Tuesday, March 11, 2014

HIPPA-protecting patients or just another means to target doctors?

This month’s ASA newsletter highlights “ethics” in an unusual sequence  at: http://viewer.zmags.com/publication/8ca586af#/8ca586af/6.
We read about HIPPA violations, while 60 Minutes last week featured the fact that anyone using the internet has already divulged extensively their personal information: http://www.cbsnews.com/news/the-data-brokers-selling-your-personal-information/ . The amount of information is extensive and exceeds that of the government. DO you think this whole protection actually does anything for patients, given the fact that it often leads to difficulty in obtaining needed patient information from “outside sources”.  Is it time for everyone to just back off? The ACA has made nothing accountable, shovels all data to government and PRIVATE CORPORATIONS in the name of quality assessment (i.e. the anesthesia quality Forum) (See http://viewer.zmags.com/publication/8ca586af#/8ca586af/42)  Is it time for everyone to just back off? Do docs need to attack the federal bureaucracies to stop wasting medical dollars to make every patient a “top secret” to practicing physicians while simultaneously making every patient a “test subject” for federal  data collection and then no one actually uses this information in an ethical manner?

Ethical implications of “special relationships” in medicine.
Once again we see colleagues lining up to point fingers at colleagues, imposing additional restrictions on doctors, well above any other group in society. The article in the ASA newsletter is found at: http://viewer.zmags.com/publication/8ca586af#/8ca586af/22 and the target is married surgeons/anesthesiologists caring together for one patient-creating conflict in legal malpractice awards to patients. Personally, this is more likely to result in an award being issued if lawsuit develops!   Why not use the example of an MD/CRNA team-this is more commonplace? I am tired of colleagues creating ever more reason to punish and constrain physicians in medical care. We see dynasties in the US presidency and god only knows how many deaths result from presidential decrees. But we physicians continue to target only our own PRACTICING DOCS.
Is a personal relationship in medicine any different than politics, law, plumbing? Why do we continue to point fingers at ourselves? Personally caring for family members is also prohibited in many states  by such ill found “ethical standards”,  although as parent, caregiver, spouse or power of attorney, NOTHING would be possible without informed consent from the “special party”!
Of course the ASA and the ABA are also very “married” to each other, exchanging leadership positions readily and creating financial adventures to extort money from practicing physicians-Yes I am referring to the scandal called MOC,  or for anesthesia: MOCA (trademark here!).  Spouses can be targeted as individuals but Corporations like the ASA and ABA remain immune (as they are in power and control this publication), although they are essentially the same people cashing in on our labor.
A Colleague recently wrote this regarding the problem:

Most doctors are not aware of the specialty medical boards copyrighting their educational materials.  Under the Hippocratic tradition, the dissemination of medical knowledge was expected to be free and without charge. 

Not long ago, an internist subspecialist sat for a board exam, but later provided a test question to a board review course that was not "blessed" by ABIM.  The response from ABIM?  Litigation, which even included attorney fees!  Dr. Christine Cassel, then head of ABIM, literaly ruined this physician for doing something that ABIM does routinely!  Has anybody else noticed how ABIM advertises its review products, along with questions like those which appear on the board exams?  Yes, and ABIM charges hundreds, if not thousands of dollars for these products? 

How does one copyright medical information?  How is such copyrighting helping disseminate medical knowledge?  Why would a specialty medical board sue a physcian for helping to disseminate this knowledge?  Is it to protect its money stream and Dr. Cassel's lucrative career? 

Dr. Cassel, of course, is no longer at ABIM.  She went over to head up the National Quality Forum,. while Dr. Richard Baron, previously at NQF, came over to head up ABIM.  Dr. Cassel, meanwhile, apparently was simultaneously "serving" on directorships of organizations that would benefit from NQF, earning significant sums on these "side jobs". 

So, thank you Dr. kmpnpm for pointing out the Hippocratic versus the hypocritical.  Let us hope that doctors will choose the former, and ditch this MOC business.

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