Different ways to protect your privacy

Carilion vs Lewis Gale hospital

HIPAA is to help you. Not to control you

Most of us have heard of HIPAA.  It's a law to PROTECT patients privacy.  HIPAA is not there to take away the patients rights.  However some hospitals hide behind the term HIPAA.  Since most patients do not know what all it means they get away with it easily.

Example:

Carilion clinc, Carilion hospital or also know as New River Valley Medical Center incorrectly hide behind HIPAA to get the patient away from their emotional support, family or friends.  Carilion fools patients into thinking that HIPAA requires them to be alone when discussing medical issues.  They use HIPAA as an excuse to isolate the often frightened patient so they can interrogate them more effectively.  This may be better for Carilion but it is harmful to the patient.  Iit is NOT what HIPAA requires.  Shame on you Carilion for taking advantage of your patients lack of understanding of HIPAA.  In what other ways do you take advantage of your patients lack of knowledge?  Makes one wonder.

At Lewis-Gale their policy is simply ask for permission to discuss medical issues in front of the patients emotional support.  This gives the patient the choice and leaves the patient in control.  Lewis-Gale doesn't inconvenience the patient while still complying with HIPAA. Good for you Lewis-Gale. 



Why would a hospital want to deceive patients?  It doesn't seem good business.  When I questioned the nurse at New River Valley Medical Center outpatient surgery she said to me "how would you like someone to watch you do your job?".  But I guess that doesn't look very good on a sign.  HIPAA is a convenient policy to hide behind.

Something to consider when choosing between Lewis-Gale and Carilion.  Sorry Carilion after years of using your services we have seen your true colors and have switched to Lewis-Gale.  The only regret I have is that we didn't do it MUCH sooner.

From the joint commission: who oversees Carilion Hospital (New River Valey Medical Center)

"Communication with a patient’s family members or friends – Health care providers can share and discuss health information with family, friends or other individuals who are directly involved in a patient’s care (HHS, Office of Civil Rights, Sharing health information with family members and friends). The law allows sharing information when the patient either agrees or if present in the room with the patient, the patient does not object. For example, providers can talk to a patient about his or her condition when a family member or friend is present at the patient’s request. Information about a patient’s needs also can be shared with a health aide, interpreter, or person driving a patient. In some situations, HIPAA also allows health care professionals to use their own judgment about whether the patient wants health information discussed in front of family members, friends, or other individuals involved in a patient’s care (HHS, Office of Civil Rights, Sharing health information with family members and friends). If a patient specifically asks a provider not to share information with an individual, then that decision must be respected. (HHS, Office of Civil Rights, Sharing health information with family members and friends)." link


 HIPAA is not about isolating the patient. 

So why does Carilion do it?  Speaking with some of the management, trying to get them to change their policies, I got a different answer than the nurse.  The management said that "patents lie" and they get better answers if they are isolated from their friends and family.  Nice to find out that Carilion treats all their Patients like liars.  Lewis-Gale, you have some new customers.

Here is an interesting article discussing patient privacy laws being misused to hurt not help patients.
http://www.propublica.org/article/who-do-federal-privacy-laws-protect-patients-or-medical-centers

Front the Government on HIPAA:

From http://www.hhs.gov/ocr/privacy/hipaa/understanding/index.html
"The HIPAA Privacy Rule provides federal protections for individually identifiable health information held by covered entities and their business associates and gives patients an array of rights with respect to that information."

and http://www.hhs.gov/ocr/privacy/hipaa/faq/safeguards/197.html
"Does the HIPAA Privacy Rule require hospitals and doctors' offices to be retrofitted, to provide private rooms, and soundproof walls to avoid any possibility that a conversation is overheard?"
The answer is "NO".

Even from Carilion on HIPAA https://www.carilionclinic.org/hospitals/carilion-roanoke-memorial-hospital/hipaa

"The Health Insurance Portability and Accountability Act (HIPAA) of 1996 established national standards to protect patients' personal and medical records. The regulations outlined by HIPAA protect the medical records and other personal health information maintained by healthcare providers, health plans and health insurers, and healthcare clearinghouses."

Carilion New River Valley Medical is also known as Carilion Clinic, or Carilion Hospital.  Radford Hospital

For reviews
on yelp: http://www.yelp.com/biz/carilion-new-river-valley-medical-center-christiansburg
The better business bureau BBB

We see you naked, and we don’t care

From a doctor:

"during the first operation that I witnessed as a medical student, I immediately realized that no one in there cares. We’ve all seen it a million times, and trust me, despite what you may believe, yours is no different than anyone else’s. I’ve had many patients who have been apprehensive about disrobing before surgery, but there is nothing remotely titillating in the operating room. Nothing."link

 I've heard this so many times.  It just makes me sick.  It is such a big lie.  First off, he says "the first operation that I witnessed."  There is a first time for EVERYONE.  There is no med student or nurse that was born with having "seen it a million times".  And keep in mind not only doctors are in the operating rooms.  A nurse, scrub tech, other techs, trainee, visitor, auditor, management could be there, too.  I've read a story where a guy boasts that his friend that worked in the O.R. took him in to see a woman being prepped for a GYN surgery.  Woman totally exposed to a stranger off the street.

Second " there is nothing remotely titillating in the operating room. Nothing." heard that from medical professionals all the time too:  Let's look at this a bit more:

Examples:
 "New Orleans breast surgeon sent himself 'surreptitious' photos of naked patients during surgery"
"A noted New Orleans breast surgeon “surreptitiously” took nude photographs of patients during surgery, emailing himself pictures showing the patients’ “faces, breasts and vaginas,”

Seems this doctor didn't get the message.  Maybe he hasn't seen enough yet?  And notice he took pictures of their "vaginas"  He is suppose to be working on their breasts but he takes advantage of the fact that the hospital doesn't allow patients to cover themselves.  Have to wonder what kind of person is making the rules.

"Doctor accused of taking photo of unconscious patient's private area"
How could she notice the tattoo and be interested enough to take a photo.  I thought they had seen it all a million times. Nice to know they do whatever they want when someone is out.

Cardiologist snapping nude pictures of a girl in the bathroom.
If he's seen it all a million times why is he trying to sneak a pic?

Doctor taking photos of Sedated patient
Tell me again they treat everyone the same and don't notice anything?

Doctor sexually assaults patient while unconscious
He also performed genital exams on a female despite being an Ear Nose and Throat specialist.  But they have seen it all.  There's no problem in that.

Prominent Emergency Room Doctor accused of four sexual assaults
This doctor seems to have made a habit of preying on young adult women who happened into his emergency room-- yet they all look the same...

And it is not just a problem with male health care workers. Female workers notice and respond to their patients' bodies as well.
Nurse texts photo of unconscious patient's penis

Female ENT doctor accused of routinely giving genital exams to male patients while they were sedated. 

Here's a whole article on protecting patients from sexual predators in the OR.

These are just a few examples of countless cases of criminal sexual misconduct in a medical setting. A few of the many cases where someone actually got caught which you know is a drop in the bucket. Since they've "seen it all" and there is "nothing stimulating," why do these things happen?

And obviously there are many, many healthcare professionals who are good, upstanding people who would never perform an abuse like those listed above. But why do we pretend that these professionals aren't human and don't even see their patients? That's simply unrealistic. A document on medical training published by the government of the United Kingdom states:

"Students must be taught that there is nothing unusual or abnormal about having sexualised feelings towards certain patients, but that failing to identify these feelings and acting on them is and likely to result in serious consequences for their patients and themselves."

"If a healthcare professional is sexually attracted to a patient and is concerned that it may affect their professional relationship with them, they should ask for help and advice from a colleague or appropriate body in order to decide on the most professional course of action to take. If, having sought advice, the healthcare professional does not believe they can remain objective and professional, they must:
• find alternative care for the patient
• ensure a proper handover to another healthcare professional takes place
• hand over care in a way that does not make the patient feel that they have done anything wrong."
link

"There is nothing unusual or abnormal about having sexualized feelings towards certain patients." It is biology. It is going to happen. So rather than pretending that doctors can turn off their sexuality like a switch, why isn't the topic dealt with realistically so that proper protections for patient and doctor can be provided for?

What about chaperones in the room during exams? This article talks about how seldom chaperones are used and how often patients are more uncomfortable when one is used. I can understand this since the general approach to chaperones is to grab some other employee (so generally a stranger to the patient), so now the patient has two strangers ogling them instead of one. And sometimes that extra has little medical training. Plus, if there is an environment of inappropriate behavior at a medical facility, it often involves more than one employee or else other employees are quiet out of fear of employment repercussions. This case, where a surgical tech was both sexually assaulted and witnessed inappropriate behavior towards patients, is an example. Bringing in a coworker does little to encourage patient trust. In fact, when chaperones are used, it is generally to protect the doctor (from accusations and lawsuits) rather than the patient. This article  explains how and why chaperones are typically used and how they aren't much help to the patient. It also includes this great reminder that doctors are human and aren't magically blind to their patient's appearance:
"A third reason respondents said they used chaperones was protection from their own sexual feelings. One male doctor talked about a female patient of his who he considered “gorgeous.” He had a difficult time examining her. “…I needed to use a chaperone." he admitted. "A chaperone not for her comfort but for mine.”

Wouldn't increased modesty for patients make the situation more comfortable for both the patient and for the doctor and other medical staff who may be sexually aroused, in spite of his/her best intentions? The less they can see, the less likely they will be notice something they wish they hadn't. You can read more on this topic here.

Isn't there also a very logical argument for using doctors and nursers of the patient's gender for intimate procedures and exams? This article shows that patients would prefer it, but are often too embarrassed to request it, in part because of the derision with which medical personnel tend to respond to these requests.

More on this topic:
Patient Modesty
How to Protect Your Modesty in a Medical Setting
Take it All Off

Topics to cover

Everyone has different preference on how they want to care for themselves and how they want others to treat them.  If your lifestyle and preferences are like the majority of people, then you will may be happy with what the standard recommendations and practices.  But some of us are in very low risk groups (Groups that much of the medical community won't even admit exist) or have preferences that the average patient doesn't have.  For us we have to dig more and make decisions on our own.  Here are some topics to think about:

Topics to cover, in no particular order:

• The cost of over testing.  Both in dollars, time and emotion.
• Concent and informed concent forms
• Patient has the option to edit or partially accept or refuse what is on the concent form.
• Hospitals make the concent forms as broad as possible.  If you sign them then it covers them.  It does NOT mean that you must concent to all of those things to be provided service.  Eliminate the things you are not comfortable with and see if they are ok with that.  Make it a dialog.
• Informed concent is not the same as just Concent.  If informed concent is required just having you sign a form without being informed is the same as no concent.
• It is all about risks.  Statistically, no one with a baby Giraffe in their car gets in an accident. 
• Cause vs Effects.  Seems this easily gets confused
• Surgical prep. -  What will they do to me once I'm unconscious?  Details they leave out.
• Moving your limp unconcious helpless body and positioning it
• Patient positioning injuries -
• Why can't I position myself before being put out?
• Shaving & Scrubbing
• Antibiotic painting
• Attaching monitors to your chest (will be made topless)
• For many surgeries the staff removes the patients gown completely.
• Draping -
• Some times drapes (cloths) are stapled to the Patients Skin
• Why don't they let me wear underwear?
• Anethesia
• Tube in the throat
• Intentional using sedatives who's side affect is Amnesia
• Peri-operative Hypothermia
• Getting cold while being operated on. 
• You're practically naked but the Dr. has on lots of layers
• Dr. controls the temperature
• HIPAA - It's there to help you.  Don't let hospitals use it against you.
• Learn more about HIPPA abuse
• Pelvic Organ prolapse - The undiscussed plague
• Female Urethral Spasms
• Dr. Kegel.  His research.
• A Nonsurgical Method of Increasing the Tone of Sphincters and their Supporting Structures
• My summary of Dr. Kegels 1948 paper
• Most common misunderstandings
• Weight lifting
• Breast X-Rays (AKA Mammograms). - We'll keep X-raying until we find something
• How does life time Monogamous relationships affect my risks and need for testing of:
• HPV - Pap smears & Cervical Cancer.  Study shows Nuns don't get Cervical Cancer.
• STDs
• Usefulness of pelvic exams on people that aren't sick.
• Cervical biopsies.  How much do they cut off?
• Probiotics - What are they?  Why haven't we heard of them?
• UTI's - Simply wipe front to back.  Yah if it was just that simple.
• Colonoscopy vs sigmoidoscopy
• Colonoscopy pants

People should make informed decisions on their medical care.  It should be up to the individual to decide what is right for them.  Not the government, not the medical community, not a non profit orginization funded by government money and certainly not the doctors.  You.  It is your body and you have to live with the decisions.  Yes we should seek out the opinions of all of those mentioned.  But keep in mind they all have different values and goals.  They might align with your values but they might not.  They write their policies or procedures to cover the masses or the average or more often the most concervative case.  If you are not "average" then what they suggest may not apply.  Or it might apply.  Learn for yourself and make an informed decision.

We are not telling you what to decide.  Just learn and make your own decision.