December 13th, 2011 by Dinah Miller, M.D. in Opinion
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In yesterday’s post on e-prescribing, the issue of patient confidentiality came up in the context of doctors being able to see a patient’s full medication history in an electronic program, and one commenter brought up that she doesn’t necessarily want to tell her shrink about a yeast infection, perhaps because she finds it embarrassing. The writer of the post, a guest blogger, suggested that this might lead to useful information that should be addressed in therapy, for example the patient’s sexual life.
Years ago, I remember being a bit taken back when a patient brought up some rather problematic (to him) sexual issues in his marriage. It wasn’t the nature of the issues that surprised me (I spent more than a decade consulting to a sexual behaviors unit and I spent several months of residency training on an inpatient sexual disorders unit: it takes a lot to shock me). What surprised me was that this was the first I was hearing about this issue after seeing the patient for 5 years of psychotherapy. He had a secret life.
There’s not really much to do about this. One can only Read more »
*This blog post was originally published at Shrink Rap*
November 26th, 2011 by Dinah Miller, M.D. in Opinion
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I’ve been asked several ‘ethical dilemmas’ in the past few weeks. I’m putting them up on Shrink Rap, but please don’t get hung up on the details. These aren’t my patients, but the details of the stories are being distorted to disguise those involved. The question, in both cases, boils down to: Should the mental health professional report the patient to his professional board?
In the first case, a psychiatrist is treating a nurse who is behaving badly. The nurse is stealing controlled substances from the hospital and giving them to friends who ‘need’ them. She doesn’t intend to stop, and her contact with the psychiatrist was only for an appointment or two before she ended treatment. Should the psychiatrist contact the state’s nursing board? Is he even allowed to?
In the second case, Read more »
*This blog post was originally published at Shrink Rap*
October 13th, 2011 by Michael Sevilla, M.D. in Opinion
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How should physicians utilize social media in their professional lives? In this video, I was interviewed by Family Practice News at the 2011 American Academy of Family Physicians Annual Scientific Assembly meeting in Orlando. Check out this blog post where there are slides of my presentation at that meeting about social media. (Also FYI, as of this posting, the video above has the most hits of any on the Global Medical News Network channel – Yay!)
Especially for Family Medicine, using social media is very important, in my opinion, to help tell our story. For too long, I believe that we, as a specialty, have let others define who we are. Social media has a chance to change that.
As far as initial use of social media, I advise physicians Read more »
*This blog post was originally published at Family Medicine Rocks Blog*
September 25th, 2011 by RyanDuBosar in Research
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More than two in five patients hesitate to discuss depression in the primary care setting, leading researchers to offer practical tips on how to encourage people to broach the subject.
The big reasons for not talking to doctors included fears about patient confidentiality and fear of losing emotional control in front of the doctor, among those with a history of depression. Among those with no prior history, a fear of antidepressants/psychiatry and the perception that primary care isn’t the right setting are two big reasons.
To learn why patients choose not to talk about their depression, researchers Read more »
*This blog post was originally published at ACP Internist*
September 23rd, 2011 by Lucy Hornstein, M.D. in True Stories
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Got a call from a long-time patient over the weekend. Hearing a not overly alarming story but one that was not terribly reassuring either, I suggested she go to the Emergency Department.
Later that morning, sitting at an internet cafe with DSS eating breakfast, each of us surfing on our respective laptops, he says conversationally, “So I see Miss LTP is in the ER.”
My heart stopped and my stomach dropped. Had he managed to access the voicemail program I use for after hours calls? My EMR? Had I left shortcuts up to any patient-related materials on that machine? When had I last used it anyway? My mind was racing. I wasn’t all that concerned specifically about him knowing that a particular person was in the ER, since he understands confidentiality. But if he was able to access confidential patient information, did that mean I had a security breach?
“How do you know that?” I asked him carefully, after a very long pause, during which all of the above ran through my head. Read more »
*This blog post was originally published at Musings of a Dinosaur*
