Privacy Starts in the Halls of Health Care
In August, I spent the better part of five days at a Florida hospital at the bedside of my very ill father.
In the bed next to his was a man who had been hospitalized after passing out from unregulated diabetes. His daughter couldn’t bring him home with her, and she was attempting to have him transferred to a Veterans Affairs hospital, since he did not have private health insurance.
In the room across the hall was an elderly gentleman. He had an inoperable brain aneurysm. He was unconscious, and the doctor said he needed to be put on life support. His wife said he didn’t want that type of heroics. But his son was insisting that everything possible be done. Down the hall, a woman in her 50s was told that her breast cancer had spread to other organs. The doctor was recommending more surgery and a major course of radiation and chemotherapy.
By now you must think I am the nosiest man on Earth. I mean, how else would I know so much about all these other patients? Well, the fact is, I never spoke to any of the people I’ve mentioned. No, everything I’ve told you, I heard from hallway conversations between medical personnel as I sat with my dad.
The openness with which they discussed hospitalized patients struck me as ironic. You see, for several years now, Congress has been grappling with the issue of medical privacy. One problem, according to “experts,” is the highly sophisticated electronic age we’re living in. In a matter of seconds, a person’s entire medical history can be transmitted almost anywhere in the world. And because there is very little regulation governing the electronic transfer of medical information, the fear is that it might fall into the hands of people who could use it to exploit or discriminate against someone.
Another problem is that the number of hands just keeps growing. At a health-care privacy conference I attended several years ago, a federal researcher reported that during a typical hospital stay, a minimum of 11 people see your medical record, while only four employees really need access to it.
Managed-care companies, such as HMOs, have added layers of personnel who review records for medical necessity, cost and fraud. Many U.S. hospitals send handwritten medical records to foreign countries for inexpensive transcription. Yet few foreign countries have laws dealing with medical privacy.
While I certainly support legislation that limits the unrestricted transfer and use of medical record information, I submit an even bigger problem is the loose lips of doctors, nurses and other medical personnel.
Recently, a man wrote me about his experience at a doctor’s office. He had taken his wife for some minor, in-office, gynecological surgery. While he waited for her, nurses and other doctors routinely walked into the waiting room, asked for women by their full names and proceeded to talk about biopsy results in full earshot of everyone else. By the time he got home, he wrote, he knew the names and intimate medical details of at least eight women!
So while Congress and the federal government attempt to take care of the legal and cyberspace aspects of medical record privacy, it’s time that medical educators train their students to keep their big mouths shut. And we consumers must do something as well.
On the second day of my Florida stay, after listening to two doctors loudly debate whether to discharge a patient, I went into the hall, walked right up to them and said, “Based on what you’ve described, I’d send the poor fellow home!”
Both physicians stared at me in shock, looked at each other, then turned and quickly walked away. I suppose they were astounded that a layperson like me, a mere visitor in their temple of cure, would have the audacity to offer my “expert” opinion on a patient’s course of treatment. Or perhaps they were embarrassed at having been “caught” talking so loudly about private medical matters.
As I watched them walk down the hall, I wondered if I had gone too far. Maybe I should have just ignored them and minded my own business. But then, I thought, I probably did the current and future patients of that hospital a big favor. Perhaps now there would be two fewer sets of loose lips carelessly spreading the intimate medical details of unsuspecting consumers.
Charles B. Inlander is president of the People’s Medical Society, a faculty lecturer at Yale University, and author or co-author of numerous books, including “Men’s Health for Dummies” (IDG Books Worldwide, 1999).
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Charles B. Inlander will speak at the Los Angeles Times Festival of Health at 1:30 p.m. Oct. 17 at USC.
