Musings of a Dinosaur

A Family Doctor in solo private practice; I may be going the way of the dinosaur, but I'm not dead yet.

Friday, February 05, 2010

HIPAA be Damned

We can be pretty informal in my office. Sometimes patients would rather sit by the front desk and chitchat with the office staff instead of going back to the waiting room, lovely though it is, and read magazines.

One of those regulars was in the other day. As she sat there filling us in on the latest goings-on with her grandchildren, the next patient walked in. As it happened, she was another lovely lady who preferred the company of the staff to the more comfortable chairs in the waiting room, so she also perched next to the check-in counter and joined the conversation.

After a few minutes of this informal give-and-take among us all, I found myself feeling ever so slightly rude. I realized it was my home training asserting itself, as I heard my mother's voice in my ear saying, "Introduce them."

So I did: "Mary, Jane; Jane, Mary."

First names only, of course. Including their last names would make them uniquely identifiable. This would constitute "Protected Health Information," which needs to be zealously guarded from inadvertent disclosure. That's what HIPAA says.

The first lady had been looking carefully at the second, but now she said, "What's your last name?"

I had to bite my tongue not to scream, "NOOOOOOOO!! HIPAA says you can't tell her that. It's Protected Health Information!"

But of course there's nothing in HIPAA that says a patient can't tell another patient her last name. They ended up exchanging not just current last names, but also maiden names -- and discovered they had gone to high school together fifty years ago. They caught each other up on their families: one was widowed; both had grandchildren. They laughed and had a lovely visit, foreshortened by me, party pooper that I had to be, to actually provide, yanno, medical care to them.

The take-home message is that privacy is the patient's. They are the ones who can choose what to do with it, including breaching it to reconnect with an old friend. It was a lovely encounter to witness, and the hell with HIPAA.


At Fri Feb 05, 10:54:00 AM, Anonymous Anonymous said...

I'm just waiting for HIPPA to tell us to put brown paper bags over patients' head when they enter the office to prevent visual identification.

At Fri Feb 05, 09:55:00 PM, Blogger Shelby said...

perfect. loved this.

At Fri Feb 05, 10:22:00 PM, Anonymous Anonymous said...

I hate HIPAA.

My favorite HIPAA story was from my tiny residency clinic:

Two patients, unrelated, with the same name and birth date (different middle names and different years of DOB) with appts one after another for the same doc - what are the chances? The nurse calling the first one back had to sort through personal info and figure out who was who. Of course she did it in the waiting room in front of all the patients. They didn't care; everyone thought it was hilarious.

Truth be told, the only people I've ever noticed who had major HIPAA issues were people with something to hide. Just saying.

At Sat Feb 06, 12:07:00 AM, Blogger Dreaming again said...

When I was a teenager, long before HIPPA
I went to a doctor where a woman with my first middle and last name ...and same DOB ...except year ... 14 vs 1964 ....
We had 2 doctors the same and many times wound up on the same return visit schedule so we actually met a few times.

Then I didn't see her at an expected return follow up ...didn't think much about it till I got the bill from the hospital ... $45,000 for a bill that took place on their geriatric ward.
As an 18 year old, it was quite the battle ...but really hard could it have been for them to realize they had TWO patients with the same name and b'days ...and one was 18 and not likely to be getting services from a geriatrician?

At Sat Feb 06, 10:52:00 AM, Anonymous Anonymous said...

I have had to visit many doctors over the last few years for a few different ailments. Personally I would like to sign something that allows my medical information to be freely distributed around the world so I can stop filling out releases. I am sick of them.

At Tue Feb 16, 04:04:00 AM, Blogger Unknown said...

agreed with shelby... perfect..
HIPAA 5010 Migration Solution


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