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What’s Medical, What’s Private?

Since medical privacy rules (aka HIPAA) went into effect, patients have signed form after form saying that our health care providers and pharmacists have told us that they comply with the laws. With restrictions on who can see, know about or be sent our medical information, it seems as if our private medical information is well-protected from prying eyes. “But that depends very much on what you mean by medical, and what you mean by privacy,” maintains Abigail Zuger, MD, in her essay, The Water Cooler, a Font of Good Medicine, which appears in today’s New York Times.

For medicine to shift from treating symptoms or disease to treating whole people, Zuger argues that the social information about patients that was once considered gossip is now relevant to their health care. She writes,

“No longer is a well patient with a sick gallbladder of medical interest for her gallbladder alone…

“Is the gallbladder upset because its owner is eating too much fatty food? Are those deep fried onion ring binges caused by unhappiness in the home? Is there a possibility of domestic violence? Should a social worker and a lawyer be called as well as a surgeon? The scans show only the inflamed gallbladder, but medical caretakers are now encouraged to see beyond the scans.

“Sharing information from every perspective has become the way of the future. In medical school, students are now encouraged to link disparate medical and social details into a cohesive story, a veritable novel about each patient.”

If talking about the gory details of my life means that my health problems are better attended to, I’ll provide refreshments for that meeting. How do you all feel about your medical privacy after reading Zuger’s essay? Please leave a comment or e-mail me.

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