How to Handle Hiring Matters Related to Patients

We are a small agency with an adolescent residential treatment program and community mental health outpatient program. We are trying to hire a parent advocate. The only applicant is the father of an adolescent who was in our residential treatment program three years ago. Part of the psychiatric staff has raised the concern that if the agency hired this individual, it would create the same ethical issues as a psychiatrist hiring a former patient to work in his or her office and that the psychiatric staff should oppose the hire.

The process for peer advocacy is one that is developing across the country. In this particular case, hiring the father of a former patient would not be unethical. However, it raises confidentiality questions, but that concern should be minimized, as peer advocates should not have access to any patient records.

Note: Since this opinion was written, it has become apparent that there is variability between agencies regarding peer advocates’ access to medical records. Agencies who employ peer advocates need to create specific policies and implement peer advocate training to ensure confidentiality.

Can a psychiatrist use the legal services of a patient who is an attorney to assist in a difficult dissolution of the psychiatrist’s practice from the psychiatrist’s current partner?

No, to do so would be a boundary violation involving dual agency. A physician cannot have both a physician-patient relationship and an attorney-client relationship with the same individual. ■