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Doc: Polite chitchat can cross privacy violation line

November 6, 2018

Dear Dr. Roach: I share some of the same providers as other family members, and occasionally I will get from a support staff person: “We just saw your family member last week” or “How is your family member doing”? But sometimes there is a slip from the provider themselves: “Well, you know this runs in your family.” My worst experience came from my family doctor’s nurse. I went to my family member’s house and was specifically asked: “Did you get linked up with that new specialist and get your meds?” I stood stunned. After inquiring, I was told: “Oh, I was at the doctor’s office last week and his nurse told me about how frustrated he was with getting you linked up. Did he get it done?” This is an ongoing pet peeve of mine, and I feel that my privacy is violated.

H.W.

Dear H.W.: Your privacy has been violated, and you are right to be upset. A medical professional discussing your medical issues with a family member without your explicit permission is a breach of medical ethics. The Health Insurance Portability and Accountability Act allows your physician to use his or her best judgment about notification of family members, but it seems to me, based on what you are telling me, that he should not have shared your information. If you had objected to sharing your information, what he did would have been a clear violation of the law.

If you still wish to continue with the same provider, you should make your wishes for your privacy clearly known. You shouldn’t have had to do this, but that is an option now. You also may want to have a different provider from the rest of your family. I have patients whose family members have chosen different primary care doctors for the sake of privacy.

Dear Dr. Roach: Since the invention of the television, in my opinion, we have become a more sedentary society. With the proliferation of video games, smartphones, computers, tablets, etc., it seems to me that the problem has only gotten worse. Has anyone considered the greater increase now of online shopping as another example of the lack of exercise? I mean, even walking through a store must have some benefit.

N.M.

Dear N.M.: I agree screens have had a big impact on overall physical activity and are part of the cause of obesity. Shopping isn’t an issue I have seen mentioned, but I think you’re right it is another part of the issue. Also, I worry all this screen time has made in-person connections less common, leading to greater personal interactions, but less-meaningful ones. This may have an implication on overall health.

On the other hand, the Pokemon GO was estimated in a scientific study to increase physical activity by 25 percent in users, a total of 144 billion extra steps in the U.S. over six weeks. So it is possible for smart devices to improve activity.

Email questions to ToYourGoodHealth@med.cornell.edu.

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