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Office of Clinical Education
Date: June 7, 1999
To: All DMS Students
From: Eric A. Shirley, MD
Assistant Dean for Clinical Education
Sue Ann Hennessy
Assistant Dean for Student Affairs
Subject: Accidental needle sticks
It has been brought to my attention by several students that they had received bills from hospitals as a result of accidental needle sticks sustained while performing clerkships as Dartmouth medical students. The charges came about as a result of the medical evaluations students underwent as a result of the needle sticks, and represented amounts not covered by their personal health insurance policies (usually because of some amount of deductible payment required). The hospitals involved have not included DHMC or the White River Junction VA, since these centers either accept insurance as full payment or cover all costs for this care. Students have pointed out that it is inherently unfair to have to pay for injuries where they may not have been at fault, and DMS administration has raised the concern that the specter of payment could act as a disincentive to reporting needle sticks and obtaining appropriate health care.
As a result of these concerns, DMS will change the Policy on Exposure to Blood Born Pathogens, effective July 1, 1999. The section of the policy dealing with payment is reproduced below, with the changes in bold type.
All expenses incurred for testing, counseling, and post-exposure prophylaxis, that are not otherwise covered by the institution in which the BBP exposure occurred, should be billed to the student's health insurance carrier. If the student's health insurance carrier does not pay the charges in full, the student should pay the uncovered portion, and then submit copies of the bills, along with proof of payment, to the Assistant Dean for Student Affairs at DMS. Arrangements will be made for reimbursement directly to the student, in an amount to cover the student's out-of-pocket expenses.
Whether such payment is requested or not, students should report ALL such accidental occupational exposures to blood born pathogens to the Assistant Dean for Student Affairs, whose office will track all such incidents experienced by all of our students at any of our affiliate teaching institutions or at other nonaffiliated teaching sites (such as during off-site electives).