Honoring Our Right to Confidentiality
by Bob Kieserman
Imagine sitting in the waiting room of your doctor’s office and you overhear one of the women at the front desk say to a patient checking in, “Your name is Mary Hamilton? You live at 134 Hemlock Drive in Philadelphia, your phone number is 215-555-1234, you are a Medicaid patient, and you are here to see Dr. Brown for a possible blockage in your artery?” Imagine you know Mary Hamilton. As they say, too much information. Actually, it goes beyond just too much information. It can actually be grounds for a malpractice suit against the doctor or the hospital system that owns the practice.
I recently saw a new doctor. Recommended by one of my other doctors, I thought that this new doctor was excellent, and I was very pleased with the examination she gave me. However, at the end of the visit, I asked her if I could have a moment of her time to talk to her about something that was bothering me. She had just completed the exam and the medical scribe was still in the room, so she asked the scribe to leave, and I proceeded to tell her my concern. I told the doctor that when I was sitting in the waiting room, I could hear everything that was being said to every patient being checked in at the front desk, and that this should not be happening because it breaches the patient’s right to confidentiality. Much to the doctor’s credit, she immediately went to get the practice administrator who sat down with me a few minutes so we could talk. I explained that many practices have a protocol to print out a sheet with all of the patient’s personal information which is given to the patient at the desk and the patient is asked to confirm the information. That way, no personal information is broadcast throughout the office for others to hear. The administrator thanked me for bringing this to her attention, and I thanked her for listening.
I am a big proponent of The Patient Bill of Rights. One of the key elements of that document is protecting the confidentiality of patient information. Unfortunately, in many medical offices and in many hospital waiting rooms, it is one of the most violated rights. Instead of taking precautions to guard information, front desk staff openly ask questions of patients and disclose information about what insurance the patient has, what medications the patient is taking, and the diagnoses for which the patient is being treated.
How Can We Protect Our Privacy?
As patients, we need to be proactive in protecting our information. When we enter a medical practice front desk or hospital check in counter and the staff person begins to ask us questions aloud, we need to quietly but affirmatively let the staff member know that we do not want to discuss our information so others can hear. Many patients come prepared with a paper showing all of their personal information – name, address, phone number, referring physician, social security number, and other relevant information – and present this to the person at the desk. You should also have your insurance card ready to present. By the way, the same holds true at the pharmacy when the pharmacy technician begins to ask for information in front of customers. Again, either a quieter one-on-one conversation should take place, or the information can be written down on a piece of paper and the technician can then take the information to the computer or to the pharmacist.
The Online Check in Process
More and more practices and hospital systems are giving patients the opportunity to enter this information online at home before the visit. This allows the front desk to already have the information in their computer and they can generate a slip for the patient to check when they arrive. This also expedites the check in and initial parts of the visit. If your particular provider is not yet using this pre-check in system, you may wish to suggest it when you next visit your provider.
What to Do If Your Confidentiality is Being Violated
We all have the right to keep our personal information and our medical information privately. If we make an attempt to ask the front desk staff to approach check in and checkout with greater sensitivity, and they are either unwilling to change or react with an attitude, patients can always ask to speak to the practice administrator. Today, all medical offices and hospital practices have someone who is in charge of the business operations and patient relations. We should not be afraid to speak up, and let the administrator know that we are upset with the way patients are registered or checked out at the end of the visit.
If we do not protect our privacy, we are to blame if someone else overhears information about our medical situation that we do not want shared. That is why we should all be proactive when we begin a visit with the doctor and if necessary, let the front desk know that we want things done differently to protect our privacy. A final recommendation is to discuss the protection of confidentiality of your personal information and medical information with your doctor and voice your concerns, if you have any, so that your doctor is aware and can hopefully change the protocols in the office.
Bob Kieserman is the Executive Director of The Power of the Patient Project: The National Library of Patient Rights and Advocacy, and publisher of Today's Patient. Now retired, for over 35 years, he was a professor of healthcare administration and medical ethics and a healthcare consultant. He is the author of over 300 articles and four books on managing the private healthcare practice, the patient/provider relationship, and the rights of patients. Bob is both a medical librarian and a medical sociologist and resides near Philadelphia.
Becoming Aware of Our Stress:
Now is a Good Time
Julianna Strano is a senior at The University of Arizona majoring in journalism and sociology. Julianna is passionate about all topics related to health and wellness and has the goal of educating and informing others through her writing. Julianna joined the editorial staff of Today's Patient to have the opportunity to help educate others on patient rights and discuss topics that she is passionate about.
by Julianna Strano
April is Stress Awareness Month. Stress and worry are common feelings that people experience throughout their day to day lives. External circumstances and events can leave us feeling stressed and overwhelmed. However, there is a difference between everyday stress and anxiety disorders.
The National Institute of Mental Health explains that about 31.1% of U.S. adults are affected by anxiety disorders in their lifetime.
“The wide variety of anxiety disorders differ by the objects or situations that induce them but share features of excessive anxiety and related behavioral disturbances. Anxiety disorders can interfere with daily activities such as job performance, school work, and relationships,” states The National Institute of Mental Health.
The difference between stress and anxiety is that with everyday stress, the feelings typically go away once the external problem or conflict that is bringing about those emotions is resolved. Although stress and anxiety are similar, they have different origins. For example, stress is typically brought on by an external cause such as an exam coming up or a project at work. Anxiety is different.
“Anxiety is a person’s specific reaction to stress; its origin is internal. Anxiety is typically characterized by a ‘persistent feeling of apprehension or dread’ in situations that are not actually threatening,” as stated by Mental Health First Aid.
David Posen, M.D. works in stress counseling and is also a renown author and speaker. He explains how he enjoys what he does and the relationships he has formed with his patients.
“The thing I find most rewarding is when people pick up on the ideas that I am sharing, find them beneficial, and tell them how much progress they are making by applying the insights and suggestions I make,” Posen says.
Posen describes anxiety as “Borrowing trouble from the future” and “long distance worrying; worrying long before something is going to happen.”
Where Does Stress Come From?
Stress can show up in a variety of ways and it varies from person to person. Understanding the ways that stress can affect the body is important because anxiety is more than just an anxious or nervous feeling.
Dr. Posen lists a few common physical effects of stress which include headaches, muscle aches, trouble falling or staying asleep, racing heart, nausea, and cramps. Stress can also cause individuals to have certain behaviors such as nail biting, fidgeting, bouncing knees up and down, and shaking. Stress can also cause individuals to be more forgetful, tired, irritable, and frustrated.
Dr. Posen explains how it is important to read your body and understand how stress shows up for you. It's helpful for everyone to be aware of what their signals are.
“Some people have trouble sleeping, others get chest pain for example. How does stress show up for you? Monitor yourself and your energy,” Posen says.
April is a Great Month to Become Aware of Our Stress
April is a time to spread awareness, information, and support each other. The popular website Stress.org explains how it can be difficult to give one definition to stress.
According to the website, “We all experience stress – yet we may experience it in very different ways. Because of this, there is no single definition for stress, but the most common explanation is a physical, mental, or emotional strain or tension. Stress is a reaction to a situation where a person feels anxious or threatened. Learning healthy ways to cope and getting the proper care and support can help reduce stressful feelings and symptoms.”
Dr. Posen suggests that individuals should take the month of April to take actions towards destigmatizing stress, anxiety, and mental health; just talk about it. It's also helpful to take time to care for yourself. Posen suggests making small changes and actions such as eliminating the amount of caffeine consumed each day, pace yourself, rejuvenate your energy, make time for rest, as well as exercise.
It's also helpful and important to check in on others to see how they are feeling.
“Listen, let people talk, reach out, ask questions, show some empathy. It goes a long way,” Dr. Posen reminds us all.
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