Are Doctor Privacy Agreements Ethical?; Long COVID-19 More Prevalent Than Thought; and Creating a Safe LGBTQ+ Health Space

October 14, 2022

How Far Is Too Far to Protect Your Reputation Online?

Doctors rely on their reputations, but some require patients to sign privacy agreements that may be unethical. Physicians may ask patients not to post negative reviews as a condition of treatment. Some agreements say that a practice will own online reviews; others demand that patients keep their family or friends from saying anything negative. Such contracts may violate ethical norms, experts say.

"They're not illegal, but they seem extremely sleazy and do raise ethical questions," said Robert I. Field, JD, MPH, PhD, professor of law and health management and policy at Drexel University in Philadelphia. "I wouldn't sign one as a patient, and I'm sure a [Health Insurance Portability and Accountability Act]savvy patient wouldn't sign one."

Why contracts exist: A recent survey found that online reviews and star ratings are the most important factor for patients when choosing a new healthcare provider.

Not enforceable? A patient could claim that they were coerced into relinquishing their free speech rights by signing a privacy agreement, and there's a chance a judge would strike them down.

For Many, Long COVID's Impacts Go on and on, Major Study Says

Almost half of COVID-19 patients still experience persistent symptoms, a major new study found. About 1 in 20 people with long COVID-19 continue to live with symptoms at 18 months, and another 42% reported only some improvement in their health and well-being in the same time frame, according to the study out of Scotland. The most common long-term symptoms included tiredness, headache, and muscle aches or weakness among 21,525 people who had symptomatic COVID-19.

The study looked at 96,238 people. Researchers checked in with participants at 6, 12, and 18 months and included a group of people never infected with the coronavirus for comparison purposes.

Most affected: Long COVID-19 risk was highest after a severe original infection and among older people, women, Black and South Asian populations, people with socioeconomic disadvantages, and those with more than one underlying health condition.

Other symptoms: Loss of smell was almost nine times more likely in the group compared with those who were never infected. The risk for loss of taste was almost six times greater, followed by risk of breathlessness (three times higher).

Best Practices for an LGBTQ+ Friendly Medical Space

LGBTQ+ patients may feel discrimination in healthcare, but there are ways that clinicians can alleviate the issue. Such patients reported some discrimination, according to a Center for American Progress survey.

About 35% of physicians said that LGBTQ+ patients receive a different level of care, and 52% of respondents younger than 45 years said so, according to Medscape's Physicians' Views on LGBTQ+ Rights Issues Report 2022: Strong Emotions, Contrary Opinions.

How to help: Experts advise asking open-ended questions such as "What is your gender identity?" "What was your assigned sex at birth?" "What pronouns do you prefer?" and "What genders are your sexual partners?"

One size doesn't fit all: But others caution against making such questions a default. Before revising intake forms, consider the purpose of the information. Details on a patient's sexual orientation or sexual activity may aid an ob/gyn but be irrelevant for a patient seeking physical therapy for a knee injury, for example.

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