Without the assurance that whatever you tell your physician will be kept confidential, there would be no trust, and you would hold back important information that your physician may need to give you the best care and most appropriate advice.
In turn, your physician trusts that you provide all the information needed to understand your situation and make a correct diagnosis.
Physicians are taught to accept without judgment all that their patients share, including excessive drinking, smoking, the use of recreational drugs and other risky behaviour. Of course, we are rooting for them to make the best choices for their health and prepared to offer support for them to make positive changes.
Be aware however, that our profession requires us to appropriately document all important information even if you would prefer it to be “off the record.” Your medical record must be complete.
Doctors cannot reliably remember everything you tell them, and information about your history and habits impact on your risk for potentially dangerous drug interactions and serious conditions such as sleep apnea, hypertensive crises, strokes, cardiac arrhythmias and heart attacks.
In your usual medical care, who else may see some parts of your medical record?
The nurses or medical office assistants who assist your physician may access your records but are also well versed in confidentiality. They will look at those portions of your record necessary for them to perform their work. If a family member inquires on the nature of your recent visit, they will not disclose any information without your permission. In fact, they understand that they cannot even confirm with parents the recent appointments made by mature teens.
When teens are capable of making their own health decisions, doctors should have a frank discussion with the family clarifying respect for the mature child’s confidentiality and autonomy. If this is not clear, parents may continue to make inquiries about their teen’s health without permission and teens may attend a walk-in clinic instead of their family physician’s office.
Other physicians who share in your care may have access to a portion of your records. This includes the physicians who belong in your doctor’s call group, doctors who are covering when your doctor is away from the office and specialists to whom your doctor refers you.
When you are injured in a car accident or applying for insurance, you may sign a consent for the release of your medical records. You should read carefully and ensure that you understand what information has been requested.
If you are injured at work and have a Worksafe claim. Medical information pertaining to this may be released to Worksafe. The same applies to ICBC claims.
There are two cases where confidentiality may be breached without your consent. If you were suicidal or homicidal – at real risk of harming yourself or others, your physician may inform others (e.g. police, family, psychiatrists) in order to protect the life of yourself or another. The other exception is a court order – where a physician is required by law to produce your medical records.
With these facts in mind, you can trust that your physician will respect your confidentiality, and you may share crucial information about your health with confidence.
On Monday, June 2nd, I’ll be speaking at the Metrotown branch of the Burnaby Public Library on “The Patient-Doctor Relationship: making the most of each visit with your family doctor.” For more information, please phone the Metrotown branch at (604) 436-5400 or register online at http://www.bpl.bc.ca/events.
Dr. Davidicus Wong is a family physician at PrimeCare Medical. His Healthwise column appears regularly in Now newspapers and the Vancouver Courier.