Priacy / confidentiality question

[babaganoosh00]

Sorry to hijack this thread, but I don't see how to start a new one.  I am a non-medical person with a question about confidentiality and this story was VERY interesting.   Hope you don't mind me throwing this into the mix.

My wife recently changed gynocologists.  In the first visit, casual conversation with the doctor / patient (I wasn't there - my wife's telling me this), they make the realization that this doctor has a daughter the same age as our daughter (17, senior in high school) and what my daughter's college goals are - ironically something in the medical field).  They live in a different town, but are the same religion as us.  My wife had envisioned having our daughter go to this doctor also, if this first visit went well.  

At home, my wife asks our daughter if she knows the dr's daughter through a regional religious group and she says yes.  She's put off by seeing this girl's father for such personal medical attention, my my wife assures her about confidentiality.

At a weekend long event this past weekend, the doctor's daughter comes up to my daughter with others around and says 'I hear you're looking to go to Tufts'.  How do you know? my daughter asks and the girl says something along the lines of 'oh, your mom was seeing my dad for , you know, and mentioned it.

My wife and I were floored - what else would this doctor be repeating to family, if not others?  Where's the line of confidentiality for a doctor talking to family?  And to a daughter who may not understand / adhere to confidentiality?  ANd who didn't even have the sense to talk to my daughter in private?  

Now my wife has to go look for another doctor.  He was very friendly and caring in the visit, but if he's going to repeat things, my wife doesn't want her or my daughter seeing him.  Hey, that friend of yours going to Tufts?  I saw her today and she's been seeing this boy for months and wondering......'?!

Thanks!

[babaganoosh00]

I meant to say considering the inocuous / 'common' / 'non medical' info that was repeated to my daughter.

[babaganoosh00]

Redhen:  I agree with you considering the info that was repeated to my daughter, but as you say '..unless the doc told his daughter about your wifes medical situation... or any medical information'.  You don't know that.  and when he's saying 1 thing, he may be saying another...

[mol6541]

My mom and I go to the same office. They asked about family history and I brought up to the dr my mom sees that she was the one that diagnosed my moms uterine cancer. She asked my moms name but made no comments whatsoever. Made me happy we go to the group we do.

[RavenT]

I am in accordance with adgal... My profession is regulated by confidentially... there needs to be an accounting by the doctor..otherwise who is to know what all he is talking about.. He should NEVER discuss his patients with his family... unless he receives permission from the patient... there should never be anything identifying info used outside the office... the ONLY that info would "leak" would be a situation where they met each other in the office lobby and that would be the kids that knew each other... and you are right about discussing "a pateint's child..." Never the use of names... especially if the conversation happened in the doctor's office!!!  

[Redhenful]

I personally would not make a big deal out of it..unless the doc told his daughter about your wifes medical situation... or any medical information.
But thats me..

[babaganoosh00]

Thanks for the comments.  I don't want to belabor the point with my daughter about the exact wording of the conversation, but from the couple times my wife and her were talking about it, it sounded like "when your mom was having an exam from my dad, they got to talking about family ..."

still it makes me and my wife wonder - if he's repeating parts of the conversation, what other parts are getting repeated.  I would think (expect) that nothing that was discussed would be repeated outside the office, or if so, more vague - a patient's kid is looking to go to tufts, a patient told me there was a sale on ____  at Staples, etc.  nothing to tie back to the patient.  Sure, in this case, the interest WAS the relationship - [daughter's name], who you know in your youth religious group is looking to go to tufts.  whether he prefaced it with 'her mom was in my office today' would likely be assumed and him specifically saying it / not saying it should have no bearing on it.  doctors have an obligation for privacy and just need to not talk about things, I think.

[AnnieBrooke]

Sorry, I meant "what if it *was* something salacious," not "what if it *has been* something salacious."  Not that it is less of a breach of confidentiality if it is something innocuous, but more harm would be done if someone said in a public place like at a party, "My doctor dad says he was treating your mom for venereal disease the other day" than if someone said "when your mom was having an exam from my dad, they got to talking about family ..."

[AnnieBrooke]

It's one thing for the doctor to tell his daughter who knows your daughter something innocuous like "Mia is thinking of going to Tufts, her mother tells me."  But for him to tell his daughter why your wife was seeing him (i.e., for what medical condition) is way out of line.  (What if it has been something salacious that people overhearing the conversation would never forget?)  Your wife should write a letter to him at his office transcribing the conversation that occurred between the girls, should say she feels this is an appalling breach of confidentiality, and then ask for her records to be transferred to [name of new ob-gyn].  That way, if he has someone overseeing him where he works, he'll definitely get reprimanded.  I don't think she has a strong case for a potential lawsuit, because even if malpractice has happened she will also have to prove that she was harmed by it.  But she absolutely has the right to complain.

[adgal]

I am in Canada, but our laws are the same.  Confidentiality is a huge issue.  You need to be comfortable talking to your Dr. about everything without hear of it being repeated, especially to a teenage girl.

I have been through a lot in terms of testing, etc. so this is something that I take very seriously.  If it were me, I can tell you that I would be lodging some sort of complaint.  Whether it be a conversation with the Dr. in question, or something more formal with the gov'ing board, I would not ignore this. I am a firm believer in accountability, especially when someone is in a position of trust like this.  That is just me though, I know not everyone is comfortable making an issue out of it.

In any event, I am glad our wife is changing Dr.'s.  There is no way she could ever be comfortable discussing any concerns or issues she may have with him now.  And if you can't be honest with your Dr. there is no point in seeing him/her.

I work in a field where confidentiality is also important.  We are not even allowed to communicate with other professionals in our field via email, etc. with any kind of identifying info.  It is automatically assumed that anything my clients tell me is confidential, and cannot be repeated without a signed waiver.  I would lose my job over something like this.  It's a big deal, at least as far as I am concerned.

[RavenT]

The doctor is bound by a legal confidentiality... its called HIPA Health Information protection act... this is for the USA -- don't know about other countries... Your wife has a right to sue the doctor for the breach!!! and if the doctor didn't know about it then he NEEDS to do something to contain ALL information. If his wife saw your wife in the waiting it is a different story but it sounds like these individuals didn't know each other but thru your daughter prior to your wife's visit to the doctor's office...

Doctors can talk about their patients with other staff using identifiable information but not outside of the office including if the feel the need to staff the patient with another doctor... they can give medical information but NO identifying information!!!!

As I said above this is US Federal policy - as a matter of fact your wife should have gotten a HIPA info sheet to read when attending her first appointment...