For many years since treatment has been established as an
ethical profession and gained full, credence people
have believed that they could and should tell their doctor
everything even remotely pertinent to their health and that
it was held in the strictest confidence. Furthermore, how
can the doctor make correct judgments when important or
significant information is missing? This theory worked very
well until relatively recently but there now exists a breach
of this confidence that citizen should know about and this
breach has advanced from the coming of third party
investigations into people's backgrounds. Your medical
records are no longer confidential because you are forced to
reveal them. Let us look at some scenarios.
When visiting your doctor's office on a Monday not feeling
well you tell him/her that you occasionally drink a half
case of beer over the weekend. Believing in the
confidentially of your records you forget about it. Some
time later when you apply for life guarnatee the company
requires you to sign a release for your curative records. (No
release, no application.) The underwriters witness your
records, note the extra beer, and subsequently rate your
premiums higher manufacture you pay extra for decades, thousands
of dollars.
You complain to your doctor of recurrent chest pain.
Investigation reveals nothing, the ache resolves
permanently and you have no additional follow-up to document
the benign resolution. All things is O.K. Ah, but not
really. Those words sit there permanently in the record.
Later you apply for a mortgage or health guarnatee or life
insurance, signing a release of your records. You are turned
down flat or at least rated a higher premium.
Perhaps you have chance to mention to your doctor that you
have stress, marital discord, job problems, and
mental/emotional problems, etc. You later apply for a job
requiring protection clearance or background checks. These
jobs are many and include police, protection and just about
any job entertaining real responsibility. Despite having
resolved the problems guess who might not get the job?
You may never find out why, either.
You injure your hand and you admit to your doctor that you
punched a wall in anger. It could be the only time you ever
did something like that but guess what? Those words will
sit there forever and be taken as evidence of emotional
instability. Want to try for a responsible job?
It indubitably is a shame to see man pay higher
life guarnatee premiums for decades or be passed over for a
job they indubitably want because of an entry in their medical
record.
What can be done about this dilemma? (Webster: A predicament
that defies a satisfactory solution.) Your concerns must be
balanced against the doctor's need for information and his
real need to document what he/she fulfilled, and why. A
correct clarification would be very welcome but one is not
apparent.
The best advent might be the following: Tell your doctor
the truth and discuss with him/her your concerns regarding
your report coming back to hurt you and how this can be
managed
in the best way. In the case of your problem turning out
to be benign then make sure the report reflects this
outcome and
is satisfactory to you At That Time. Don't be required to
scramble around years later trying to correct it. That's
lame at best and you probably won't even get a chance.
Besides, even doctors don't live forever.
If your problem turns out not to be benign, then there is no
choice but to have it in your record. That's life.
When faced with a dilemma all one can do is make the most
carefully carefully decision one can. Work with your doctor
and try to get a corollary that is best for you. After all,
it's your life.
Just be true out there.
(c)Vincent R. Moloney Md
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