rules do not affect existing legal and ethical obligations concerning the maintenance and confidentiality of employee medical information, the duty to disclose information to a patient/employee or any other aspect of the medical-care relationship, or affect existing legal obligations concerning the protection of trade secret information." The rules do not pose any ethical problems beyond those already inherent in occupational medicine practice. In the case of providing access to trade secret information, they help resolve an existing ethical dilemma.
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