Treatment of partners in the setting of STIs is medically appropriate. This article did not address the pitfalls of prescribing medication for an unknown and unseen patient whose medical history cannot be confirmed. Anaphylaxis to cephalosporins is well known and there are numerous medications with potential adverse interactions with azithromycin.
As a physician, I am unwilling to subject an unknown patient to potential harm and am equally unwilling to incur the legal liability attached to an adverse outcome in this situation no matter how noble the cause. (health care equity)
The (potential) patient has the responsibility in this case. ED physicians are neither qualified nor justified to act “in loco parentis” for the community.
How do you propose we prescribe medications to a patient we don’t have a chart for, don’t have a relationship with, haven’t performed a history on, and don’t know what their allergies are? This seem like a risk I’m not willing to take. I don’t think I’m willing to start handing out prescription to unknown individuals.
At some point, patients must take at least partial responsibility for their care and initiate a relationship with a medical provider, be it in an ER, public health clinic, walk-in clinic or a PCP.
While “social justice and health equity” are noble motives and lofty goals, the reality of EPT is far more gritty.
Even granting the supposition that there may be some legal protection for the prescribing physician, what protection is there for the unexamined and unseen patient?
Cephalosporins are well-known to have a not insignificant allergic/anaphylactic profile. The myriad potential drug interactions and adverse reactions with doxycyline are well documented.
Nonetheless, the EPT approach is to expose patients to these risks without their consent and lacking any first-hand knowledge of their medical condition.
It is neither the province nor the responsibility of Emergency Medicine to act in loco parentis in these situations. The patient must bear some responsibility.
“Social justice and health equity” in this context is already being well-served. There are numerous free clinics for the treatment of STI.
4 Responses to “Expedited Partner Therapy Can Stop Sexually Transmitted Infections”
June 20, 2021
Gary RobertsTreatment of partners in the setting of STIs is medically appropriate. This article did not address the pitfalls of prescribing medication for an unknown and unseen patient whose medical history cannot be confirmed. Anaphylaxis to cephalosporins is well known and there are numerous medications with potential adverse interactions with azithromycin.
As a physician, I am unwilling to subject an unknown patient to potential harm and am equally unwilling to incur the legal liability attached to an adverse outcome in this situation no matter how noble the cause. (health care equity)
The (potential) patient has the responsibility in this case. ED physicians are neither qualified nor justified to act “in loco parentis” for the community.
June 20, 2021
TWhat if partner has an allergy or adverse drug reaction. You never did a formal evaluation. Is their sovereign immunity?
June 21, 2021
Matt JaegerHow do you propose we prescribe medications to a patient we don’t have a chart for, don’t have a relationship with, haven’t performed a history on, and don’t know what their allergies are? This seem like a risk I’m not willing to take. I don’t think I’m willing to start handing out prescription to unknown individuals.
At some point, patients must take at least partial responsibility for their care and initiate a relationship with a medical provider, be it in an ER, public health clinic, walk-in clinic or a PCP.
June 21, 2021
Gary Roberts, MD, JDWhile “social justice and health equity” are noble motives and lofty goals, the reality of EPT is far more gritty.
Even granting the supposition that there may be some legal protection for the prescribing physician, what protection is there for the unexamined and unseen patient?
Cephalosporins are well-known to have a not insignificant allergic/anaphylactic profile. The myriad potential drug interactions and adverse reactions with doxycyline are well documented.
Nonetheless, the EPT approach is to expose patients to these risks without their consent and lacking any first-hand knowledge of their medical condition.
It is neither the province nor the responsibility of Emergency Medicine to act in loco parentis in these situations. The patient must bear some responsibility.
“Social justice and health equity” in this context is already being well-served. There are numerous free clinics for the treatment of STI.
https://www.yourstdhelp.com/free_clinic_locator.html
Noble motives and the possibility of legal protection are flimsy and totally inadequate excuses to expose unknown patients to significant risks.