I fell and broke my HIPAA

Driving home from work just now I heard a news report concerning the possibly privacy issues inherent in medical staff blogging about their job and their patients. With that in mind, here's another blow to HIPAA.

At work last night, we had a particularly crowded emergency room with, at one point, over 60 people in the waiting room, and another 60 already in beds, ready to be seen by a physician. Normally, those numbers are closer to half that. Four of those patients were on some degree of psychiatric watch. The craziest, by far, was a certain teenage alcoholic.

Under the kind of strain, interesting things are bound to happen.

Upon arrival it was clear he had to be restrained. He didn't want to be restrained. He fought with spit, urine, tooth and nail - emphasis on the tooth. He bit the hand of a security guard who was holding him down while the nurses wrapped the leathers around his wrists and ankles. This security guard decided not to be the bigger man in the fight and instead punched the kid several times in the head. A nurse pulled the curtain around the bed, surely thinking only of HIPAA.

Don't get me wrong. Patient confidentiality is very important, especially when there is still a social taboo on things like getting an AIDS test and having a mental illness. It was just an awesome story I had to tell.

The radio piece was almost entirely ridiculous. Every single hospital staffer I've met in every single hospital in which I've worked knows not to freely discuss patients' information unless necessary for, or at least related to, the job at hand. The only time that info gets passed around willy-nilly is when a story is just too great to pass up (like the one up there) and people are scrupulous in leaving out names and other specifics.

The main concern of the broadcast was that if enough nonspecific information were posted, a person might be able to identify themselves as the patient being discussed, or, worse yet, an acquaintance might be able to identify the person.

This reminds me of a website I saw recently. It was a forum that allowed restaurant staff to post the names of bad tippers with the goal of humiliating these bad tippers to their friends and families. The main failing of this site is the same as the main defense of healthcare blogs: the internet is vast, and the population large.

The odds of someone who knows you finding your name on a 'bad tipper' list, or even caring to look, are slimmer than my chances having hair when I'm 60. Likewise, the odds of someone finding you, and being able to identify you by a vague description at best, are practically nonexistent. And if you manage to find yourself mentioned? Keep quiet about it and nobody else will know!

At least the article ended on a positive note, explaining that prospective patients often feel more comfortable with a doctor who shares openly his medical know-how in a blog or otherwise, rather than one of those stuffy white-coat types who only communicates with you via stethoscope.