Is HIPAA Creating More Problems Than It's Preventing?

Neil Chesanow

Disclosures

September 16, 2013

In This Article

Why Small Practices Fear HIPAA

Physicians in small practices have their own reasons to dislike HIPAA. These doctors already live in fear of spurious malpractice suits and Medicare audits. The Privacy Rule is yet another complicated thing to worry about, and it seems like there are steep financial penalties if you inadvertently make a mistake.

The simple solution: Don't tell anyone anything and stay out of trouble. Many of these doctors have privileges at hospitals where this mindset is already pervasive, and they introduce it into their practices as the hospital-endorsed safe thing to do.

In some cases, however, the Privacy Rule may serve as a convenient excuse to avoid the very (HIPAA-sanctioned) communication that doctors claim it prevents.

"If families are kept at arm's length, the easier it is to avoid difficult conversations about prognosis and treatment options," Levine explained in her testimony. "With some exceptions, healthcare professionals are not well trained in or skilled at communicating with lay people -- patients first of all, but even more so their families." Yet, she said, "social support is clearly an important element in managing chronic illnesses, and it is difficult for family and friends to be intimately involved with the patient's care to provide that support without relevant information."

Congressman Tim Murphy (R, Pennsylvania), Chairman of the Congressional Subcommittee on Oversight and Investigations, which held the hearing on HIPAA last April, summed up where we are now as a result:

"HIPAA, as initially conceived and enacted, reflected an effort to replace a patchwork of state laws and regulations impacting the confidentiality of medical information. From the start, HIPAA was accompanied by considerable anxiety on the part of providers, or 'covered entities.' Fearful of new penalties for violating HIPAA, doctors and nurses were refusing to even talk about a patient's illness with caretakers, all of whom were [professional] caretakers, spouses, siblings, or those managing the affairs of their elderly parent."

"My sister, who was in severe abdominal pain, asked me to accompany her to the emergency department of a major New York City medical center," testified Levine about the absurd lengths that many institutions go to protect patient privacy in the name of HIPAA, which are nowhere to be found in the actual legislation. "We waited and waited, and finally a triage nurse told my sister to follow her into a room. I got up to join her, but the nurse stood in my way, saying, 'You can't come with her. It's a HIPAA rule.' My sister said, 'But I want her with me.' No way."

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