Health Care is the big topic of debate right now–when we aren’t distracted by those who no longer need any health care at all–and I am leery of alienating anyone by taking sides.
But there is one thing that is very important. Something that we can–and should–agree on regardless of where we stand on Goverment-Subsidised Health Care.
In 1995 the Association of American Physicians And Surgeons adopted The Patients’ Bill Of Rights.
All patients should be guaranteed the following freedoms:
To seek consultation with the physician(s) of their choice;Any change in U.S. health care that robs you of your right to pick your own doctor flies in the face of the basic principles of the Constitution. How can you have liberty or the pursuit of happiness if you’re stuck in an unhappy situation by fiat?
To contract with their physician(s) on mutually agreeable terms;
Your doctor wants to be paid, and you want to be able to pay her what you can without having to trade in a couple of your offspring.
To be treated confidentially, with access to their records limited to those involved in their care or designated by the patient;
The records which say you’re complaining about painful intercourse, burning when you pee, cockroaches laying eggs in your belly button or any other private thing are between you and the folks who are trying to help you. Any change to the current system where those records become part of a third party database designed to “assess risk management positions” or “ferrett out patterns of drug abuse” may sound well-meaning but are a direct violation of your expectation of privacy. In the long run they can harm patients by making people less forthcoming with their doctors and therefore not telling the whole story to the treating physicians. Without the necessary information, many avenues of treatment go unexplored and make problems worse. Privacy is essential to optimum patient care.
To use their own resources to purchase the care of their choice;If you want to use your Christmas bonus to get a boob job, that’s your business.
To refuse medical treatment even if it is recommended by their physician(s);
If you are a woman and your doctor says “get a hysterectomy” but you’d like to keep your own uterus and ovaries for as long as posssible, that is your choice. If you’re a man and you’d like to not have chemo but would rather spend the last few months of your life saying goodbye to your kids and grandkids, that’s your business. No court or hospital or group of doctors should exert control over your most fundamental rights to your own body.
To be informed about their medical condition, the risks and benefits of treatment and appropriate alternatives;
Let’s say there are three ways to treat your problem. You want to know all three. You don’t want to be told only of the option that is least expensive to your insurer–whether that insurer is Blue Cross or Blue State.
To refuse third-party interference in their medical care, and to be confident that their actions in seeking or declining medical care will not result in third-party-imposed penalties for patients or physicians;
You should be able to tell the insurance company to stuff it. If you want to refill your pain meds sooner than they say, and you don’t mind paying the extra $50, that’s your business. If you want to tell the government you’d just as soon stick with Blue Cross, that’s your business.
To receive full disclosure of their insurance plan in plain language, including:
CONTRACTS: A copy of the contract between the physician and health care plan, and between the patient or employer and the plan;
INCENTIVES: Whether participating physicians are offered financial incentives to reduce treatment or ration care;
COST: The full cost of the plan, including copayments, coinsurance, and deductibles;
COVERAGE: Benefits covered and excluded, including availability and location of 24-hour emergency care;
QUALIFICATIONS: A roster and qualifications of participating physicians;
APPROVAL PROCEDURES: Authorization procedures for services, whether doctors need approval of a committee or any other individual, and who decides what is medically necessary;
REFERRALS: Procedures for consulting a specialist, and who must authorize the referral;
APPEALS: Grievance procedures for claim or treatment denials;
GAG RULE: Whether physicians are subject to a gag rule, preventing criticism of the plan.
I’ve already seen my confidentiality broken at Vanderbilt, and a lot has to do with those electronic records they say will make it easier for us. They mean THEM.
Anyone who works at Vanderbilt in the medical dept can access them.
I don’t like that for the reasons you mentioned. THere is no such thing as a confidential conversation with your doctor.
Now, even your pharmacist is listed on your records. I didn’t give permission for that, but I looked, and there she was. I didn’t give permission for temp workers to look…but they have.
Don’t buy the bull(not you…everyone) that electronic records will save us all money unless you want anyone to access the time you got your husband’s penis stuck in the door or whatever.
No, all people can never agree on anything…
Sharon, it’s strict policy at Vanderbilt that those with electronic medical record system access should only be accessing records for which they have a legitimate need/reason – it’s not the case that any worker with system access is allowed to access any/all records. I have access for the purposes of providing clinicians with information and resources relevant to patients when there are evidence questions, and while I may technically be able to get to the records of anyone in the system, I am only allowed to look at records for which I have a direct and legitimate need. Looking at the records of my friends, family members, or anyone else without cause is a fireable offense on the first instance. Because I have not been designated as his proxy, I could be fired for looking at my husband’s medical record one time. Which records individual users have accessed is supposed to be audited on an ongoing basis for compliance. If you feel your privacy has been violated, please contact the privacy office – http://www.mc.vanderbilt.edu/root/vumc.php?site=hipaaprivacy&doc=1594
Rachel–
I have no doubt about your integrity.
However, my lawyer is taking care of this, as it was that egregious. I know my privacy was violated, by whom, what they said, whom they said it to, and they are going to be held accountable.
And, in my opinion, temps shouldn’t have access to them.
I am so unhappy with the electronic records. Even though they have many good points, I am afraid not as many people have your integrity.
Anyone who works at Vanderbilt in the medical dept can access them.