Question: A Reproductive Endocrinologist (clinic) that refers me business does not follow ASRM recommendations for psychological evaluations in all third-party cases. As a mental health professional providing services to this physician’s patients, what should I do?
Answer: It’s tough to bite the hand that feeds you, but sometimes it is necessary in order to meet professional responsibilities and deliver the best possible standard of care for patients. As professionals, we know our professional ethical standards require us to put our obligations to our client above our own financial gain. But, the ASRM guidelines do not rise to the same level of professional obligation and responsibilities that are attached to our professional licensing requirements. Instead, the ASRM guidelines create a standard of care — which could be used against a professional in this field who does not follow them in cases that result in dispute or litigation.
Here are a few ideas on how to discuss ASRM guidelines:
- Don’t let a clinic’s policy or procedure surprise you. Meet with staff at the clinic to figure out ahead of time what they do and why. Let them know you follow ASRM guidelines. Explain why they should too by appealing to their noble intentions. These guidelines are designed to protect the patient and help the clinic ensure that the minimum standards of care outlined by the FDA when dealing with bodily fluids.
- Give ASRM guidelines to every client/patient.
- Let patients know what the guidelines are and why you choose to follow them.
- Prepare the patient to ask probing questions of the doctor as to why the recommendation is not being followed in his/her case.
- Draft a letter thanking the RE for the referrals and including a copy of the ASRM guidelines.
- An attorney shared her strategy for getting doctors on board with legal clearance in her area with success. She prepared a short write up from Recommendations for practices utilizing gestational carriers: a committee opinion (Fertil Steril 2015;103:e1–e8.© 2015 by American Society for Reproductive Medicine) detailing ASRM’s reasoning and how it would help the clinic better serve their patients. She took the write up along with copies of the guidelines to the doctors and offered to put on a lunch and learn for the staff. She did the same again with Recommendations for gamete and embryo donations: a committee opinion (Fertil Steril 2013;99:47-62. ©2013 by American Society for Reproductive Medicine) This opened a wonderful dialogue and changed the way the clinic operated.
- Speak with a local attorney that is an ASRM member about what your state law requirements are for disclosure to the patient about the protocols of the clinic.
Finally, before discussing the ASRM guidelines with another professional, conduct an audit of your own policies and procedures to ensure that your practice is at peak performance standards. ASRM recommends that all assessments should be handled in accordance with American Psychological Association Ethical Standards. Dale Carnegie said it best, “Do you know someone you would like to change and regulate and improve? Good! That is fine. I am all in favor of it. But why not begin with yourself? From a purely selfish standpoint, that is a lot more profitable than trying to improve others-yes, and a lot less dangerous.”
The ASRM Legal Professionals Group (LPG) and the Electronics Committee are not hereby providing legal advice. This is for informational purposes only. You should contact your attorney to obtain advice with respect to any particular issue or problem. Use of and access herein do not create an attorney-client relationship between the LPG or its members and the reader. You should not act upon any such information without first seeking qualified professional counsel on your specific matter and obligations.