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The PJ Tatler

by
Paul Hsieh, M.D.

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January 21, 2014 - 7:07 am

Will the federal government be taking a closer look at conversations between doctors and patients, in the name of protecting privacy?Here is an excerpt from a recent e-mail sent by a hospital administrator to physicians I know.  (I’ve deleted the name of the sender and the hospital).

Please protect yourself while protecting our patients. Make it part of your practice to ask every patient for permission to speak in front of others when others are present.

It is preferred that others are asked to step out of the room before asking for permission to allow the patient to freely respond, if this is not an option, the question must be asked regardless.  Never assume that it is “o.k.” to speak in front of others, i.e; husband, wife, mother, father, friends without asking for permission before speaking.  If a patient initiates a conversation in front of others, take a moment to ask permission before responding.  THIS IS IMPORTANT.

Privacy complaints are being reported to The Office of Civil Rights, (the OCR is the agency who investigate alleged Privacy violations)  with much more frequency than years past.  Fines for privacy violations can range from $100 to $50,000 for each violation for accidental violations up-to and including $50,000 for each violation for willful neglect.   Willful neglect violations, (involving monetary gain), often include criminal penalties…

Should doctors protect patient privacy? Yes, of course.

Should doctors take steps to make sure patients are free to discuss sensitive information (by requesting family members step out if necessary)?  Yes.

Should it literally become a “federal case” if doctors fail to follow proper protocol before each medical discussion with patients and their families?  I don’t think so.

Federalizing these relatively minor offenses has tremendous potential for misuse and selective enforcement.  We’ve seen this in other areas, as in this 2011 Wall Street Journal piece, “As Criminal Laws Proliferate, More Are Ensnared“.

It looks like we may be seeing more of this in health care as well.

Also read Vodkapundit: Care versus Coverage

Paul Hsieh, M.D. is a member of the Colorado chapter of Docs4PatientCare (www.Docs4PatientCare.org) and co-founder of Freedom and Individual Rights in Medicine (www.WeStandFIRM.org).

Comments are closed.

Top Rated Comments   
I think many patients will be deeply offended by the doctor's asking their spouses, significant others, et al. to remove themselves from the office. And I know that wives will be angry and insulted if asked to leave their husbands' exams.
43 weeks ago
43 weeks ago Link To Comment
"It is preferred that others are asked to step out of the room before asking for permission..."

I've had doctors do this to me when my medical advocate was in the room - ask them to leave. I've always regarded it as a power play on their part. I specifically asked that person to be in the room precisely to protect me (from forgetting something that was said, from feeling intimidated into agreement with a doctor's suggestion, etc.). To ask them to leave is to remove protection that I've already decided I prefer to have.
43 weeks ago
43 weeks ago Link To Comment
All Comments   (20)
All Comments   (20)
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This is the wrong way to handle an important but hardly catastrophic or criminal problem.

There doesn't need to be a government agency waiting for people to complain, nor should there be statutory limitations on what anyone can and cannot say. If someone suffers "harm" as the result of privacy violations -- and I think that bar would have to be set pretty high -- they should be able to file a lawsuit and recover damages, based on legal precedent, not regulatory policy. That is the way it should be handled in a free country, not through a Ministry of Medical Complaining.

To enforce rules on health care professionals violates their right to treat patients according to their own judgment, for better or worse.
43 weeks ago
43 weeks ago Link To Comment
Next thing we'll have a political officer in the room during all examinations.

If you want affordable health care offered in a competitive price environment get used to the idea of a world without government medical licensing.
43 weeks ago
43 weeks ago Link To Comment
I'm surprised by this.

Not that it's happening but that there remain things that aren't federal cases.
43 weeks ago
43 weeks ago Link To Comment
I think many patients will be deeply offended by the doctor's asking their spouses, significant others, et al. to remove themselves from the office. And I know that wives will be angry and insulted if asked to leave their husbands' exams.
43 weeks ago
43 weeks ago Link To Comment
In the past, it has always been assumed that if a patient has invited someone else (family member, friend) into the exam room, that they have given implicit consent for that person to be privy to their healthcare information. I guess someone got reported for this.
43 weeks ago
43 weeks ago Link To Comment
HIPPA violations are just another way patients and attorneys will bankrupt health care ....
43 weeks ago
43 weeks ago Link To Comment
Comrade, all your conversations are belong to us!

We are all criminals, it just remains for the State to decide when we will be arrested, persecuted,and jailed.
43 weeks ago
43 weeks ago Link To Comment
So now etiquette and manners are criminal issues?

Something has to give; this BS can't go on.
43 weeks ago
43 weeks ago Link To Comment

This kind of thing has been baked in the cake since HIPPA was passed in 1996.
It contains numerous restrictions on the use and communication of patient information, with fines for non-compliance.
43 weeks ago
43 weeks ago Link To Comment
The acronym is spelled HIPAA and pronounced like "high pay". To pronounce it like "hip pa" is to violate the rules of basic English pronunciation.
43 weeks ago
43 weeks ago Link To Comment
I've never heard it pronounced like that.

Maybe we should go back to basic Klingon and pronounce it hiPAA!
43 weeks ago
43 weeks ago Link To Comment
I do believe that the Feds and IRS are exempt from prosecution under HIPAA, so long as they are gathering taxes (a la John Roberts)!
43 weeks ago
43 weeks ago Link To Comment
Notice the pro-aborts, who are always on about no one getting between a doctor and his patient, will have absolutely zero to say about this.
43 weeks ago
43 weeks ago Link To Comment
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