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cinna

Member
I had a situation come up between me and my Medical Doctor and I am looking for feedback.

I have had severe complex PTSD for over 3-1/2 years. My MD took care of me in regards to filling out forms for work, and supporting me. The person who actually treated me for my illness, and knew everything about me, was my Psychologist.

My MD was a wonderful doctor, and I felt very blessed for everything he did for me. Because of the good relationship between us, I developed a trust and respect for him. It was therefore, that I revealed something confidential to him, that only my Psychologist knew about.

In the middle of this year, my MD was requested to write a report on me. We talked about this confidential information because he wanted to include it in the report. He thought it may help me at this point, but I talked to him again, about how this information would be of no benefit to me now, with circumstances being more complex. He was silent after I finished, and thought that he had agreed with me.

I had asked that I be called so I could have a look at the report before he sent it in. I was denied access to it, and lame excuses were made as to why I couldn't see it. I then asked for him to give me a call once the report was finished, so I could have a copy, and I never received a call. It wasn't until I heard from the requestor of the report, that I knew he had completed the report. So, I went to my MD and requested a copy, only to be told that I couldn't have a copy unless I paid $ 50 (the requestor paid for it, also).

I was very surprised when I read the report, for he went ahead and commented on what I had confided in him. I felt very betrayed and hurt. In my next appointment with him, I wanted to find out why he did what he did. I was pleasant, and was willing to just talk about it. After all I had always a good relationship with him, and liked him. Perhaps there was something I was missing.

I was shocked at his attitude and behaviour to me. He misconstrued everything I said and acted like a bully. I told him that when we talked about it, he didn't say anything. I expressed that it wouldn't have been a shock if he would have told me that he was going to put it in anyway. At least then, I would have had a choice, as to whether I wanted to proceed. I feel totally disrespected. My MD never answered my question about why he broke our confidentiality. He did not seem to realize how important, or serious it was to me as a patient. Instead he told me that I was ungrateful for him writing the report, which didn't make *any* sense at all.

Is there such thing as a doctor/patient confidentiality? There was nothing written down about it, it was purely verbal
 

Daniel E.

daniel@psychlinks.ca
Administrator
So, I went to my MD and requested a copy, only to be told that I couldn't have a copy unless I paid $ 50.
That does seem strange. In many states in the US, for example, there are price limits set on the copies for medical records, like $1 per page or whatever. So I guess this is not considered a regular part of the medical record since the report was likely paid for by a third party.

What about asking for a copy of the report from the party/organization/company who originally paid for it?
 

David Baxter PhD

Late Founder
I was very surprised when I read the report, for he went ahead and commented on what I had confided in him. I felt very betrayed and hurt. In my next appointment with him, I wanted to keep things

Cinna, it looks like there's something missing here...
 

cinna

Member
Cinna, it looks like there's something missing here...

Hi, Daniel. Good thinking. This is exactly what I did and it was free.
thank you, Cinna

---------- Post added at 07:32 PM ---------- Previous post was at 07:30 PM ----------

David, sorry I pressed the submit button, instead of the preview button. I was not yet finished explaining..
I have completed my post now.
Thanks Cinna
 

Daniel E.

daniel@psychlinks.ca
Administrator
but I talked to him again, about how this information would be of no benefit to me now, with circumstances being more complex. He was silent after I finished, and thought that he had agreed with me.
Before he submitted the report, did you specifically tell him you did not want that information in the report? Or did you just imply it?

On the positive side, only a few people may read such confidential reports. And people who work with such reports tend to see everything as a blur after a while.
 

cinna

Member
Hi, Daniel.

Yes, I very specifically told him that I did not want this information in the report. Was I asking too much that he should have at least told me he was going to put it in there? Why would this make him so angry?

Without revealing what the confidentiality was, it's hard to explain it, but as I predicted, this comment hurt me in that it revealed an open option. In reality, because things got more complex as my PTSD progressed, it was not so cut and dry, and many other factors were in place. This of course, was known most well by my Psychologist. My MD had no right to make a judgement, as he did not treat me.

In summary, the report was not accepted. When I mentioned to my MD that it was rejected because of the comment, he told me he knew it was going to be rejected, anyways. Again, he side steps. I totally don't understand. And, I'm not looking for anyone else to figure that out, but just looking for some acknowledgement that anybody would feel the way I do.
 

Daniel E.

daniel@psychlinks.ca
Administrator
Well, it seems you almost certainly consented beforehand by signing something. And then you verbally requested that he not include certain information. So, as you imply, it's a question of ethics rather than law since your written request was not retracted or modified.

It seems your doctor did what he thought was in your best interests, and your written consent was unconditional. So it seems more like a difference of opinion than an unethical violation of confidentiality.

In other words, it seems your doctor interpreted your verbal requests as just that -- requests, not mandates.
 

cinna

Member
Hi Daniel.

Before I write more, what do you mean by written consent? I'm not sure what you are referring to ?
thanks , Cinna
 

Daniel E.

daniel@psychlinks.ca
Administrator
Didn't you sign a medical release form or something like that? It was probably prepared by the third party and you just signed it.

What many people don't know is that you can add conditions to these forms. Medical releases don't have to be all-or-nothing.

But, of course, when it comes to insurance companies, etc., it's probably best to make it seem like you aren't hiding anything.
 

David Baxter PhD

Late Founder
To clarify one thing, due to the way doctors get paid up here (Candian health care plan via provincial health), they have to charge for every form, letter, report, photocopying, etc., because the government plan doesn't pay them for that. If they don't charge, they are out of pocket.
 

cinna

Member
Hi, Daniel.

Yes, I did sign a consent form for my doctor to release my records. Nothing was in my records about it, however, perhaps this release also meant anything verbal, as well.

In summary, I believe what you are explaining is that a physician has no obligation to his patient, either personally or professionally, to hold any confidential information, for any reason. Since you say most people don't know this, then my question or concern wasn't uncommon. nor out of line, and he could have just answered me like you did here with confidence and respect, and thus it would have been end of story.

Thanks for your replies.
Regards, Cinna
 

Daniel E.

daniel@psychlinks.ca
Administrator
In summary, I believe what you are explaining is that a physician has no obligation to his patient, either personally or professionally, to hold any confidential information, for any reason.
No, what I'm saying is that it was in your best interest to waive your confidentiality (without exclusions), which you did.

But you can't expect to have it both ways, i.e. to have medical release forms that show you are being totally open and also have verbal requests (which the third party would be unaware of) that stipulate what cannot be shared. So that's why I think your verbal requests were seen more as preferences than mandates.

My point just regards confidentiality, though, not your doctor's communication skills, etc.
 

cinna

Member
No, what I'm saying is that it was in your best interest to waive your confidentiality (without exclusions), which you did
Yes, I know now that I gave up my right to any verbal or written confidentiality, when I signed the consent form. Regarding my best interest, it turned out not to be, although it could have been. I see more clearly now, that perhaps if my physician would have added more details, it would have actually been ok, and displayed itself accurately. Instead, it was misleading and incorrect and conveyed an open avenue. I think the greatest factor to this happening, is that (and I stated it earlier) he didn't treat me, and therefore had a complete lack of knowledge, overview, and understanding. It showed by the way he worded the comment and not realizing how it could be miscontrude.

My point just regards confidentiality, though, not your doctor's communication skills, etc

Yes, more than anything his behaviour and attitude towards me hurt the most. To be treated so disrespectfully all of a sudden, is not only shocking, but grievious. I know in my heart that there was something going on with him that has nothing to do with me. Still, it doesn't make it hurt less, nor make his behaviour ok. Our relationship naturally was very important to me in many ways, so I did take it personally. Well, anyways, I think I have expressed enough, and don't want to drone on.. LOL It's water under the bridge now, and I'll forgive and move on.

Thanks again, Daniel
Regards, Cinna
 
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