A Word About HIPAA

Let us address HIPAA right away lest I be accused of neglecting to mention it. Any semblance of a moral compass dictates that you keep people’s private business private, but because that compass tends to point towards gossip instead of good sense the forces of law and order in this country also dictate that anyone associated with health care must abide by a certain standard of confidentiality. That standard, in a nutshell, is HIPAA, the Health Insurance Portability and Accountability Act, although why they called it that instead of something like “Confidentiality Act” is one of life’s great mysteries.

HIPAA protects doctor-patient confidentiality, which is actually doctor-nurse-PA-tech-med student-nutritionist-physical therapist-case manager-billing department-insurance company-patient confidentiality. Nursing students fall under this umbrella, as does anyone else who lays so much as half a retinal cell on patient information of any kind. Whole forests of documents are shredded at the end of every day and there are Very Serious Consequences for anyone caught violating HIPAA, intentionally or otherwise. HIPAA is the Nazi-Argument-Theory of the medical world: bringing up Hitler automatically ends an internet debate, and the mention of HIPAA instantly ends any discussion in our field. Can you tell me about that lady I saw in the waiting room earlier? Sorry, HIPAA. Did that guy really have a heart attack? Sorry, HIPAA. What should we do with our patient’s hideously leaking orifice? I’ll tell you upstairs because HIPAA says we can’t talk about it in the cafeteria.

This is as it should be, because I may not particularly care if anyone knows I broke my wrist when I was seven (true story, not exciting, fell off a sofa), but loads of people would prefer to keep their irritable bowel syndrome, genital warts, and social security numbers to themselves. Some personal details are mundane, some are embarrassing, but they are all PERSONAL, and HIPAA helps keep them that way.

Are there doctors, nurses, and a host of peripheral health care workers that go home in the evening occasionally to say to their families (or their psychiatrists), “So guess what I saw today…?” Sure, and that’s a HIPAA violation. If you have attracted the attention of the federal government such that they are listening in your home, you may be in real trouble for that seemingly innocent dinnertime tale. The rest of us will get away with that tiny breach, but small bits of carelessness often lead to bigger, and for those foolish enough to publicly discuss, publish, or leak patient information (including, heaven help us, on Facebook) the considerable wrath of a dozen medical associations and government agencies will rain down on their heads like all Ten Plagues of Egypt.

So, much as I would like to regale my audience with amusing tales of Unit X in Hospital Y in City Z, I cannot provide all the gory, cringe-worthy, delicious, giggle-inducing details. My significant other’s great-uncle was Senator Joseph McCarthy, who would be ashamed that I cannot name names, but I can speak freely about non-HIPAA matters, and leave specific and identifying information out of certain other anecdotes. Fear not, there are lots of good stories to be told without violating HIPAA.