At lunch today a couple of the guys were talking about hospital visits and how the staff log everything. Who visited when and did they bring flowers, did they hold the baby, was there any conflict or arguing? And more than one person claimed this was true. A perfunctory search on google yielded nothing to back up these personal anecdotes, but I’m going to go on the assumption that is true. Someone mentioned that a resident friend of his told him he had to write everything down because you, as a doctor, didn’t ever want to be accused of not knowing something or not remembering something that might have been critical to a patient’s welfare. Doctors get sued for malpractice all the time. They pay outrageous amounts of money for malpractice insurance. I can see why you’d want to take careful notes about everything you possibly could.
But it raises a really interesting privacy issue, too. Medical records should be “sacred secrets”, shared only with other professionals when absolutely needed. But if doctors and nurses are actually taking such copious and detailed notes — it’s not just your medical records, it’s also personal data in those files. HIPAA (Health Insurance Portability and Accountability Act), which went into effect on April 14, 2003, set national standards for maintaining the privacy of health information, but is limited to the information maintained by health care providers, health plans and health clearinghouses only if they transmit it in electronic form. And it doesn’t actually prevent medical information from being shared for marketing purposes, or sharing between doctors without explicit consent, or providing information to the public and the media (unless the patient explicitly opts out), and we don’t have the power to sue if these regulations are grossly violated. Doesn’t seem like a whole lot of privacy, does it? <HIPAA Myths, HIPAA Basics>
I was just reading an article last night about how HIPAA could hinder information flow — even if you’ve made legal provisions for someone to act in your stead if you become completely incapacitated or incompetent. If you don’t make explicit HIPAA clauses in your legal documents, the distribution of your money and tangible goods, or your requested medical wishes, might not be honored because without the medical information there is no way for your wife or child or other designated stand in to prove that you are in the condition you’ve claused in your will.
And it made me wonder how soon after a lawsuit occurred challenging these difficulties, would someone try to alter the minimal standards of medical privacy we currently have. Privacy is such a hard thing to try to maintain. If we really care about our privacy, we have to make a conscious and concerted effort to try to safeguard it. And it’s easy to give up because convenience is always the pay off for giving up some privacy. I’m just as guilty of it as anyone else.
And the threats to privacy only get worse as technology ever increasingly becomes more advanced. Cameras are everywhere. RFIDs are prevalent and soon to become much more so (big business is already touting the high returns on investment in RFID), unencrypted email, wireless networks, data mining and caching. Not to mention threats to homeland security and the rights we’ve lost with the PATRIOT Act. It just doesn’t end.
