On November 23, 2010, Pennsylvania enacted a new mandate1 requiring physicians, nurses and other health care professionals to wear photo identification badges that state their credentials and job title (such as "physician" or "registered nurse") in large block letters. The new photo identification requirements, which are slated to take effect in June 2015 after the final regulations are in place, are designed to make it easier for patients to verify the identity and the credentials of the health care professionals from whom they receive medical services. Specifically, the new law requires physicians and employees of health care facilities, health care providers, private practices of physicians and employment agencies to wear photo identification badges containing:
- a recent photograph
- the employee’s name
- the employee’s title, and
- the name of the health care facility or employment agency with which the employee is affiliated.
The law does not require an employee to wear a photo identification badge while delivering direct care to a consumer in circumstances in which it is not clinically feasible to do so. The law also permits an employee to omit or conceal his or her last name when delivering direct care to a consumer who exhibits symptoms of "irrationality" or "violence."2 While many health care providers already use some form of photo identification, Pennsylvania’s new law is a step toward making the use of such badges an industry standard, more uniform and more useful for the patients who have to interpret them.
The impetus for the legislation was concern for patient safety, along with the desire to avoid patient confusion. To better advocate for themselves in health care environments, patients need to know that the health care professionals from whom they are receiving care are who they say they are and are qualified to provide the level of care sought by the patient at that particular time. Patients may be deterred from questioning an employee’s credentials because of the fear of embarrassment or the fear that the employee will be offended and become upset. Additionally, patients may be reluctant to question the authority of health care employees for fear that the level of care they receive will be affected. Photo identification that clearly states an employee’s credentials can help patients ensure they are receiving the care and advice they need.
Pennsylvania’s passage of the photo identification law comes at a time when other states are also placing greater emphasis on patient safety and the need to guard against those who would misrepresent their level of training to patients. Eight other states have enacted similar photo identification laws.3 This trend may extend to even more states in the coming months as the issue gains more national attention and a greater number of health care providers realize that they also stand to benefit from the implementation of a photo identification policy.
Many health care providers already are vocal supporters of the use of photo identification badges in the health care industry. For example, the American Medical Association’s Truth in Advertising campaign, an initiative that encourages increased transparency in health care, includes model legislation that requires practitioners to wear clearly visible photo identification badges when caring for patients. In Pennsylvania, many health care providers and facilities, including members of the Pennsylvania Medical Society and the Pennsylvania Academy of Dermatology and Dermatologic Surgery have been strong supporters of the new photo identification legislation. The Joint Commission’s standards require health care organizations to identify individuals entering their facilities, but each organization is expected to determine who requires identification and how the identification process is implemented. The photo identification requirement that will be implemented in Pennsylvania and that has been implemented in a similar form in several others states constitutes one method of complying with those standards.
The increase in the number of non-physician health care practitioners and the number of doctorates awarded to non-physicians has made it more difficult for patients to differentiate between physicians and non-physicians. From the health care provider’s perspective, in addition to alleviating patient confusion, proper photo identification can also help prevent medical errors and scope-of-practice issues. In Pennsylvania, for example, Section 18.402 of the Pennsylvania Code allows physicians to delegate the performance of certain medical tasks to non-physician health care practitioners who possess the requisite skill and training to perform such tasks. Practitioners may not, however, perform tasks outside the scope of their particular areas of practice. When patients and providers alike are aware of the level of expertise of the health care employees around them, it becomes more difficult for an employee to go unnoticed in the performance of a task that exceeds the scope of his or her practice or level of expertise. Proper photo identification has the potential to prevent costly errors and adverse incidents resulting from the performance of medical tasks outside the scope of employees’ areas of practice. It can also help prevent a medical error from being attributed to the wrong employee.
A possible drawback of the new photo identification law is the potential cost and administrative burden associated with adopting the new photo identification badges. Many health care facilities already have some type of photo identification procedure in place and would likely have to modify the badges they currently use to comply with the specific requirements of the new law and the forthcoming regulations. This cost will likely impact smaller health care facilities and private practitioners to a greater extent than it will impact larger health systems with more economic resources. It is not clear how the new regulations will phase in their compliance with the new photo identification requirement or how the financial impact on smaller health care entities will be tempered, if at all.
Despite the cost, the implementation of photo identification laws of this type around the country are sure to result in greater standardization and increased transparency in the health care industry—a result that will benefit both patients and health care providers in the long run by easing the uncertainty between patients and health care practitioners and increasing patient safety.