Comments on: Patient information used for extortion http://www.kevinmd.com/blog/2008/11/patient-information-used-for-extortion.html Tue, 14 Feb 2012 22:04:00 +0000 hourly 1 By: Anonymoushttp://www.kevinmd.com/blog/2008/11/patient-information-used-for-extortion.html#comment-88164 Anonymous Fri, 14 Nov 2008 23:57:00 +0000 http://clients.emmense.com/kevinmd/2008/11/patient-information-used-for-extortion.html#comment-88164 What is has to do with Hippocratic ethics is as an illustration of the risks of letting what was once under our control get out of our control. Drug dispensing was once under doctors control and then moved out to pharmacies, accrued the involvement of insurance companies, which spread involvement to PBM's. We are now discussing letting the entire medical record get out of the doctors control and into the hands of those who don't share our oath and over whom we do not have control. That is an ethical issue. What is has to do with Hippocratic ethics is as an illustration of the risks of letting what was once under our control get out of our control. Drug dispensing was once under doctors control and then moved out to pharmacies, accrued the involvement of insurance companies, which spread involvement to PBM’s. We are now discussing letting the entire medical record get out of the doctors control and into the hands of those who don’t share our oath and over whom we do not have control. That is an ethical issue.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/11/patient-information-used-for-extortion.html#comment-88124 Anonymous Fri, 14 Nov 2008 00:22:00 +0000 http://clients.emmense.com/kevinmd/2008/11/patient-information-used-for-extortion.html#comment-88124 Anon: 1:46<br/><br/>You are right, there was no physician involvement which is the problem. A part of the doctor-patient interaction that used to be kept between the doctor and patient was outsourced a hundred years ago to the pharmacy--with the result of a breach in the wall of privacy. Rarely a problem. Then insurance breached it further. Then contractors like PBM's and clearing houses brought more people into the circle. Now the powers-that-be want to breach the final barrier, the entire medical record, and take it out the hands of the profession altogether. This single episode of a problem--just one example of many occurring all the time now--is an alarm bell to stop this process and take as much of the doctor-patient relationship back to a purely private two-party relationship as the demands of state of the art medicine allow. <br/><br/>One place to start would be to dispense the more common generics in our offices. My family doc did when I was a kid and we appreciated the inconvenience. Anon: 1:46

You are right, there was no physician involvement which is the problem. A part of the doctor-patient interaction that used to be kept between the doctor and patient was outsourced a hundred years ago to the pharmacy–with the result of a breach in the wall of privacy. Rarely a problem. Then insurance breached it further. Then contractors like PBM’s and clearing houses brought more people into the circle. Now the powers-that-be want to breach the final barrier, the entire medical record, and take it out the hands of the profession altogether. This single episode of a problem–just one example of many occurring all the time now–is an alarm bell to stop this process and take as much of the doctor-patient relationship back to a purely private two-party relationship as the demands of state of the art medicine allow.

One place to start would be to dispense the more common generics in our offices. My family doc did when I was a kid and we appreciated the inconvenience.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/11/patient-information-used-for-extortion.html#comment-88113 Anonymous Thu, 13 Nov 2008 18:46:00 +0000 http://clients.emmense.com/kevinmd/2008/11/patient-information-used-for-extortion.html#comment-88113 What on Earth does this have to do with Hippocratic medicine, or medicine at all for that matter?<br/><br/>From what I see here, the doctor saw the patient, did his/her thing, and prescribed a medicine. The patient could have gone to the pharmacy next door, but reasonably chose to save money by using the mail-order pharmacy.<br/><br/>Someone in that pharmacy system, likely a non-physician, chose to use the information given in good faith, to attempt to blackmail the patient. It could have happened with a local pharmacy just as easily.<br/><br/>I don't see any physician involvement, though. What on Earth does this have to do with Hippocratic medicine, or medicine at all for that matter?

From what I see here, the doctor saw the patient, did his/her thing, and prescribed a medicine. The patient could have gone to the pharmacy next door, but reasonably chose to save money by using the mail-order pharmacy.

Someone in that pharmacy system, likely a non-physician, chose to use the information given in good faith, to attempt to blackmail the patient. It could have happened with a local pharmacy just as easily.

I don’t see any physician involvement, though.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/11/patient-information-used-for-extortion.html#comment-88099 Anonymous Thu, 13 Nov 2008 13:16:00 +0000 http://clients.emmense.com/kevinmd/2008/11/patient-information-used-for-extortion.html#comment-88099 The maintenance of patient confidentiality is an age old fundamental ethical basis of Hippocratic medicine--not a modern add-on or legal complication. Discard it or outsource responsibility for it and you have removed so much of the foundation as to define a new profession while killing the old.<br/><br/>To outsource a fundamental obligation to non-physicians (government, insurance companies) is frankly unprofessional and a violation of a large element of the patient trust upon which the doctor patient relationship is founded. Would lawyers ever do that? Would they put all their clients record in unified database? Is law the only true profession left that understands what ethical obligations are? The maintenance of patient confidentiality is an age old fundamental ethical basis of Hippocratic medicine–not a modern add-on or legal complication. Discard it or outsource responsibility for it and you have removed so much of the foundation as to define a new profession while killing the old.

To outsource a fundamental obligation to non-physicians (government, insurance companies) is frankly unprofessional and a violation of a large element of the patient trust upon which the doctor patient relationship is founded. Would lawyers ever do that? Would they put all their clients record in unified database? Is law the only true profession left that understands what ethical obligations are?

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/11/patient-information-used-for-extortion.html#comment-88092 Anonymous Thu, 13 Nov 2008 03:07:00 +0000 http://clients.emmense.com/kevinmd/2008/11/patient-information-used-for-extortion.html#comment-88092 I second that. I want my medical records kept the old fashion way. If the doctor's computer is stolen or hacked, that doctor is liable. I second that. I want my medical records kept the old fashion way. If the doctor’s computer is stolen or hacked, that doctor is liable.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/11/patient-information-used-for-extortion.html#comment-88085 Anonymous Thu, 13 Nov 2008 01:46:00 +0000 http://clients.emmense.com/kevinmd/2008/11/patient-information-used-for-extortion.html#comment-88085 An even better reason why there shouldn't be a national electronic database. I want MY medical records on old fashioned biodegradable flamable paper--that my doctor's heirs will incinerate as soon as legally possible after his death--if he hasn't already. I want some of the information to only exist in his aging noggin even if that causes me difficulty. An even better reason why there shouldn’t be a national electronic database. I want MY medical records on old fashioned biodegradable flamable paper–that my doctor’s heirs will incinerate as soon as legally possible after his death–if he hasn’t already. I want some of the information to only exist in his aging noggin even if that causes me difficulty.

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