MPIE Risk Management GEM (Volume I): Ask MPIE: When are Physicians Required to Report Suspected Child Abuse or Neglect?

Recently a call came into MPIE’ s risk management hotline about mandatory reporting requirements for suspected child abuse in Michigan. After reviewing the physician’s situation, we advised the physician and provided resources and links to help them meet their responsibility under the law. As a service to all MPIE providers, we take the opportunity to review aspects of mandatory reporting requirements.

Reporting requirements vary by state, but generally, state child welfare laws impose an obligation on licensed healthcare providers to recognize and report instances of suspected abuse to Centralized Intake (CI) at the Department of Health and Human Services (DHHS). In many states, including Michigan, these persons are referred to as “mandated reporters.” Other mandated reporters include counselors, therapists, social workers, teachers, and school administrators.

It is important to note that requirements are not that providers have absolute certainty before a report is required. Instead, mandatory reporters with a good-faith basis to suspect abuse are obligated to report it. Typically, physicians with a good-faith basis to suspect abuse are shielded from repercussions by the patient or the caretaker. In addition, the reporter’s identity is generally kept confidential. In Michigan, confidentiality is provided in the Child Protection law and will be disclosed only with consent or by judicial process.[i]

The obligation to report a child’s suspected physical or sexual abuse typically includes it being done in a specific amount of time. Most state agencies involved have a 24-hour reporting hotline or an online reporting option. Many states also require a written follow-up to be completed within a specified time. Michigan, for example, requires an immediate notification by phone or through an online reporting system and a written report following within 72 hours.[ii] Failure to report that suspected abuse can lead to both civil and criminal liability and disciplinary actions. Physicians (and others considered mandatory reporters) who fail to follow state reporting requirements when abuse is suspected may open themselves to various professional liability implications, including lawsuits. For example, a physician who treats a very young child for an arm fracture finds indications of prior healed fractures and observes a history of recent care for other suspicious injuries. The physician suspects abuse but does not report and discharges the child to the parent. Shortly after that, the child dies due to further abuse. Attorneys for that child’s estate may be able to pursue that doctor for not protecting the child through reporting the suspected abuse.

To assist providers in knowing and following their mandated reporting requirements, MPIE provides the following information.

Risk Management Recommendations

  1. Be familiar with state-specific mandatory reporting requirements (some resources listed below).
  2. Be familiar with the signs and residual effects of physical or sexual abuse.
  3. Establish protocols for responding to suspected abuse.
  4. Educate staff on requirements, including making sure any suspected abuse is immediately made known to the physician or healthcare provider.
  5. Ensure thorough and accurate charting that illustrates why the provider suspects abuse or neglect.
  6. Be prepared to answer questions from state investigators and possibly testify in court proceedings. Please contact MPIE Claims for assistance if you believe the reporting of issues may result in criticism of medical care provided or if other professional liability concerns may be implicated.

Resources and More Information



If you are an employed provider of a healthcare system and have questions on this subject, please consult your organization’s risk management department for advisement as to system policy or protocol.