Doctors deserve privacy too: Credentialing should not require revealing your entire health history
At a time of stringent requirements for patient privacy, what about the legitimate rights of physicians?
Editorial. Jan. 20, 2003. Additional information
With all the publicity -- and controversy -- surrounding the Health Insurance Portability and Accountability Act and its attendant requirements for safeguarding patient privacy, most physicians should be at least generally aware of the protections afforded their patients.
But it's unlikely those same physicians are as well versed in ways to protect the privacy of their own medical information through the licensure and credentialing processes.
It's not surprising. Licensing requirements, often vested with state medical boards by state law, vary greatly. In addition, there is no shortage of credentialing horror stories among physicians, who are often required to fill out a new, and often different, set of forms for each hospital and managed care organization with whom they are affiliated.
No one disputes, and case law backs up, the duty to license physicians and regulate hospital staffs and clinical privileges. However, the scope of the information necessary to fulfill that duty has been the subject of controversy in the health care community. And rightly so. A desire to practice medicine should not equal a forfeiture of privacy rights afforded to people in most other professions.
The AMA hopes to narrow the scope of information sought for this process under new policy passed at the meeting of its House of Delegates in December 2002. The policy states that "only information regarding current health status should be required for credentialing purposes."
For example, the AMA suggests that questions regarding medical status or treatment of alcohol or substance abuse should be limited to within the past two to five years. Anything more is neither relevant nor necessary.
The AMA will also recommend that "medical staffs, managed care organizations and other credentialing and licensing bodies adopt credentialing processes that are compliant with the Americans with Disabilities Act."
Physicians who are employed by an entity with more than 15 employees are covered by the act, signed into law in 1990 to prohibit discrimination against individuals with disabilities. Divided court opinions make it less clear whether the act applies to independent physicians. A majority of federal circuit courts of appeals have interpreted the ADA to extend protection to medical staff members, and the AMA said that hospitals and other credentialing bodies can reasonably assume that the ADA is applicable to physicians whether they are employees, independent medical staff members or independent contractors.
It is, after all, the intent -- and often, the triumph -- of the ADA that erroneous perceptions about disabilities and challenges are not allowed to get in the way of an individual's ability to get the job done. The privacy provisions of that law are one of the safeguards that make the ADA effective in reaching its goal.
Physicians are, in many cases, making significant procedural changes to ensure the privacy of their patients' medical records and complying with the letter -- and the spirit -- of HIPAA. It is not unreasonable to expect that licensing bodies and credentialing organizations should recognize that physicians are also entitled to medical records privacy of their own and set about making sure they get it.
Copyright 2003 American Medical Association. All
rights reserved.
Additional information
Previously: Insurer wants doctors' own medical files