Strictly Confidential, a Guide to Privacy Practices

A patient should not have any reservations making full disclosure to a chiropractor, who should not reveal information without the express written consent of the patient unless required by law. One change that has occurred in health care is the use and reliance on technology concerning medical records, privacy, and confidentially issues. Medical records serve as a basis of patient care for continuity in the evaluation of the patient’s condition and treatment. Records also document communication between the treating doctor and other health care providers who contribute to the patient’s care, and assist in protecting the legal interest of the patient and the doctor responsible for the patient. Restricted Access, although ethical principles are not legally binding, the courts have regularly ruled that health care professionals preserve confidentiality during the course of treatment. Courts have held that a doctor’s disclosure of medical information without patient consent constitutes a breach of an implied condition of the patient/doctor relationship or contract. Courts have also adopted an invasion of privacy theory, concluding that a doctor’s disclosure of medical information obtained in the course of treatment constitutes tortuous conduct. Patients also have a right to rely on the ethical standard of the medical professional as an expressed warranty of confidentiality. Legal and regulatory issues for release, privacy, and confidentiality of medical records.

Access to medical records should be made to the patient, the patient’s legal representative, and other health care professionals involved in the care and treatment of the patient. A legal representative is defined as: a competent adult appointed in writing by another competent adult, a court appointed representative, the parents of a minor (except with regard to pregnancy or sexually transmitted diseases), and a personal representative of an estate (not necessarily next of kin). If there is a will, then a personal representative appointed by the courts; when there is no will, then next of kin or a personal representative.

There are exceptions to access medical records and confidentiality. In workers’ compensation, the employer and insurance company are entitled to relevant records. A subpoena, but not for super confidential records, must have a seal of the clerk of the court who issues the subpoena or the Agency for Health Care Administration for investigations. In an emergency medical treatment governed by state law, always try to obtain patient’s consent. This would relate to any chiropractor that renders aid outside his or her office under the Good Samaritan Laws. If the chiropractor acts in good faith in an emergency situation, the chiropractor does not need consent and should not be concerned about obtaining medical information, as this will delay emergency care.

Super confidential records cannot be released except with the patient’s consent. Super confidential records include: in some abortion/pregnancy cases, HIV/AIDS, drug and substance abuse, alcohol abuse, psychotherapy, mental health, psychiatric, and genetic testing. In these types of records, a court order signed by a judge is generally required. In most state statutes regarding patient records release, a patient can consent in writing to the release of his or her medical data. Many states do not allow a patient to revise or alter the authorization. Some states provide a more stringent requirement and different release forms for the release of sensitive or super-confidential information.

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