201612-Edwards-Smith-Chad-Mr-Nov16

While colleagues often discuss cases with each other, remember, WA’s a very small place.

201612-network-socialising-chatOver the party din, Maureen clearly heard him say: “… and she comes to me to complain about shortness of breath and low exercise tolerance. The woman is 120kg plus and clearly isn’t in any shape to be tackling the Rottnest Channel Swim! So I tactfully suggest she might first lose a bit of weight and recommend some lifestyle changes. But then she starts lecturing me about my weight and starts asking about my diet. Apparently she’s a dietician, if you can believe it, and suddenly I’m copping a serve from my patient about my lifestyle!” There’s laughter all round.

Maureen wonders whether he might be talking about her friend Alice – a dietician and once an avid swimmer. Last time they met, Alice had certainly put on a few kilos but she didn’t know she was planning to compete in the Rottnest swim. She’d try to catch up with her on Facebook and ask.

A few weeks later a doctor contacts the our advisory line: “Someone’s complained that I’ve breached patient confidentiality. But it wasn’t like that, all of the people I spoke to were actually doctors, and I was only trying to get some feedback on a difficult case. I never mentioned any names! Surely I can do this? After all, we’re all doctors, and we all share a duty of confidentiality don’t we?”

While doctors (and healthcare providers generally) routinely disclose confidential health information between themselves for the purpose of facilitating the patient’s healthcare, this ‘sharing’ of information is permissible, not because the conversants are doctors or healthcare providers, but because of the purpose of disclosure.

The Privacy Act (1988) allows for disclosure of sensitive health information where:
•    the disclosure (secondary purpose), is directly related to the reason that the patient provided the information in the first place (being the primary purpose – which is usually to enable treatment); and
•    the patient would reasonably expect that their information would be disclosed in such circumstances.

A well-recognised situation of disclosure is where healthcare providers share information to facilitate the patient’s care. This would include a GP liaising with a specialist, or a registrar taking advice from a senior colleague as to the best treatment.
This part of the Privacy Act enables the healthcare system to work, without the need to constantly obtain the patient’s consent for each and every interaction between healthcare providers.
Doctors may feel the need to vent about their day but any disclosures regarding patients should be limited to completely de-identified scenarios – remembering it is not enough to merely refrain from mentioning names.

So remember, when it comes to disclosing confidential information among colleagues:
•    The common duty amongst doctors to maintain patient confidentiality does not mean that doctors can indiscriminately share patient information.
•    Any disclosure between colleagues needs to be for the purpose of facilitating the patient’s care. De-identifying a case involves more than just omitting the names (particularly in Perth).( Refer to the OAIC Guidelines on de-identification of data and information
ED: Chad is head of Avant’s Medical Defence Services (WA)

 

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