HIPAA- the big GYPPA?

Ok so I was asking some questionss of an IM doc about shadowing, and she mentioned HIPAA is making it very diffcult for non-medical students to do shadowing due to the new patient information sharing restrictions. She also mentioned that they are very strict on this, check up on you, and test your office. My eventual hope was to go into practice for myself, perhaps even rurally or in an underserved area. But the more hear about how many “hassles” you have the more I’m starting to think twice. Between things like HIPAA, HMO’s and high insurance costs, it make it very difficult, which a lot of time spent on overhead tasks instead of focused on your patients, which is where your true focus should be.

For those who didn’t know(which probably amounts to just me) HIPPA entails a patient confidentiality clause that says you cannot disclose patient information casually to other doctors, to other patients, or even to immediate family without explicit written consent from the patient. This also applies when the patient is incapacitated mentally or physically, unless they have a preexisting power of attorney. So if your patient is diagnosed with say, a mental disorder, and his/her spouse calls in for info, you can’t disclose it to them without written consent. Very frustrating. Does anyone know if this has been challenged at all? Has this affected anyone’s desire to practice privately(among other things)?

Zan, On the one hand HIPAA has made more work for those of us in the medical field, but it is supposed to benefit the patient. One of my current jobs is working in the Radiology file room ( I am known as the finder of lost films). HIPAA is one of those double edged swords. It can protect someone - for example an unscrupulous spouse trying to get a divorce or custody of children can potentially use medical information to create a false image of the other - from defamation; but it can potentially prevent appropriate treatment or intervention. At the other extreme of protection is the way our administrator at the hospital understands the protection to extend to us protecting ourselves from our medical information. If I needed to get a copy of my x-rays or reports I am not to access the information. I am supposed to fill out the forms and have a coworker fill the request. I personally think that is a bit much, especially when the transporters typically have the patient hold their own chart, but I digress.
Just like any type of legislation it needs revision. Hopefully, we as future physicians can help shape this and other rules which effect how we may interact with our patients.
I would think that the person you are shadowing would be able to have you sign a legal document (just as they have their employees sign) saying that you are held under the same confidentiality provisions that any of their employees are? I don’t know if that would help or not, just a thought.

Lately when you try to shadow doctors, the office staff won’t let you get the foot in the door before they slam it on you. When I was looking for a DO to shadow I called every office that had DOs listed in the phone book. Each and everyone said no and almost all of them blamed HIPPA. They wouldn’t even ask the doctor if they would allow me to follow them around. I ended having an interview with a DO and that was enough to get me LOR, but I never had this problem a few years ago when I shadowed a number of doctors.