Doctor-patient confidentiality is an absolutely essential element in effective mental health treatment and in health care today as evidenced by HIPAA, the Health Insurance Portability and Accountability Act. Being able to share your greatest concerns and your darkest secrets safely and without scrutiny can be a liberating and healing act on your path to greater mental health and wellness. You can be assured, I will do my upmost to protect your health information.
The requirement for doctor-patient confidentiality is balanced with an equally significant counterweight: safety and the principle of Primum non nocere or “First, do no harm” which all physicians since the time of the Hippocratic Oath in the 5th century, B.C., aspire to maintain as a pillar of our profession. As such, there are multiple exceptions to doctor-patient confidentiality which relate to the safety of the individual, the safety of society, and for health care to be provided in an effective manner given the need for third party payers and administrative staff in physician offices across the country. This balance between confidentiality and safety has led to yet another principle which is the “need to know.” This principle dictates that when health care information is shared, it is done so appropriately and only the minimum information necessary to provide care or complete an administrative task is given.
Listed below are the exceptions to doctor-patient confidentiality:
Treatment: Providing outstanding treatment is based on different providers and agencies sharing essential information such as medications and using collective expertise to help you maximize your overall physical and mental wellness. As such, you will be asked to fill out a release of information form for your primary care provider and therapist so that necessary information may be exchanged to optimize your care. Other providers may be included if necessary, depending on their level of involvement and nature of involvement in your care. In the unlikely event you may require inpatient hospitalization, coordination of care is essential from the point of any ER visit through discussing your care with the inpatient team.
Payment: Third party payers (insurance companies) may request treatment plans and even progress notes on rare occasion and will want access to your records if they are partially covering the cost of care. If you do not want them to have access, you simply do not have to file a claim with the insurance company. Also, administrative staff may assist me with monthly receipt mailings and general accounting. This staff will not be accessing your personal records except to get demographic and financial information necessary for bookkeeping purposes. Moreover, all staff will sign a confidentiality agreement.
Requirement by Law: I may use or disclose your protected health information to the extent that the use or disclosure is required by law. The use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law. You will be notified, as required by law, of any such uses or disclosures. Primary examples include:
Also, note that unless authorized by you via a written release of information to discuss information with a family member, I will not discuss your care with these individuals. If a perceived emergency exists or you are having a serious exacerbation of symptoms, however, I may contact your listed emergency contact for additional collateral information even without your consent only to obtain additional information about your current state of health. In this exceedingly rare circumstance, I will not volunteer information about your diagnosis, treatment, or progress, nor will I contact anyone not listed as your emergency contact. Please discuss with me any concerns, if any, you may have about these exceptions to confidentiality as stated above.