Confidentiality

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The objective of this presentation is to make you aware of issues which are generally confronted during medical practice. SOURCES OF LAWS: PRIMARY SOURCES Laws passed by the Parliament or the State Legislative Ordinances passed by the President and the Governor Subordinate legislation: Rules and regulations made by the executive through the power delegated to them by the Acts. SECONDARY SOURCES: Judgments of the Supreme Court, High Court and Tribunals (The ratio decedendi is a binding precedent) Judicial legislation Judgment of Foreign Courts International Treaty

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Sabrina Ragland, a medical assistant with 12 years’ experience, works for a gastroenterologist, Dr. Tim Taylor. She comes from a family heavily involved in the medical fi eld. Her father was a surgeon and her mother was his offi ce assistant. Two of Sabrina’s sisters are nurses, and her brother is a respiratory therapist. Her husband, Joe, is a biomedical technician, and his mother, Elsa Ragland, has been an RN for 40 years. For more than half of her career, Elsa has worked for a local internist, Dr. Royce Berry. A casual comment at the Ragland family picnic resulted in a medical professional liability lawsuit based on violation of patient privacy. Sabrina and Elsa’s careers were jeopardized by a simple exchange of what seemed to be innocent information. Vivian Adams, a 42-year-old hospital insurance biller, saw Dr. Berry in his offi ce for pain located in her lower left quadrant. Ms. Adams was not a new patient but had not visited the offi ce in approximately 2 years. When she arrived for her visit, she was presented with the offi ce privacy policy and was asked to sign the document. Vivian glanced through it, signed it, and saw the doctor. He performed an examination and found that Vivian was likely suffering from irritable bowel syndrome and prescribed medication. Ms. Adams called the physician 1 week later complaining that she was no better. Dr. Berry changed her medication without seeing her and did not hear from her again, other than her requests for refi lls of the medication. After 6 months with no improvement, Ms. Adams went to Dr. Taylor; after several diagnostic tests, she was told that she had colon cancer and was given a bleak prog- nosis. She told Dr. Taylor that she blamed Dr. Berry for not being more thorough in his testing. Sabrina was in the room and heard the comment. That weekend at the picnic, Sabrina mentioned Ms. Adams to her mother-in-law and stated that the patient might sue Dr. Berry, although the patient never said those words. Elsa defended Dr. Berry and proclaimed that he was a good doctor, then expressed her hope that Ms. Adams would not sue her employer. One week later, Elsa was in a grocery store and saw Ms. Adams. Elsa immediately expressed her sympathy about her diagnosis, and then asked if there was anything she could do. Her intent was to be kind and try to avert litigation against Dr. Berry. Her gesture might have been well received had Ms. Adams’ daughter, Terri, not been standing with her. Terri was not yet aware that her mother had been diagnosed with cancer. Ms. Adams had told no one about her illness at that point. After the incident at the grocery store the fi rst person Ms. Adams told was her attorney. While studying this chapter, think about the following questions: 291 16 SCENARIO Privacy in the Physician’s Offi ce • When can the medical assistant discuss a patient, and with whom, and under what circumstances? • What has HIPAA done for the medical industry and the pati.

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