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Column by Mike Zagata, June 8, 2018

Doctor-Patient Discussions

Private? Little By Little,

Confidentiality Goes

Mike Zagata

Are there circumstances where it’s OK to violate your privacy? It might be OK if you make an informed decision to allow that to happen – but what if you don’t?
Have you heard of HIPPA – the Health insurance Portability & Accountability Act of 1996? If you have, you probably have a sense of comfort that it protects conversations your doctor has about your care or treatment with nurses and others.
Does it really do that, and are there times when it’s OK for your doctor, now known as your primary-care physician, to divulge information learned about you during a visit to law enforcement officials?
Does the doctor face an obligation to do so? It’s not your doctor’s fault if they do as they didn’t volunteer to assist your government.

Why these questions? If you’ve had a recent doctor’s appointment, the following questions might sound familiar: “Do you feel secure at home?” and, “Are you depressed?”
What is likely to happen if you answer “no” to the first question and “yes” to the second?
If you’re a firearms owner, you’re likely to receive a visit from the state police and see your firearms depart with them. You may also receive a visit from the folks at Social Services in an effort to determine if you’re the victim of spousal abuse.
The goal is to reduce the likelihood of domestic or other forms of violence, e.g. school shootings. That’s a laudable goal. However, does it, at the same time, violate your right to privacy and lead to the breakdown of the doctor-patient relationship? Is it the best way to achieve the goal?
As with most issues like this, there will likely be opinions on both sides of the issue. That’s one of the many benefits of living in America. The fact that we are losing our privacy right at an alarming rate is just that – fact.
The debate has already been held – by someone somewhere – and the decision made to allow that to happen.
Do you want your driving habits to be recorded each time make a trip to the grocery store or church? Do you want your location recorded each time you dial a number or utter a voice command on your cell phone? Do you wonder why you receive certain e-mails from marketers who seem to know your buying habits?

Yes, our cars and mobile phones offer convenience – but at what cost? To those of us who are older, this cost represents change and thus we are likely to be aware that it is happening. But what about the next generation?
This is life as they know it and therefore not perceived by them as a threat. You can be certain there will be more change – change they may then perceive as a threat because it’s different from that to which they are now accustomed.
It will happen incrementally over time and, at some later date, those of us still alive will awaken to the fact our lives are no longer recognizable and ask: “What happened?”

Mike Zagata, DEC commissioner in the Pataki Administration and environmental executive in Fortune 500 companies, resides in West Davenport.

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