One Dozen Things
Confidentiality
Scenario Analysis
Hopefully, it should be obvious that this scenario demonstrates what not to do regarding patient confidentiality. The two physicians are in a public area of the hospital, an elevator shared with patients and visitors, and are discussing a patient, her treatment, and another physician with complete disregard for who may be able to hear their conversation.
They identify a patient by name, indicate that her treatment is not going well, and imply that it may be the fault of the treating physician, who is also identified by name. All of this can be clearly heard by people who could be relatives of the patient or patients of the doctor being maligned. This could cause the patient or the patient’s family a great deal of distress, could undermine their confidence in the treating physician, and could even lead to litigation. Even though in this case the patient and the physician caring for her are unknown to the people in the elevator, the facial expression of the woman on the elevator indicates that she recognizes that it is inappropriate to have such a conversation in a public place.
Orientation to any hospital or health care facility will include extensive education about the provisions of a comprehensive set of rules known as HIPAA, from the Health Insurance Portability and Accountability Act of 1996. These government regulations provide very precise guidelines about what kind of patient information can be shared with whom, and what safeguards must be taken to ensure that information remains secure. While dealing with medical records and documentation, you must be very aware of HIPAA requirements. What this video emphasizes is that confidentiality is an all day, every day consideration!
Residents spend long hours in hospitals during their training, and much of that time is in public areas (hospital corridors, cafeterias, etc.) where they will be surrounded by many different people. Hence, you must be certain that the content and tone of your conversations do not violate patient confidentiality or present negative images of medical staff or the care rendered in the hospital. To assist staff in doing this, many hospitals post reminders in elevators and other places that patient information should not be discussed in public areas.
