HIPAA

HIPAA stands for Health Insurance Portability and Accountability Act. HIPAA provides for broad protections for the privacy of your medical records. Each health care provider must observe the protections defined by HIPAA. It’s not just law it’s the right thing to do. Additionally, each health care provider must have in place a written agreement that contractually binds each of its business affiliates to the provisions of HIPAA.

That usually works. Some of our readers get their prescriptions through third-party prescription renewal services. One such service is Express Scripts. I mention Express Scripts specifically because it seems to neglect basic requirements for confidentiality. For over two years Express Scripts has been sending me refill requests and “courtesy notices” in which the prescription needs of its customers are disclosed. That would be fine if these were actually my patients. They are not. Despite the fact that I have notified Express Scripts on multiple occasions they continue to violate the privacy rights of patients by sending refill requests to me.

So? You ask. Well it’s fine if you’re refilling your antacid. But what if Express Scripts sends me the refill request for your anti-AIDS drugs or your viagra- and by the way you live next door to me? What if its your testosterone inhibitor to control your pedophilia? What if its a medication that you actually need refilled in a timely fashion- I don’t, by the way, refill these drugs. In fact after two years I simply discard the mailings unread into our secure shredder. I have found that notifying Express Scripts of these errors does not stop the mailings (Express Scripts now faxes the forms so I pay for the paper that I later shred).

So? You ask again. It’s your health care information. You should carefully screen who “touches” or controls your information. And, if you use Express Scripts you definitely need to make sure they’re not sharing your private information.

Its you health care. Take it seriously and take charge.

Autism

The relationship between autism and vaccines has been at issue since 1998. Now there appears to credible evidence that the entire study was faked.

Regardless of the relationship with autism the reduction in vaccination rates has led to a direct increase in the incidence of measles in the UK and subsequent measles deaths. Unfortunately, Andrew Wakefield’s scientific fraud is not an isolated incident. Dr. Scott Reuben, also fabricated data related to perioperative pain relief. While we might see the adverse effects of Wakefield’s malfeasance now the effects of Reuben’s remains incalculable. That’s because Reuben’s work forms the basis of an enormous body of subsequent research.

The average patient could not possibly have understood these occurrences. In fact few of us in clinical medicine understood these occurrences. So what should you do? First, always be skeptical of “breakthroughs.” Next, always ask your doctor to explain new information. You should also use reputable print and electronic media for information. Do not rely on nut-job blogs and conspiratory-theory pundits. Last, watch for confirmation from other reputable scientists.

The medical literature may have more physicians seeking name recognition at the expense of scientific integrity. Use good judgement and be safe.