Did Swim's doctor break any privacy laws?

[BobTheGreat]

Back in early January swim was under a lot of stress and had a panic attack. He had no idea what was going on and thought it was a heart attack so he went to the doc. Afraid it was from past drug use he told the doc about his past cocaine use. She said swim needed to go the the hospital and couldnt drive himself. Swim called his mom who worked down the street to take him. When swim's mom arrived doc went ahead without swim's conscent and told his mom about the cocaine use. Swim is 20 and emmacipated. He was thinking lately doesnt he have the right the privacy? Did swim's doc have the right to give out persoal information without his conscent?

[fnord]

yup they did break your confidentiality,swim once got a jail guard in alot of troble for looking over a jail nurses shoulder and reading the med list while he was in line.

[old hippie 56]

Swim should report the doc to the state board for violating your privacy.

[bcubed]

SWIM would urge SWIY to be very, very careful in what one discloses to one's doctor and in what circumstances. The meidcal community both makes money treating the "addicted" and gets to set the standard: consequently, said standard is set in their favor.

Basically admitting to ANY artificial euphoria is asking for trouble. To wit, consider this guy, clean driving record for 23 years, who loses his license (later regained with the proviso of INDEFINITE ignition lock) because he told his doc he likes to drink "6-10 beers" a day.

HARRISBURG, Pa. -- A man who told his doctors that he drinks more than a six-pack of beer per day is now fighting to get his driver's license back because the physicians apparently reported him to the state.

Keith Emerich, 44, said Tuesday that he disclosed his drinking habit in February to doctors who were treating him at a hospital for an irregular heartbeat.

"I told them it was over a six-pack a day. It wasn't good for me -- I'm not going to lie," Emerich said in a telephone interview from his home in Lebanon, about 30 miles east of Harrisburg.

Emerich received a notice from the Pennsylvania Department of Transportation in April that his license was being revoked effective May 6 for medical reasons related to substance abuse. He has petitioned a judge to restore the license, and a hearing has been set for July 29.

A state law dating to the 1960s requires doctors to report any physical or mental impairments that could compromise a patient's ability to drive safely, PennDOT spokeswoman Joan Nissley said. Nissley said she could not discuss the details of Emerich's case because of confidentiality requirements that also protect the doctor from being identified.

The law requires revocation of the license until the driver can prove he is competent to drive.

Emerich said his heart problem has prompted him to limit his beer drinking to weekends. Aside from a drunken-driving conviction when he was 21, Emerich, a pressman at a printshop who lives alone, said he has a clean driving record and does not drink and drive.

"What I do in the privacy of my own home is none of PennDOT's business," he said.

Asked if he considered his client to be alcoholic, Horace Ehrgood, Emerich's attorney, said: "It depends on what your definition is."

"He's been able to go to work, and he's got a heck of a nice work record. He's been able to function in all other avenues of life," the lawyer said.

Pennsylvania's transportation agency receives about 40,000 medical reports and revokes 5,000 to 6,000 licenses a year but does not keep any statistics on its reasons for doing so, Nissley said. She also said she did not know how many revocations get appealed.

Pennsylvania is one of six states that require doctors to report motorists with medical conditions that could affect their driving, according to the American Association of Motor Vehicle Administrators. The other states are California, Delaware, Oregon, Nevada, and New Jersey.

All other states and the District of Columbia allow physicians to submit reports on a voluntary basis.

Beth Givens, director of the Privacy Rights Clearinghouse, a San Diego-based watchdog group, said cases like Emerich's highlight a tension between medical privacy and public safety.

"Certainly, cases like this could lead individuals to refrain from giving their doctors adequate information to treat them," Givens said.

I'm gonna ask my doc a few questions re: drug interactions, and I'll damn sure be SWIMming 'em.

[BobTheGreat]

bcubed,

Swim figured out pretty quick not to tell the doc about drug use if youre not ODing. All the docs he saw pretty much just blamed it on drugs without much thought into anything else.



What would Swim need to do to report her? A quick google search lead from the Medical Licensing Board website to a general consumer complaint website. Is this how?

[Nagognog2]

When Bongo told his new doctor, many years ago, that he had smoked marijuana - the quack-doctor wrote a letter to Bongo's parents. Bongo was of legal age, but he did anyways. He told the parents that Bongo was an incorrigible drug-addict and he - Quack - would be happy to sign commitment papers to put Bongo away in a state mental institution for life. He said there was no cure for a marijuana-addict and the disease would only lead to such horrors as homicide, rape, robbery, and homosexuality.

Bongo should have sued the son-of-a-bitch, but didn't. His parents laughed. A new doctor was found. Bongo's father was growing pot in the yard at the time. Should have gotten the Family-Plan commitment. Alas.

Bongo was overjoyed to hear that quack had broken both his legs in a car-crash. Dr. Quack was driving drunk.

Reputation Comments on this post:

Nice resolution to Dr. Quack there. But hey, its ok to drink your drug right?

[fnord]

SWIM would urge SWIY to be very, very careful in what one discloses to one's doctor and in what circumstances. The meidcal community both makes money treating the "addicted" and gets to set the standard: consequently, said standard is set in their favor.


NO NO NO!!! swim belives in telling his doctor everything,he might not get good mmeds but at least he can get good advice on harm reduction,if it comes down to it get two docotrs one to tell your drug use about and another for well other things...but swim strongly belives swiys doc should know what your up too.

[stoneinfocus]

Froget it, docs have the onyl profession in crawling up their prof´s arse durifng study, later on selling pharma-sponosred medicaments to the sponsered and etablished therapies agendas and makinfg as much of a profit for their institute as they can -nothign else.

Or how intelligent and overthinking would you judge someone, that´s tearing you apart in a surgery, nailing, sawing, hammering, screwing, but refuses to give more than 2 days opaites against pain, post surgery, bnecause you might get addicted thinking drugs are bad?

they´re no better than a normal mechanichs, mostly with not much more of an understanding of how something should be done, to work properly.

Those, researching do this and propose the most unbelievable and most well- thought therapies and possibilities that were absolutely unheard of by the praticising doctors, that arr luckily ignoring these, giving pills away and gettign brain-washed at the next carribean conforence.

[schwing]

argh. By "I" I meant to say SWIM. I wish newbies had message edit function...

[schwing]

First up, sorry for resurrecting this old thread. But I have a question:

SWIM's going to see a doctor for the first time in almost ten years about something. But because he'll be seeing a new doc, he's nervous that if he tells doc that he's a chronic user of *randomol* (either something illegal or something with sketchy legal status) then the doc may be compelled to inform a law enforcement... I know that doctors (whether a psychiatrist or a home doctor) are supposed to keep a strict doctor-patient confidentiality, but how do I know that I won't get into trouble? Do doctors get into legal trouble for disclosing enformation regarding their patients to the police? What if he decides (for whatever reason) that SWIM needs help that he/she's unwilling to get (for the reasons of SWIM's own safety, not others)?

Reputation Comments on this post:

good question. positive rating given so that you are closer to being able to edit

[schwing]

If SWIM seems paranoid, it's because the doctor may ask him/her to get a blood test... if the blood test is done by an outside laboratory (as I assume it will be) and the test comes up drugs positive, then is the said laboratory similarly obligated to keep the test results confidential?

This is probably a dumb question because drugs probably don't show up on random tests not designed for drug detection... but SWIM wants confirmation that it's a dumb question so that he/she'll have a peace of mind... much thanks.

[Bio-Cellular Enigma]

Allow SWIM to add his voice to the chorus: Do not tell any medical personnel (particularly doctors, but also nurses, billing department personnel, social workers, etc.) about drug and/or alcohol use unless it's a case of overdose requiring emergency treatment. Admitting to it can cause a variety of problems.

Likely the most common is simply a prejudicial or judgmental response on the part of the doctor; e.g. the issue of "enabling" continued use becomes the main factor determining treatment, particularly in regard to prescriptions and such. Most doctors do not consider addiction to be a disease, despite what they may say if asked casually; SWIY may be morally judged and shuffled to the bottom of the doctor's priority list, or simply not treated at all. The doctor may also have concerns about legal liabilities should he/she prescribe something that didn't mix with the recreational substance, do something that made an addiction-related issue worse, or whatever else the doctor thinks up, really.

All this is of course in addition to what's already been posted, i.e. being reported or "told on." There may be other potential negatives which haven't yet been mentioned.

P.S. SWIM might make an exception in the case of e.g. a small clinic and a trusted/nonprejudiced "family doctor" (GP). Not that it would be risk-free, just that potential benefits (requested meds to help aid withdrawal, various tests like EKG, blood, urine following a binge or something, various symptomatic treatment) might outweigh the risks.

[schwing]

Thanks for the reply. Ok SWIM just came back from an appointment with a GP (a walk-in clinic) and as he/she feared the GP asked to have a lab test done (what the fuck...!). It says to get hematology, TSH and macroscopic urinalysis (and microscopic if dipstick positive whatever that means). I'm guessing that this sort of test won't detect any drugs in the system (if present)... can anyone confirm?

SWIM told the doctor "no" to street drug use but admitted that he may have had a joint while drunk at a party a couple of weeks back but that he/she isn't a regular user (this was before SWIM read your post unfortunately...). Maybe SWIM should just conveniently forget about the lab test and not go back to the GP? SWIM didn't want to ask too many questions about the test for the fear of appearing suspicious...

[Bio-Cellular Enigma]

Originally Posted by schwing

SWIM told the doctor "no" to street drug use but admitted that he may have had a joint while drunk at a party a couple of weeks back but that he/she isn't a regular user (this was before SWIM read your post unfortunately...)

Well, there are degrees of risk to almost everything... telling a doctor SWIY "may have" smoked one joint at a party two weeks ago (while drunk, which really equates to "by accident"), PLUS emphasizing not using regularly is the least risky admission of drug use SWIM can personally imagine.

P.S. do people really still roll joints? SWIM hasn't even seen one for quite a number of years.

[Bajeda]

Originally Posted by Bio-Cellular Enigma

P.S. do people really still roll joints? SWIM hasn't even seen one for quite a number of years.

Thats all swim smokes really. When he came to the US he found that not many people smoked them. Most would use pieces of some kind, and some would use blunts. Not many knew how to roll joints. Swim changed that, and has taught a number of people to roll, and a few others have learnt how since to go with the flow.

God how he tires of smoking out of pipes. Joints are, and probably will forever be, swim's preferred methods of smoking.

[Bajeda]

Swim encountered a very similar situation not too far back. The doctor was a chill guy and swim would have been fine telling him about his drug use, but what was the point? It would be too long a story, swim didn't want to chance a situation like the OP's,there was no related medical issue that necessitated the doctor's knowing of swim's drug use, and basically it would just be a futile exercise. Swim just politely answered 'no' to the inquiry about drug use and went on his way happy as a clam!

[Heretic.Ape.]

Usually blood tests etc from doctors are not looking for drugs other than levels for perscriptions you are on and such things as measuring liver function, etc--they are specific tests for what is relevent to your condition. If you are smoking pot, or other fairly benign drugs, disclosure isn't really necissary. It may be a good idea if you are regularly using stimulants. If you are using perscription drugs recreationally and don't want to tell your doctor what you're taking on your own time and your doctor prescribes something for you, you may want to get a book like "the pill book" that lists pretty much every common medication and its interactions with other meds.
If you don't feel comfortable talking to your doctor you should probably go find another doctor--you are employing them, not the other way around.

[schwing]

Thanks guys for the responses... Yeah SWIM told me that his/her doc seemed unphased by the MJ story.

Bio-Cellular Enigma: really? I hear that rolling a joint is the most popular method where I'm from (or maybe just SWIM's acquaintances? Dunno). They're more portable and discreet than other methods (except for oral ingestion I guess). In fact with a circle friends SWIM's never used other methods.

[ojos_de_brujo]

There are good doctors and bad ones. Anyone, not just drug users, should learn what their doctor thinks like. Does he follow the latest developments in medicine? Does he know much about psychology? Does he really care?

Do not trust a doctor immediately, but find out if he is worthy of your trust.

A doctor can do the opposite of ratting you out: Swim has a doctor that she told most of her (former) problems to. One day, Swim was arrested after some false accusations someone made against her. (Swim's dear mother said she was going to kill Swim if she saw her in the house again, Swim went away, and dear mum called the cops saying Swim had disappeared and was suicidal)
When the district attorney found out about this he wanted to commit Swim to a mental hospital ( to come out of when pigs fly)
At this time, because Swim's doctor knew Swim's family history, he could calm the situation down and prevent this from happening. He convinced the cops and the DA that Swim was not suicidal. He actually put himself on the line defending Swim.

[Pinkavvy]

Originally Posted by BobTheGreat

Swim is 20 and emmacipated.

20 and emancipated? That's odd. Shouldn't need to be emancipated, unless swiy is actually a minor. So, incase it's the case; if swiy is a minor a doctor not only doesn't have to keep things from swiy's parents but is required by law to inform swiy's parents of life-threatening illness for example possible heart complications caused by possible cocaine use.

If swiy really is 20 and not a minor then it's possible the doctor violated swiy's doc-patient confidentiality agreement, but not necisarily. More details are needed. A doctor is required not to devulge medical conditions to anybody. Past coke-use is NOT a medical condition. If swiy told the doctor that swiy is a Coke Addict, which is a legal medical illness, and the doctor told swiy's mother that information then yes they did violate the doc-patient confidentiality. Another loop hole here is that swiy called swiy's mother for a ride to the hospital which means that the doctor may have been able to and perhaps required to (depending on the state swiy lives in) to provide needed information about swiy's current medical emergency to the person transporting (and therefore responsible for) swiy to the hospital.

Not all cut and dry here. Personally, the swip of "emancipated" and the doc telling swiy's mom makes swip think swiy is a minor and just upset their doc told on them. But even if swiy is 20, it's likely the doc didn't break swiy's confidentiality. In today's day and age, with the already high rates of insurance that doctors pay, it's unlikley to catch a doctor breaking confidentiality on a whim.

[BobTheGreat]

Originally Posted by Pinkavvy

20 and emancipated? That's odd. Shouldn't need to be emancipated, unless swiy is actually a minor. So, incase it's the case; if swiy is a minor a doctor not only doesn't have to keep things from swiy's parents but is required by law to inform swiy's parents of life-threatening illness for example possible heart complications caused by possible cocaine use.

If swiy really is 20 and not a minor then it's possible the doctor violated swiy's doc-patient confidentiality agreement, but not necisarily. More details are needed. A doctor is required not to devulge medical conditions to anybody. Past coke-use is NOT a medical condition. If swiy told the doctor that swiy is a Coke Addict, which is a legal medical illness, and the doctor told swiy's mother that information then yes they did violate the doc-patient confidentiality. Another loop hole here is that swiy called swiy's mother for a ride to the hospital which means that the doctor may have been able to and perhaps required to (depending on the state swiy lives in) to provide needed information about swiy's current medical emergency to the person transporting (and therefore responsible for) swiy to the hospital.

Not all cut and dry here. Personally, the swip of "emancipated" and the doc telling swiy's mom makes swip think swiy is a minor and just upset their doc told on them. But even if swiy is 20, it's likely the doc didn't break swiy's confidentiality. In today's day and age, with the already high rates of insurance that doctors pay, it's unlikley to catch a doctor breaking confidentiality on a whim.

Sorry to bump such an old theard(got nothing to do so why not catch up on DF). Swim only mentioned he was emmancipated cuz he was in college so still filled as a depedent in his taxes but wasnt when he went to see the doc. Also swim lives in IN if that clears anything up. Swim still hasnt done anything so he is still would apreciate oppinions. He would like to talk to a lawyer but is scrapping by as it is. Does anyone know of a place to get a free consultation?

[Jatelka]

^^^ Pink: Are doctors in the US really required by law to inform a minor's parents?

In the UK the guidance is that minors (under 16's) should be strongly encouraged to tell their parents, but if the doctor is satisfied that they are competant to make decisions regarding their own health-care then they CANNOT break confidentiality in this way.

[Psych0naut]

In the Netherlands, where SWIM lives, doctors will get their license revoked if they would do something like that, if they even would do that, which they never would. Instead they will refer you to one of the many drugs education centers if any help or guidence is needed.