Minor Patient, Divorced Parents, Coach, and Social Media
A 16-year-old competitive soccer player is receiving outpatient PT after ACL reconstruction. The player's mother signed the consent and attends most visits; the parents are divorced, and the mother says the father 'has no say' and must not receive records. The father calls and asks for the treatment notes and the surgeon's protocol. The player's high school coach calls the front desk asking whether the athlete will be 'cleared' for next week's playoff game. The PT also wants to post a short video of the player doing a box jump on the clinic's public social media page because the player 'looks great.' The player says she does not want her teammates to see the video but does not object to the coach knowing she is 'doing well.' The clinic's release form is generic and does not mention social media.
1. Who may consent to this minor's PT and who may access the records? How should the PT handle the mother's and father's requests?
Read the worked answer
Because the patient is 16, the PT should generally look to a parent or legal guardian for consent, but the mother's statement that the father 'has no say' is not enough to deny him access. The clinic should ask for the custody order or other legal documentation. If the father retains legal custody or is otherwise authorized to act for the minor, he may be a personal representative with access to records; if a court order limits his rights, the clinic should follow that order. A generic consent to treatment is not a release to every family member.
The PT should not release records to either parent until the clinic verifies authority and obtains a proper authorization or confirms that the parent is a personal representative under applicable law. The response should be neutral and documented: what was requested, what documents were reviewed, what was released or withheld, and why.
2. Can the PT tell the coach anything, and can the PT post the video? Explain the authorization and documentation requirements.
Read the worked answer
The coach is not a health care provider and is not entitled to the player's clinical information without authorization. The player's statement that she does not mind the coach knowing she is 'doing well' is not a written authorization, and even a general statement about progress can reveal protected health information. The front desk should decline to discuss clearance and explain that the clinic needs a signed authorization from the patient's parent or legal guardian, plus the patient's assent where appropriate. Clearance for sport should come through the treating clinician and the surgeon's protocol, not a phone report to a coach.
The video should not be posted. Social media use requires a specific written authorization that describes the disclosure, and a generic release form that does not mention social media is insufficient. Because the patient is a minor, the clinic should obtain parent or guardian authorization and should honor the patient's objection. The PT should document the request, the refusal, and the patient's wishes.
3. What should the PT document about the player's objection and the clinic's decisions?
Read the worked answer
The PT should document the player's statement that she does not want the video shared with teammates, the fact that no social media authorization was obtained, and that the video was not posted. The record should also note the coach's call, the clinic's refusal to release information, and the need for a signed authorization. If the father's request is pending, the clinic should document the custody verification steps and the final decision.
The documentation should be factual and avoid labeling the patient as difficult or the parents as adversarial. The goal is a clear record that the clinic protected confidentiality, respected the minor's wishes, and did not release information without proper authority. If the mother or father later disputes the decision, the documentation should show what was requested, what was verified, and what was disclosed.