Confidentiality breaches in clinical practice, ( Beltran et al. 2016): what happens in hospitals? (2016). Confidentiality is associated with individual respect and patient rights in a hospital set up. It is a concept that is long recognized in the law and considered in the ethical duties owed by doctors to patients. Confidentiality law exists mainly because there is a need for the doctor to protect any personal information given to him or her by the patient. Furthermore, the patient should be assured the information will stay between the doctor and him or her in order to gain the courage to share such data for treatment purposes. Confidentiality protects information given in confidence and it is an important element of the doctor–patient relationship covered in equity, common law and statutory regulation, as well as through professional ethics and codes of conduct. The protection of personal data of the patient is one of the crucial ethical and legal procedures in the medical field. Discussions between a Doctor and a patient are strictly private as well as information about an individual’s medical condition. Health Insurance Cover Portability and Accountability Act (HIPAA) guidelines, define exactly what information can be released and to whom.
Becky Lynch, a 23-year-old university student, made an arrangement to see her Doctor, Peninah Clent, one of the partners at ST Mary’s Family Medicine Facility, who she has been seeing for long now. Dr.Clent is the long-time family Doctor for Becky’s mother and sister. The purpose of Becky’s visit was to get advice and prescription for birth control pills. They went through various contraception options available, as well as the disadvantages and advantages of each and came to a conclusion that the best option for Becky was the pill. After going through Becky’s medical history and performing a brief physical examination, Dr. Clent gave her a six-month pill for Ortho-Novum 10/11, together with reading materials on oral contraceptives. Becky was also to plan a six-month follow-up meeting over summer break.
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During check out, the billing clerk told Becky that their billing system was undergoing a software upgrade so she won’t receive the bill at that moment. Lynch requested the bill be sent to her university address as she wanted to pay for the visit herself and not submitted to her mother’s insurance since she did not feel like revealing this visit to her mother back home. The billing office assured her that the invoice would be sent to her college address once the system upgrade is complete . About three weeks later, Mrs. Ever Clever, Becky’s mother had an appointment with Dr.Clent. While checking in, she passed by the billing office and requested the insurance clerk to check a notice of claim statement she had been sent from her insurance company concerning a visit by her daughter. Mrs. Clever was sure her daughter did not visit the facility since Becky was in school. The clerk said she would check on the claim and should have information for Mrs. Ever by the time she was through with her appointment with the Doctor.
When Mrs. Clent entered the Doctor’s room, Clent asked about the Clever family and stated that Becky has grown into a gorgeous, bright young woman. Mrs. Clever was thankful and asked the Doctor when she saw Becky and the Doctor carelessly said a couple of weeks ago when she was in for her appointment. Mrs. Clever asked why her daughter had come to see Dr. Clent. The Doctor realized her tone had changed and suggested that she ask Becky herself. At this moment, Dr. Clent realized that she had said too much to Becky’s mother. Mrs. Clever was not pleased by the Doctor’s response because she demanded to know why her daughter was there. She fumed and left the office and at the billing point she was told it was correct Becky had come to see the Doctor on that particular date as claimed by her insurance company.
Becky’s right to confidential information and privacy was obviously breached to some extent by both Doctor Clent and the hospital’s billing office. As a result, Both Becky and Mrs. Clever cancelled their relationship with Dr.Clent and St. Mary’s Family Medicine Facility. Becky sued the hospital for a breach in patient’s confidentiality, non-compliance and causing her psychological trauma. She also filed a Privacy Violation Complaint against both the Doctor and the hospital with the Office of Civil Rights (OCR). The investigations into the incidence found Dr. Clent made a mistake of revealing that Becky came to see the Doctor at the Facility. Her openness was not in a negative way but she did not think it through before uttering the words to Becky’s mother. However, even if Dr. Clent had not mentioned Becky’s visit, her privacy would have been interfered with when the facility filed the claim with Mrs. Clever’s insurance, despite Becky’s arrangement for them not to. Dr. Clent agreed she should not have told Mrs. Clever about Becky, especially after the Doctor had confirmed to Becky that her request for the description would remain between them.
The OCR’s investigation into this matter found various ways where the hospital, as an insured facility, did not comply with HIPAA Privacy guidelines. The facility was supposed to have precise policies and procedures put in place for protecting patient confidentiality, other than a record release policy. The facility was supposed to have a privacy officer to perform duties in that regard, and also perform a risk assessment to know where patient privacy procedures were missing and improve them.
Personally, I agree with the findings of this case and support Becky’s decision to file a law suit against the facility. Patient confidentiality is a practice that has been in existence for so long and every medical officer knows it as it is part of what they are taught in medical school. Furthermore, revealing patients information has die consequences including the patient committing suicide depending on how private that information is. Patients must feel confident that personal data they reveal to their Doctors will not be released to the public without their
Consent. Without this assurance, a patient might be unwilling to share important information that is needed for her care.
References
Beltran-Aroca, C. M., Girela-Lopez, E., Collazo-Chao, E., Montero-Pérez-Barquero, M., & Muñoz-Villanueva, M. C. (2016). Confidentiality breaches in clinical practice: what happens in hospitals?. BMC medical ethics , 17 (1), 52.
https://www.psicinsurance.com/webres/File/physicians/CaseStudy_PatientConfidentiality.pdf
