For many years since rehabilitation has been established as an
ethical profession and gained farranging 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 physician make spoton judgments when important or
significant facts is missing? This ideas worked very
well until relatively recently but there now exists a breach
of this reliance that people 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 insurance the company
requires you to sign a publish for your medical records. (No
release, no application.) The underwriters inspect your
records, note the extra beer, and subsequently rate your
premiums higher development you pay extra for decades, thousands
of dollars.
You complain to your physician of recurrent chest pain.
Investigation reveals nothing, the ache resolves
permanently and you have no further follow-up to document
the benign resolution. All things is O.K. Ah, but not
really. Those words sit there constantly in the record.
Later you apply for a mortgage or health insurance or life
insurance, signing a publish of your records. You are turned
down flat or at least rated a higher premium.
Perhaps you have chance to mention to your physician that you
have stress, marital discord, job problems, and
mental/emotional problems, etc. You later apply for a job
requiring safety clearance or background checks. These
jobs are many and consist of police, safety and just about
any job sharp 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 physician 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 actually is a shame to see man pay higher
life insurance premiums for decades or be passed over for a
job they actually 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 facts and his
real need to document what he/she done and why. A
correct solution would be very welcome but one is not
apparent.
The best approach might be the following: Tell your doctor
the truth and discuss with him/her your concerns regarding
your record coming back to hurt you and how this can be
managed
in the best way. In the case of your qoute turning out
to be benign then make sure the record reflects this
outcome and
is satisfactory to you At That Time. Don't be required to
scramble colse to years later trying to spoton it. That's
lame at best and you probably won't even get a chance.
Besides, even doctors don't live forever.
If your qoute 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 careful out there.
(c)Vincent R. Moloney Md
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