Dr wrote a false thing in my medical record

[rustyrex]

Recently started prep and had a mini confessional with the doctor that I was discussing starting treatment with. A couple days later I looked at the note in my chart and noticed that the doctor said that I used a drug (poppers) on occasion. I was surprised and a little upset because the mention of me using any kind of drug for recreation was never discussed. Such information if looked into by my employer/health insurance company for any reason could get me fired or create higher premiums or denial of coverage. Even in spite of the laws protecting my health record things like this still happen in healthcare, I have a feeling with the way things are going it will become more common place. My buddy works for this doctor and I asked him to send a note to her to retract that part of the medical record since it was never discussed. When I read the note it seemed as though the doctor used a template because it was all matter of fact language that was generalized. The doctor seemed nice and I take this as a mistake but has this happened to anyone else?

[gallahadesquire]

You may be in violation of HIPAA for asking your buddy to send her a note, and could get him in deep shit.

 

You need to contact the physician DIRECTLY to clarify this. Either by phone (which could be monitored); by email (NEVER confidential!); by certified, signature required, deliver to addressee ONLY (difficult); or in person (Best).

[rvwnsd]

I haven't experienced this, thankfully, but as you said it was probably a mistake. However, I would have made the request of the doctor directly, not through a friend who works at the doctor's office.

[rvwnsd]

You may be in violation of HIPAA for asking your buddy to send her a note, and could get him in deep shit.

 

You need to contact the physician DIRECTLY to clarify this. Either by phone (which could be monitored); by email (NEVER confidential!); by certified, signature required, deliver to addressee ONLY (difficult); or in person (Best).

Thank you, @gallahadesquire for this post. My gut said there was a potential HIPAA violation here, but wasn't sure where and didn't want to comment on something outside of my wheelhouse.

 

My question to the OP is how you came to read your chart? Were the comments recorded on a patient-accessible website or app or did your buddy grab your chart for you? If your buddy "helped you out" he could be in deep shit for doing that, too. Also, if he "helps" you out he might help himself to information about patients, including you.

[rustyrex]

I'll clarify...my buddy works as the doctors nurse. All correspondence must go through the nurse before it gets to the doctor.

[gallahadesquire]

I'm not meaning to continue this investigation. Just be careful with your healthcare information and who you ask to read it.

 

At my hospital, we were forbidden from reading our electronic medical record unless they had a Release of Information on file. My internal dialog went something like this:

 

"I'm going to see what my primary wrote about me."

"No you're not! I won't let you!"

"What are you going on about. You want to know what it says, too."

"Yes, but we don't have a Release of Information on file."

"Those idiots. I'll fill one out and keep it here in my desk, if they ask."

"No you won't. I won't let you."

"You can't stop me."

"Yes I can. I won't fill it in!"

"But I have control of my right hand."

"But I have control of vision!"

"Too bad, I read it."

"Forget it! Forget it right now!"

etc.

[TruthBTold]

Because you requested that your friend write or speak with your doctor about something specific perhaps you waived your HIPAA rights as far as that particular thing. You would have to check the HIPAA form you signed when you originally saw your doctor which informed you of your rights and what happens when you initiate the conversations as opposed to the other way around.

[Bearofdistinction]

Recently started prep and had a mini confessional with the doctor that I was discussing starting treatment with. A couple days later I looked at the note in my chart and noticed that the doctor said that I used a drug (poppers) on occasion. I was surprised and a little upset because the mention of me using any kind of drug for recreation was never discussed. Such information if looked into by my employer/health insurance company for any reason could get me fired or create higher premiums or denial of coverage. Even in spite of the laws protecting my health record things like this still happen in healthcare, I have a feeling with the way things are going it will become more common place. My buddy works for this doctor and I asked him to send a note to her to retract that part of the medical record since it was never discussed. When I read the note it seemed as though the doctor used a template because it was all matter of fact language that was generalized. The doctor seemed nice and I take this as a mistake but has this happened to anyone else?

 

1) Confront Him About the Record (Be Prepared to Look for a new Doc)

2) File a Complaint for HIPPA Violation

3) Report a Violation to the State Medical Board - for False Records - and Defamation

4) Set his house on fire - When he runs out - Kick his Ass!

 

I had a Situation Where I wasa in Excruciating Pain due to a fracture post surgery - he reported that

everything was FINE and I reported no pain and it was a surgical success -- as a result I could not get meds for pain management or reasonable accomadation for work. He lives a block from me -

never apologized - refuse to change the report -- I still spit on his car -- And I have a new Doc

 

Medicine is a Business - Demand your rights as a consumer --

[Lookin]

I was sitting in my shrink's office one day when she stopped to take an emergency call. My eyes were drawn to my chart which she had left open on the desk. Reading upside down, I saw that she had written, "Fussy old pervert with delusions of grandeur."

 

When she hung up, I reminded her that I was not that old, that my sexuality was perhaps a bit fluid but not abnormally so, and that I considered self-confidence to be a worthwhile trait. On the spot, I asked her to correct the file and update my chart.

 

She picked up her pen and immediately scribbled a line through the entry.

 

At least I thought she had. When I reached for a pen to write a check at the end of the session, I noticed that she had merely underlined the word "Fussy". http://www.boytoy.com/forums/public/style_emoticons/default/rolleyes.gif

[+ poolboy48220]

I saw a note in my record at my dentist's that said "Always late". I made a point of being on time after that.

[Walker1]

Does it violate the HIPAA statue if a patient reveals his record to friends and family. I believe I can share to anybody I want-only the hospital/providers/caregivers are not allowed to share without my consent?

 

But on the OP, I believe you should meet with the doctor again and ask why he/she wrote that and if they refuse to change, perhaps get a lawyer as it affects your job/future health premiums etc?

[+ sniper]

Am I missing something here? How is the OP in trouble for reading HIS OWN medical record? And aside from that, he's not discussing it with anyone outside the doctor's office.

[LookingAround]

You may be in violation of HIPAA for asking your buddy to send her a note, and could get him in deep shit.

 

You need to contact the physician DIRECTLY to clarify this. Either by phone (which could be monitored); by email (NEVER confidential!); by certified, signature required, deliver to addressee ONLY (difficult); or in person (Best).

Nope not at all. This is so wrong it’s almost laughable. The patient can disclose his or her medical information to ANYONE. It’s the doctor of staff who cannot disclose it. The OP is at zero risk and is free to share his medical information with anyone he chooses. Asking a staff to communicate something to the doctor is fine.

[LookingAround]

I'm not meaning to continue this investigation. Just be careful with your healthcare information and who you ask to read it.

 

At my hospital, we were forbidden from reading our electronic medical record unless they had a Release of Information on file. My internal dialog went something like this:

 

"I'm going to see what my primary wrote about me."

"No you're not! I won't let you!"

"What are you going on about. You want to know what it says, too."

"Yes, but we don't have a Release of Information on file."

"Those idiots. I'll fill one out and keep it here in my desk, if they ask."

"No you won't. I won't let you."

"You can't stop me."

"Yes I can. I won't fill it in!"

"But I have control of my right hand."

"But I have control of vision!"

"Too bad, I read it."

"Forget it! Forget it right now!"

etc.

You have very strange ideas about HIPPA that have no basis in reality. A patient has a complete right to his entire medical record any time he or she wants with the exception of psychotherapy notes. If the patient is denied this right then the doctor is in violation of HIPPA.

[+ Robster]

When I was in the hospital last year, one of the doctors who came in to check on me asked if I had any other medical conditions he should be aware of, to which I said no. Then he asked if I was on any medications, to which I said PrEP. He said, rather rudely, "When a doctor asks you if you have any medical conditions, you need to mention that you're HIV-positive." My husband and I were shocked, and explained (to a doctor, mind you) that I'm HIV-negative, and on PrEP to prevent HIV. I'm still not sure he was entirely convinced.

 

And yeah, I'm not seeing any HIPAA violations here either.

 

Rob

[+ sniper]

When I was in the hospital last year, one of the doctors who came in to check on me asked if I had any other medical conditions he should be aware of, to which I said no. Then he asked if I was on any medications, to which I said PrEP. He said, rather rudely, "When a doctor asks you if you have any medical conditions, you need to mention that you're HIV-positive." My husband and I were shocked, and explained (to a doctor, mind you) that I'm HIV-negative, and on PrEP to prevent HIV. I'm still not sure he was entirely convinced.

 

And yeah, I'm not seeing any HIPAA violations here either.

 

Rob

I'd have reported that doctor's behavior. If he's that ignorant, what other mistakes is he making?

[Rudynate]

Nope not at all. This is so wrong it’s almost laughable. The patient can disclose his or her medical information to ANYONE. It’s the doctor of staff who cannot disclose it. The OP is at zero risk and is free to share his medical information with anyone he chooses. Asking a staff to communicate something to the doctor is fine.

 

 

And if the buddy has a legitimate reason for looking at OP's medical record, such as to confirm OP's complaint before speaking to the doc, there's no violation. If buddy were gratuitously looking in the record out of personal curiosity, that's a violation.

[LookingAround]

Who talked about the buddy looking st it for his fun or amusement?

[Racketjock]

Some great advice given here. I would request to see and have a complete copy of your medical record now, review it, then address any and all issues you have with it directly with your physician. If there are errors that conflict with care delivered or their assessment, request for a correction to be made and obtain another copy post to validate it has been updated. It is your right.

[gallahadesquire]

I was sitting in my shrink's office one day when she stopped to take an emergency call. My eyes were drawn to my chart which she had left open on the desk. Reading upside down, I saw that she had written, "Fussy old pervert with delusions of grandeur."

 

When she hung up, I reminded her that I was not that old, that my sexuality was perhaps a bit fluid but not abnormally so, and that I considered self-confidence to be a worthwhile trait. On the spot, I asked her to correct the file and update my chart.

 

She picked up her pen and immediately scribbled a line through the entry.

 

At least I thought she had. When I reached for a pen to write a check at the end of the session, I noticed that she had merely underlined the word "Fussy". http://www.boytoy.com/forums/public/style_emoticons/default/rolleyes.gif

 

We're instructed never to "scribble out" an entry. It needs to be visible for "transparency." At least, that's what Harvard Law school taught us. A single line with your initials, time, and date added.

 

I misspoke. Yes, the patient is allowed to read their own record. It is recommended, however, that this occur with a member of the profession. Some phrases may not mean what one thinks. I learned the legal term "dismissed with prejudice' didn't have the connotation I thought it did.

[Rudynate]

Who talked about the buddy looking st it for his fun or amusement?

 

 

I did - speaking hypothetically, to illustrate the fact that the same action, motivated by different intents can have different outcomes.

[Bearofdistinction]

Am I missing something here? How is the OP in trouble for reading HIS OWN medical record? And aside from that, he's not discussing it with anyone outside the doctor's office.

 

No OP is just Fine ---- HIPPA puts restrictions on the Hosp/Medical Providers --

 

The Patient OWNS the medical information and can take it to the local bath house and do PPT presentation on his huge cock - his magic engorged prostate and his lovee of Pat Nixon who gave him crabs!

[Bearofdistinction]

We're instructed never to "scribble out" an entry. It needs to be visible for "transparency." At least, that's what Harvard Law school taught us. A single line with your initials, time, and date added.

 

I misspoke. Yes, the patient is allowed to read their own record. It is recommended, however, that this occur with a member of the profession. Some phrases may not mean what one thinks. I learned the legal term "dismissed with prejudice' didn't have the connotation I thought it did.

 

Dismissed with Prejudice means that the adjudicating body has found the complaint filed by the instigating party is dismissed to be insufficient to a level where the body will not hear the complaint again if amended it is barred and may NOT be refilled.

[+ sniper]

No OP is just Fine ---- HIPPA puts restrictions on the Hosp/Medical Providers --

 

The Patient OWNS the medical information and can take it to the local bath house and do PPT presentation on his huge cock - his magic engorged prostate and his lovee of Pat Nixon who gave him crabs!

 

Actually IIRC medical records are the property of the physician's office. The patient has a right to see them.

[LookingAround]

Actually IIRC medical records are the property of the physician's office. The patient has a right to see them.

 

And to not only see them but be given a full copy.