Doctor-Patient Confidentiality in the TG world

I have a couple questions.

I’m slightly familiar with the Canadian Medical Association’s stand on doctor-patient confidentiality and assume the rules are similar in most of the western world.  I’m also aware of  physician-patient privilege – the legal concept that prevents doctor-patient discussion from being used in a court of law, except under certain, very specific circumstances.

I do trust that doctor’s take this need for confidentiality very seriously but, to my knowledge, access to patient records is not restricted only to doctors.  Office staff, nurses, medical transcription people all might have access to those records.

SeleenaK_4763sReading about a “Get Tested” initiative here in Canada got me thinking.  The program is designed to make it easier for anyone to be tested for STD’s.  Is embarrassment or confidentiality concerns part or all of the reason we need discreet testing?

And are confidentiality concerns justified?

Does an HIV test imply a high-risk lifestyle? Does getting tested for chlamydia or gonorrhea imply careless promiscuity? Many of us in the lifestyle aren’t too quick to judge but what about the town gossip?

Ethics violations are serious charges for doctors but what about the doctor’s staff?  I would assume that dismissal would be the extent of the penalty for outing a patient to friends or acquaintances with “loose lips”.  Maybe not a big deal for those who change jobs and employers frequently but for the victim, it could be devastating.

The fact that a patient was tested for something, regardless of the results of the test, is likely as implicating as a positive test result.

So my questions are:

  • Is there something bigger preventing medical office personnel from telling the world about the documented discussions that go on between doctor and patient?
  • how common do you think it is for someone to be outed after visiting their doctor?

I personally have heard a medical office employee joke and laugh about a TG patient who comes in to the practice regularly for hormone therapy.  She volunteered so much detail that I thought she would have certainly provided a name if anyone asked for it.

Luckily no one asked.

 

more information is available at:

http://www.cpso.on.ca/policies-publications/policy/confidentiality-of-personal-health-information

http://en.wikipedia.org/wiki/Physician%E2%80%93patient_privilege

4 thoughts on “Doctor-Patient Confidentiality in the TG world”

  1. Unfortunately there will always be people with a lack of professionalism, a lack of work ethics and a lack of respect for others. The only options available are a) denounce such behaviour to their superior or the media and remember that the latter may drag you in a situation with the media even worse for your privacy. The option b) is to seek services else where and let it go.

    In the best of world of respect, I want the medical field including my pharmacists to share my medical information for my own safety, i.e. drug history, prior diagnostics as well as current health issues. In fact such information should be available worldwide via a secure private network for occasional and frequent travellers. It only make sense to me to practice preventive medicine rather than reactive medicine.

    Even if there are gossipers, bad mouths and people with a lack of professionalism , the damage caused by their behaviour is much less risky in the long term than a medical error caused by a lack of communication.

    Liz.

    1. thanks for the comments Liz. In a perfect world, I totally agree.

      But I also believe that mental and emotional health is just as important and critical as the physical. And if the confidentiality situation is as it appears, seeking and monitoring physical health can cause great mental trauma if discretion can be so easily compromised.

      Let’s all strive for the timely sharing of all medical information as you suggest (the “circle of care”), but also try to ensure no one’s emotional well-being is compromised?

  2. S.K.

    The protection of privilege extends to bind not only the primary “professional” – lawyer, doctor – but in law binds all employees of the primary. Violation by an underlying is a violation by the primary, and a doctor or lawyer can be fined heavily and barred from practice for the misconduct of their employees. In addition to the penalty that a professional body can impose on the primary, the injured party has a civil right to sue for damages for breach of privilege/confidentiality – and be able to collect from either the breaching employee or the professional employer or both. The law in both Canada and the U.S. treats breaches of privilege extremely seriously. Those foolish enough to do so can expect no leniency or quarter before a disciplinary hearing or a judge.

    1. Thank you so much for clarifying this Candy. It’s very reassuring! Hopefully this knowledge will be reassuring to those who might be less diligent about their health care due to privacy fears.

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