Doctors are of course ethically bound not to divulge their patients' medical histories in any way other than through accepted medical and legal channels.
And there are of course strict laws governing this process.
But what happens when patients
prefer not to share with their doctors certain medical events in their own personal medical histories, for various reasons, despite the doctor-patient relationship, the promise of confidentiality?
What if a woman doesn't want her doctor to know that she had an abortion once? Or another person that he was once treated for an illegal drug habit? Or another who is ashamed to reveal that he has an alcohol problem? So they all say nothing.
Of course patients should realize that doctors have "seen it all," and are unlikely to be shocked or offended by almost anything appearing in a patient's record. But some patients are still unsettled by having certain things available for view in their medical records, regardless of who sees it.
The article linked below addresses this issue.
Highlights from its discussion:
"Today, patients do have to give permission for doctors to share their records with other health providers. But usually that permission is all or nothing, applied to everything in the record."
"The question is whether some systems might offer patients the option to determine which health professionals they want to have access to their electronic medical records and to what parts of that record."
"(a test system) allowed patients to hide some of their health data–say their reproductive health history, or their use of antidepressants– from certain kinds of doctors, like a podiatrist."
"Given the option, 49% of the 105 patients who participated decided to withhold at least some information from their doctors. Four patients went so far as to withhold all of it, meaning every time they saw a doctor, they’d start with a clean chart. Every single patient, even those who wanted doctors to see all their data, said they wanted to be asked."
"In today’s lawsuit-driven world, most doctors, nurses, and others in the clinic were not as enthusiastic about not having all information available to them. Some were fine with it, if it was the patient’s choice, but others strongly objected if it meant they may not be providing the best possible care."
“There’s this tension between patients having confidence that the information about them is not going to be leaking and having control over it, versus the health care providers, especially the physicians, who can’t practice high-quality care without all the information.”Of course a patient may choose simply not to disclose to the doctor a certain medical fact in his history, so the doctor never learns of it, but if the truth is found out later, the patient may eventually face his doctor, now exasperated, and asking the patient why he, the doctor, wasn't told about
this fact to begin with. It might even have been something that could have had a major impact on the treatment of the patient.
I would imagine, or at least I would hope, that most patients are honest and straightforward with their doctors about
their medical histories, all of it, and sharing of it never becomes an issue for them.
But when there is equivocation of this sort on the part of the patient, the consequences might just be very serious.
OTOH, are there genuine gray areas, matters, some even of a medical nature, which are not essential for a doctor to know? And the patient chooses to withhold this information?
But it may be a risky choice on the part of the patient, who may wind up not telling the doctor something which is fact important.
Thoughts?
https://www.fastcompany.com/3042699/many-patients-would-like-to-hide-some-of-their-medical-histories-from-their-doctors