Anyone here into firearms?

semtex · 12-14-2011, 01:59 PM

Quote:

Originally Posted by wstar

To this (and semtex above): I agree that doctors shouldn't have a *right* to grill you on personal details. But I think being silent and/or hostile when they ask about guns hurts rather than helps us. You can be truthful without going into warrantless detail or being hostile, and it helps shape the statistics in the doctor's mind back in our favor.

As for all the rest of that lifestyle stuff: Again, I don't agree they have a *right* to know, but I'm also not fond of the idea that one should have to maintain a privacy barrier with one's physician. It's their job to be concerned about your health and safety, and you should be able to talk openly with them about anything and trust their confidentiality. When that trust breaks down, it negatively affects your standard of care.

I should welcome a conversation about my sex life with my doctor, or my driving habits. Maybe he just read a journal article about how SA-2005 rated helmets, while still allowed at many events, are *very* inferior for preventing certain types of injury compared to the SA-2010 standard and wants to let me know. Maybe he wants to let me in on the not-widely-known fact that using BDSM gear made of a certain type of rubber promotes skin infections. You get the idea...

If you don't trust your physician, find a new one, IMHO.

I think your position is quite reasonable. But have you considered that your physician may be just the "tip of the sword" in terms of where that information goes subsequent to your conversation with him? That's the aspect that worries me more than whatever personal biases my physician may have. There's a good chance that your responses to his (or her) interogatories are going to end up in some database somewhere, and you'll have no idea who's viewing it and for what purpose. It just so happens that I work in healthcare now. Specifically, I work in an area known as Data Governance. What data is it that my unit is governing? Personally identifiable data on everything from ER wait times to STDs to participation in high-risk behaviors (both sexual and non-sexual). Some of the information gathered in the databases I work with is blood-curdling. Well, I should say that it's potentially blood-curdling. You see, my job is to make sure it doesn't fall into the wrong hands. And my unit is also supposed to ensure that all personal identifiers are stripped out of the information before it is forwarded to statisticians for analytic purposes.

Question is, do you really want to place all your trust in a stranger like me to make sure that (a) your identity is properly cleansed from the records, and (b) the data doesn't ever fall into the wrong hands? Because I can tell you that your doctor isn't keeping your responses to himself. He's uploading them to regulatory agencies like mine. And I can also tell you that mistakes happen and breaches do occur. We're all human, after all.

MacCool · 12-14-2011, 03:31 PM

Quote:

Originally Posted by semtex

I think your position is quite reasonable. But have you considered that your physician may be just the "tip of the sword" in terms of where that information goes subsequent to your conversation with him? That's the aspect that worries me more than whatever personal biases my physician may have. There's a good chance that your responses to his (or her) interogatories are going to end up in some database somewhere, and you'll have no idea who's viewing it and for what purpose. It just so happens that I work in healthcare now. Specifically, I work in an area known as Data Governance. What data is it that my unit is governing? Personally identifiable data on everything from ER wait times to STDs to participation in high-risk behaviors (both sexual and non-sexual). Some of the information gathered in the databases I work with is blood-curdling. Well, I should say that it's potentially blood-curdling. You see, my job is to make sure it doesn't fall into the wrong hands. And my unit is also supposed to ensure that all personal identifiers are stripped out of the information before it is forwarded to statisticians for analytic purposes.

Question is, do you really want to place all your trust in a stranger like me to make sure that (a) your identity is properly cleansed from the records, and (b) the data doesn't ever fall into the wrong hands? Because I can tell you that your doctor isn't keeping your responses to himself. He's uploading them to regulatory agencies like mine. And I can also tell you that mistakes happen and breaches do occur. We're all human, after all.

Absolutely correct! The government is actively, rabidly, pushing widespread adoption and standarization of electronic health records. They increasingly mandate exactly the kind of data gathering mentioned above. Right now they're using mostly the carrot (do a google search on "meaningful use" and the associated reimbursement scheme), but it won't be long (about 3 yers) before they start using the stick. They want that information. They believe, especially the current adminstration, that something as important (read "expensive"), and as relevant to the governmental social agenda, as health care should not be left to being something just between the patient and his doctor.

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