DIRTY LAUNDRY

24 March 2002

It's an interesting position to be in, the position I have. For something like twenty years I have worked typing medical, psychological and psychiatric reports. This is a relatively small town, and most people get their health care from local physicians. For many years I was a roving transcriptionist, going from office to office and filling in when the regular transcriptionist was on vacation. Next, for ten years I transcribed in the most popular ob/gyn practice in town. Then I managed that office. Now I manage a smaller office.

On CNN or one of the news services this morning I heard a heated debate about legislation to insure the confidentiality of medical records.

Don't be fooled. There ain't no such thing as medical confidentiality. No matter what laws they pass, no matter how strict the rules and regulations, there is no way on earth that your medical record can remain strictly between you and your doctor. The best way of making certain that records remain confidential is for the doctor to do all of his own typing, all of his own filing, learn to use a computer and keep every single record under a password, or lock and key. That ain't gonna happen.

This doesn't mean that there is a lot of tittering over the water cooler about Mrs. Smith's "little problem," or the story that the Jones family is telling people about their daughter's sudden vacation. I take the issue of confidentiality very seriously and in all the time I have had medical records pass through my hands, whether typing reports, or filing, or looking up information, I have never even been tempted to divulge the slightest thing about someone that I know, even when that information affects something that someone else might be doing.

Maybe it's having grown up in the Catholic church, where the "seal of the confessional" is sacrosanct.

I really try to "forget" things as soon as I type them. But still it's an interesting situation to be in to "know things" about people who have no clue that I am privy to their innermost secrets.

If there is a plus side for me, it's learning that no matter how "together" a family appears in social situations, no matter how lofty their reputation, things are not always necessarily what they appear to be on the surface.   It makes me feel better about some of our own shortcomings.  (I once heard a great quote:   "we are always comparing ourselves at our worst to everybody else at their best."  Think about it.  It's true!)

A family I remember from years ago when our children were all in school together has been going through hell with an adult child (once a child I knew well) who has been in and out of mental institutions and has decompensated to the point of being non-functional much of the time. I still see the mother from time to time. I'm always careful not to ask "how is your family?"

I know the criminal records of a lot of people who may have been involved in petty crimes, so it never makes the papers, but when we meet at the farmer's market, or downtown at Baskin Robbins, I know.

There was a time when I knew of the extramarital affairs, sexually transmitted diseases and drinking problems of a lot of people I'd meet at PTA meetings.

A friend I saw quite often during a period of time in the last 20 years would be mortified to know that secrets that should have been kept secret were dictated into a machine and transferred to me to transcribe. Try as I do to forget, still the first thing that goes through my head when we meet is "I know that little quirk of yours."

I have to admit that I think about this a lot when it is my turn to go to the doctor. I run information through my head--what would I not mind making known if a friend of mine transcribes this report? It is, I have to admit, one of the things that kept me from going to see a doctor for so long. The medical group to which I belong occasionally sends its records out to be transcribed by a company I used to work for. I know how the records arrive, and the weight is always printed on the top of the forms. I didn't want my former co-workers to know how much I weighed--even if I rarely see them these days. Fortunately, I am able to pick and choose--if I need to discuss something very private, I make sure I go to a provider for whom I am the transcriptionist!

You have to know how to work the system.

And be able to transcribe medical records!!

Olivia and I were supposed to go on our first bike ride on Friday, but the weather did not cooperate.  It has been raining for two days, but it is predicted to be sunny tomorrow, so we're going to try for then.  I'm all set.  I bought myself a rack so I can carry the bike on the car, and yes, Terri, I bought gloves.    We're taking a page   from Terri and David's book and spending the day of our first ride at the Alameda Naval Air base, which, as Terri describes it has "No traffic to speak of. No hills or bumps. No innocent pedestrians for me to run down."  Terri just completed her first 30-mile ride, a mere 11 months after her first wobbling attempts so I feel there is hope for me (though I don't expect to be doing as much biking as she has done in the past year)