Employment physical

[Babushka2]

Has anyone had an employment physical where you have to provide a medical history? Do you have to disclose everything?

[VivaLasViejas, ASN, RN]

I've never had to go through anything like that, but I've heard that quite a few employers will at least ask for a list of medications. In my opinion, one does not give up the right to privacy when s/he becomes a healthcare professional, and if faced with this request I would be asking why this information is necessary and who would have access to it. The last thing any employee needs is to have his/her boss aware of a health condition that may be stigmatizing, e.g. Hep C or a mental illness.

A physical capabilities test is one thing; if they want you to produce a medical history and you have a couple of skeletons in your closet, you'll want to ask if your supervisor(s) will be aware of your health issues before giving out information that is protected under HIPAA. Even if all they want is a list of medications, a lot can be inferred by what meds you're taking (for example, if you were to look at my med list, there is no way that you could NOT know that I am being treated for bipolar disorder). At the end of the day, though, your PHI really is none of their business. Best of luck to you.

[llg, PhD, RN]

Most places I have worked have required a general health screening -- but not a detailed physical exam. Failure to tell the truth in the screening, if discovered, would lead to automatic termination.

In all cases I have experienced, the health care service doing the screening is separated from the employer by a "fire wall" that keeps your details private. I know when I have hired people, that I am not told -- and not allowed to know -- the details of their health screening. I have gotten a report that says they have either "passed" the health screening or that they need special accommodations or that they are ineligible for hire.

My current employer "encourages" a yearly screening now that is tied to our health insurance coverage. Anyone who doesn't get screened and go to follow-up appointments based on that screening has to pay more for health insurance. A lot of companies are doing things like that.

Ask about the privacy of your information and how that is protected if you have a concern.

[HarryTheCat, MSN, RN]

Those "firewalls" are in place not only to protect your privacy, but also to protect the employer from a potential charge of discrimination. The provider performing the physical (typically an outside occupational medicine clinic) receives a list of bona fide occupational qualifications (BFOQs) for the position, and applicants are evaluated against that list. For example, a BFOQ might state "Ability to lift up to 30 pounds", "Ability to stand or walk almost constantly for the duration of a 12-hour shift", or "Ability to use fingers of both hands", etc. The provider simply performs an assessment, including a review of the applicant's medical history, to determine that individual's ability to meet each of the BFOQs. Each is a "go-no go" checkoff, with no further explanation given to the employer.