Saturday, October 14, 2006

HIPAA-Crit

This post is not about suicide. Suicide is an important topic and there's been some good discussion here, but frankly it's getting to me a bit. I went out to dinner last night with a friend who had to identify her brother's body ten days after he killed himself. Then she had to clean up his blood soaked room. Then we had a suicide in our neighborhood a week or so ago, and my neighbor still hasn't been able to return to the house. So as far as the blog topic goes, my final word would be: Just Don't Do It (with apologies to Nike). It's a freakingly mean thing to do to your loved ones and friends.

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And now for something completely different:

I'm going to pose a problem to our readers and ask for advice---how's that for a switch? (Actually, I just needed an excuse to try out our new polling feature.)

Here's the situation:

I went to the bank this past Saturday. It's a rather small branch, and on weekends it's crowded. On this particular day the line for the teller curved around the perimeter of the lobby where two people were waiting to see a banker. The first person was a middle-aged woman and a young man with peach-fuzz cheeks (for future reference, Peach Fuzz Man). The woman was talking to Peach Fuzz as he tapped on his PDA. He appeared to be looking something up. I wasn't paying much attention until I heard Peach Fuzz say the phrase, "You definitely meet DSM." At that point my ears pricked up like Harold the Vampire Cat in front of a humming bird (but without the jumping at the window part). I heard some more mumbling and then I heard Peach Fuzz state quite authoritatively, "You need a full cardiac workup." Now, by this point I'm somewhere between amazed and aghast.

Every physician has been in a social situation where someone asks for clinical advice after they find out what you do for a living. I generally say something about not discussing individual cases in public, or I'll talk about a diagnosis in general terms without reference to any particular individual details. I think this situation takes the case as far as lack-of-privacy goes. I have no doubt that every person standing in line heard as much of that conversation as I did.

I'm making a lot of assumptions here, I know. I'm assuming they didn't know each other before they came to the bank, and that during casual conversation the woman found out what Peach Fuzz did for a living and asked for professional advice. I'm assuming Peach Fuzz has some medical training, although what happened sounded more like medical student or intern behavior. (Then again, there are faculty physicians around here these days who look pretty Bambi-ish.)

So there's the situation. My question for the blog is, what would you do if you heard a doctor discussing this woman's case in public? Unfortunately the poll doesn't let me ask questions about the voter, because I'd love to know if people had different advice based on whether they were health care providers or patients. Regardless, give it a shot and then see how others voted.