The Problem With Hipaa

From a patient care point of view HIPAA preserves the privacy of those within the health care system. It is necessary given the sensitive nature of the medical profession. For a physician, patient privacy is intertwined with the trust that is essential in the patient-physician relationship.

At the same time, HIPAA robs the patient of his or her identity. Violia Freeland becomes VF or "63 year old Caucasian female" when I try to describe her to someone else. The absence of the name reduces the subject into a collection of symptoms and attributes, many of which aren't particularly unique, but all of which together, forms a unique narrative and a special individual. It is within a person's name that everything becomes attached- chief complaint, history of presenting illness, past medical history, social history--all of this becomes significant because they comprise parts of this person's narrative. This is why the name is important; because without it, I must try to make sense of a faceless entity. Perhaps this is why so many medical students like reading cases instead of textbooks because instead of an outline of factoids, we are reading a vignette, a discussion about a story, how this story relates to others (a differential diagnosis) and a treatment that pertains to this specific case.

As this M3 year draws to a close, I find myself thinking about the many patients I came across throughout the year. I realize that there are many patients that simply became faces in a sea of daily activity and yet there are others whose names and stories will remain with me for quite some time. It comes to me as no surprise that I often have names to attach to the latter. This isn't to say that the former were insignificant experiences--there is still much value in them yet--but when it comes down to the core of medicine, I believe that there is a significance to beginning with a name, a face, a history before the physical. While the lab work and imaging studies receive much of the attention, money, and publicity when it comes to health care, I have to remind myself that the reason why I decided to stick it out this past year was because I hope to one day assist the Leonard Andersons, William Hartwigs, and Suzanne Bowens, to continue living their lives, no matter how long or short their narratives may be.