Wednesday, May 13, 2015

Top secret

Dr. Grumpy: "Hi, this is Dr. Grumpy. You guys referred Mrs. Spazzo to me, and I'd called earlier to have her most recent labs faxed."

Ms. Desk: "Yes, I sent them over a short while ago."

Dr. Grumpy: "I got them... but there's no lab results here. It just says they're 'abnormal'."

"How much more helpful can it get?"

Ms. Desk: "Well, that's because they're abnormal."

Dr. Grumpy: "Okay... but this doesn't tell me what's abnormal. Or even if they're high or low. The CMP has roughly 10-15 different things on it. Which ones are abnormal? Or is it all of them?

Ms. Desk: "Well, you're not the ordering physician. I don't see why you need more information."

Dr. Grumpy: "Because I'm trying to figure out what's wrong with the patient, and knowing which of her labs are off would help me. A lot."

Ms. Desk: "We have to protect patient privacy."

Dr. Grumpy: "But you referred the patient to me."

Ms. Desk: "Obviously, that was a mistake."



Loki said...

So, were you supposed to order your own, duplicate, labs to be able to see the information? Or are you simply supposed to diagnose via voodoo?

The one is the sort of thing that drives up healthcare costs without affecting outcomes at all, and can leave the patient on the hook for the lab costs if they get denied by their insurance/Medicare - so that's bad. Voodoo medicine has a horrible outcome ratio - which is worse.

And so from Ms. Desk's POV you're the problem here?

/me headdesks

Heidi said...

Ms. Desk is not well suited for her job.

Aunt Murry said...

Wow...just wow.

Anonymous said...

Ms. Desk has probably been so frightened by her administrators re HIPAA violations that she is afraid to give anyone information. One part fear + one part poor understanding = the situation we see here.

Carolyn said...

I really hope you had a conversation with the doc or office manager about Ms. Desk - that's pretty outrageous and her snide comment before hanging up on you was way over the line. I don't need some power hungry psycho hamstringing the doctors who are trying to treat me - her ego (or laziness or whatever made her so obstructionist) has no place in my care!

I've worked as a dental receptionist and as an office manager in the same practice - I would never have treated ANY caller the way Dr. Grumpy was treated on the phone when I was answering the phone (if I was unsure whether or not I could send more detailed lab results I would have asked my office manager or the doctor!) and I would have fired a receptionist I had overheard speaking like that to anyone when I was office manager. There is no place for that.

Packer said...

Ms. Desk just hit the lottery and could give a shit about anything at this point. I kind of think you all would have picked up on that. People have been fired and laid off so often in the past few years that the prospect no longer scares anyone.

Hannah said...

I work in a pre-anethesia clinic and we request records all the time. I run into these roadblocks occasionally. The last one was a 90 year old who lived 5 hours away. I spoke with the pt on the phone, then sent an ROI for the results of some testing she had done to see whether she needed to make the trip in to be seen by us. Medical records demanded the patient's signature on the ROI despite the fact that the records fall under a continuation of care. Trying to rationalize with the woman was pointless. So I sent another ROI the next day and whichever medical records personnel happened to pick it up faxed the info back to me. Sigh.

PGYx said...

My former dentist's receptionist told me that she couldn't fax me payment records from my visit because it would violate HIPAA. I set her straight and got the record, but she clearly hoped to use the HIPAA-shield to justify her profound laziness.

Once tried and failed to get lab records from the fortress that is NY Presbyterian. The patient signed two separate releases and called them personally in my presence, but they refused for multiple reasons including that I was not the ordering provider. Our staff spent over 2 hours on the phone with 6 NYP records folks trying to get records. Never got them and had to repeat them all.

Great staff like Mary make doctoring possible.

Anonymous said...

Well, Dr. G... clearly this shall we say, difficulty, with Ms. Desk- just doing her job, let's just all concede that right up front- in all her diligence, as gatekeeper of state secrets great and stems from some of the- shall we say, choices- made by Ms. Desk regarding this matter. But couldn't we all benefit (as all health professionals, together) if you too would concede your plain and obvious failure to use the 'magic word'? Hmm?


Mage said...


Anonymous said...

I work in a (private) imaging department. TheCollege of Phys & Surgeons in our province insists that we obtain clinical follow-up on suspected pathology cases. You would not believe the roadblocks we run into !! FFS, they sent the patient to us in the first place.

Laura said...

Yes... sometimes people are just starting a job and don't know where the line is between actual private information and stuff you should give out to people who have credentials.
I work in an investment firm, and there was one day I needed a company's address so I could send them an application, and they wouldn't give me their address unless the client was also on the call. The address to send the app to. That's not ever classified information. I was trying to give them money.

Sue Denyhm said...

Here in Australia, you would have been able to just call the lab and get the results from them, provided you knew which lab did the analysis/report. Of course you need to have the patient details, a provider number given by the government and unique to every dr in the country, and also possibly a seperate password provided to you from the lab. This is to prevent just anyone from being able to access the results.

Anonymous said...

Nnnnngh. It happens in vet clinics too. The privacy law was recently changed here (late last year, I think) to say that the owner of the pet has to be the person to tell Clinic They're Leaving to send their pet's medical records to Clinic They're Joining.

Two out of the three clinics in my small town haven't bothered, and have carried on doing things as we've always done - that is, if something turns out to be a second opinion at Clinic B, the receptionist will e-mail the receptionist of Clinic A while the owner is in consult, A will send through the records immediately, and they will pop up on the vet's computer in the consult room within a few minutes.

Except for Clinic C. The boss of Clinic C - out of sheer pettiness, we suspect, since he's always accusing us (A and B) of poaching his clients - will not let medical records be sent without instruction from the owner, and threatens to report our clinic for violating the Code of Conduct if we see one of his clients as second opinion without getting those records first. Resulting in the very awkward situation of the owner having to phone Clinic C in the waiting room and request the records, and Clinic C then asking all sorts of questions about WHY they are leaving Clinic C.

I got a little sidetracked there...but I wouldn't be surprised if Ms. Desk here has a Clinic C boss breathing down the back of her neck making things difficult like that.

Library-Gryffon said...

HIPAA has done nothing beneficial for health care, at least as far as this patient can tell.

My sister-in-law went into UVA about 10 years back for an outpatient gamma knife procedure for an aneurysm. When my niece-in-law called to find out when she could pick up her mother she found out she was having open brain surgery. Being a very, very poor candidate for general anesthesia (overweight, COPD, etc., etc.) SIL had a stroke on the table and came out in a persistent vegetative state.

NIL was never, ever able to get anyone to tell her why the procedure was converted, and they would not let her see her mother's medical records, although she was the medical proxy of record. They would only release the records to another medical provider, and that required paying the $1 a page copying fee. If I'd had the money I would have had them sent to my father, since he is a doctor (PhD in a hard science) and you know they would never have bothered to check an out of state license.

We've always wondered if we shouldn't have threatened a malpractice suit.

And six months later, SIL came out of the permanent vegetative state we had been told she would never, ever come out of. She enjoyed another two years with her family.

migraineur said...

I work in a call center for one of the major US labs, if you just call us, confirm you're a medical provider, and that the pt is in your care, we will send you the records. It's less tricky if you already have an account with us, but we do it either way. Then you don't have to deal with the referral doc sending over a scanned copy of a faxed document that they've redacted info from

RehabNurse said...

I know! You need a crystal ball, so you can just look at the paper and know what the values were.

Treating a 12 HgbA1C is just exactly the same as a 5, isn't it?

OMG...HIPAA gone mad.

rapnzl rn said...

Epic Gatekeeper FAIL. Enabled by HIPAA, sadly.

Horrendously sadly. Argh.

Loren Pechtel said...

I wouldn't say HIPAA is totally useless. Back in college I gave up on the idiot doc at student health and didn't bother to correct an incorrect conclusion he reached--I realized there was no point to a future visit and thus I didn't care.

Hassles came when he provided that incorrect conclusion to a teacher.

Anonymous said...

Desk is not her last name, but her first name. Her last name is Dragon. Yes, you have encountered a Desk Dragon. They are legion.

Arzt4Empfaenger said...

Wow, what a sweetie-pie!

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