Is Your Patient a Victim of Human Trafficking?
By Amy Wasdin, RN, MBA, Patient Safety Risk Manager II, The Doctors Company

Most healthcare providers are aware they have a responsibility to identify and report victims of child abuse, elder neglect, and domestic violence. Another type of abuse—human trafficking—is, however, on the rise in every state throughout the nation. The National Human Trafficking Hotline statistics for 2017 include 8,524 cases reported and 26,557 calls received.

This crime occurs when a trafficker uses force, fraud, or coercion to make an individual perform labor or sexual acts against his or her will.

Research shows that an overwhelming majority of victims see a medical or dental professional during captivity. Human trafficking victims are commonly seen in medical and dental practices with the following conditions:

• Trauma such as broken bones, bruises, scars, burn marks, or missing teeth.
• Poor dental hygiene.
• Gynecological trauma or multiple sexually transmitted infections.
• Anxiety, depression, or insomnia.

Medical and dental providers and their staff should be trained to recognize the signs of human trafficking and know what steps to take.

Below are examples of red flags exhibited by human trafficking victims:

• Fearful.
• Depression or flat affect.
• Submissive to his or her partner or relative.
• Poor physical health.
• Suspicious tattoos or branding.
• Lack of control over personal identification or finances.
• Not allowed to speak for himself or herself.
• Reluctance or inability to verify address or contact information.
• Inconsistency with any information provided (medical, social, family, etc.).

If you suspect that someone is in immediate danger, call 911. If you suspect that a patient is a victim of human trafficking, contact the National Human Trafficking Hotline.

Follow state laws regarding mandatory reporting to provide notification of patient abuse or neglect situations. All states require reporting of child trafficking but may not require reporting for adults. While the HIPAA Privacy Rule allows the disclosure of protected health information without authorization in some circumstances, such as imminent danger, contact your risk manager or legal counsel if you are in doubt. Unless calling the authorities is mandatory or impending danger is suspected, it is best not to do so without the patient's permission.

For more information, contact patientsafety@thedoctors.com.