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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by Deborah14 on October 22, 2000, at 23:30:55
I am new to this website. I have found the website extremely informative, helpful and fascinating. I know that you have probably heard this all before and I know the disclaimers are on the site. However, I can't help to be extremely concerned about people's, including my own, medical privacy. It seems too easy and too tempting to reveal too much detailed private medical information to strangers on this website.
Specifically, there are two areas I am concerned about.
1) In order to preserve one's medical privacy one should not discuss their medical diagnosis,especially in detail, on-line. Please be careful about identifying yourselves. You do not know who can and will use this information to their advantage against you - insurance companies, medical information bureaus, pharmaceutical companies, companies that buy and sell mailing lists, and yes even the government- just read the fine print in the Kennedy-Katzenbaum bill (HIPPA) that was approved by HHS. I am not being paranoid, definitely not one of my issues, just smart. This is an area of my expertise. It you want more information contact the Coalition for Patients Rights (CPR). Remember, even dr. bob warns that anything that is written on this website, he can use.
2) It is very important that lay people who are receiving and exchanging psychopharmacological advice with each other be extremely careful - especially on acting on advice without consulting with their pdocs. Unfortunately, many of us have not had good experiences with the medical advice we have receive. Our pdocs don't have all the information, aren' t gods and some are better than others. Many of us are suffering and have suffered for a long time and are seeking information and non-traditional help because it seems that all else has failed. That is one of the allures of the site. However, on the flipside, many of us have very complicated, long medical histories and by maintaining our medical privacy, we are receiving information that is based on only a fraction of what can and should be revealed. Therefore, I would advise from the little I learned so far. Take the information you've received, do your own research and talk with your pdoc or get another professioal consultation before acting on anything you read on this site. We all have too many medications in our medicine cabinets that when used in combinations different than how they were prescribed orginally, could be lethel.
I hope I don't sound like I'm preaching, I'm just concerned about keeping a balance between maintaining medical information privacy and learning new helpful information that may or may not be useful to anyone of us individually.
Thanks for listening.
Posted by stjames on October 22, 2000, at 23:54:21
In reply to Privacy Concerns, posted by Deborah14 on October 22, 2000, at 23:30:55
If you use an HMO or file insurance your informantion
is shared and given out to lots of people. Insurance companys do share this info.
This is why many doc's put as little as possible in the chart. Only when you pay
the doc, in private practice, do you have rock solid privacy.In general I think it is a bad idea to use your name as an e-mail
address.james
Posted by coral on October 23, 2000, at 5:23:09
In reply to Re: Privacy Concerns, posted by stjames on October 22, 2000, at 23:54:21
If a person is curious as to what medical/psychological information is available about them, they can write the Medical Information Bureau (MIB) and receive a copy. Sadly, this information is WAY too available to too many people.
Posted by chdurie2 on October 23, 2000, at 12:20:18
In reply to Re: Privacy Concerns, posted by coral on October 23, 2000, at 5:23:09
> If a person is curious as to what medical/psychological information is available about them, they can write the Medical Information Bureau (MIB) and receive a copy. Sadly, this information is WAY too available to too many people.
Coral-how do you write or e-mail MIB for this medical/psychological info?
thanks- caroline h.
Posted by Bob Day on October 23, 2000, at 13:06:37
In reply to Re: Privacy Concerns: Writing MIB? » coral, posted by chdurie2 on October 23, 2000, at 12:20:18
> Coral-how do you write or e-mail MIB for this medical/psychological info?
> thanks- caroline h.Caroline,
I just happened to have the same interest earlier today so I found the MIB web site.
If you live in the US, you can either obtain a PDF version of the MIB's "Request For Disclosure" (Form D-2) from the following URL: http://www.mib.com/consumer/about_usres.html
If you have trouble downloading the form you can request a copy from the MIB via the following email address: mailto:disclosure@mib.com
Canadian residents can request the disclosure form by sending an email to mailto:canada_disclosure@mib.com
...or by contacting the MIB at:
MIB, Inc.
330 University Avenue
Toronto, Ontario
M5G 1R7
tel. 416-597-0590
FAX 416-597-1193Once you print / receive the form, fill it out, sign it and mail it in to the appropriate address (US / Canada) along with a processing fee ($8.50 for the US).
As well as the D-2 form, the MIB site contains a good deal consumer info regarding the MIB and its operations. The main site URL is: http://www.mib.com/
Yours,
Day
Posted by coral on October 23, 2000, at 13:11:02
In reply to Re: Privacy Concerns: Writing MIB?»chdurie2, posted by Bob Day on October 23, 2000, at 13:06:37
The url for MIB is: http://www.mib.com/consumer/about_general.html
Day did a much more complete job of providing information. Thank you!
Posted by Deborah14 on October 23, 2000, at 18:59:42
In reply to Re: Privacy Concerns: Info on MIB, posted by coral on October 23, 2000, at 13:11:02
The MIB only contains information from the records of disability or life insurance companies. The MIB does NOT contain any information that medical insurance companies, hospitals, HMO's, etc. have within their databases. If you have applied for life or disability insurance, did not reveal your medical history in full on the application and your entire medical condition is not diagnosed as a result of the physical the carrier's doc performs on you, your complete medical history will not be in the database of the MIB. However, this does not mean the information doesn't exist on many other databases that are open to abuse.
One of the most incidious practices that is occuring presently is the sale by large drugstore chains of certain customer lists that contain the names and exact prescriptions of users of certain drugs to pharmeceutical companies. Caveat Emptor!
Posted by Greg on October 23, 2000, at 20:07:02
In reply to Re: Privacy Concerns: Info on MIB, posted by Deborah14 on October 23, 2000, at 18:59:42
Deborah,
Can you be more specific about the other databases that are open to abuse? No offense meant, but that comment was a little vague.
I contacted my pharmacy after reading your post and they assure me that it is against the law for them to provide any information about me or the meds I use without my written permission to anyone other than my doctors and my insurance company. One rule of thumb for me is to always read what you sign before doing so.
Greg
> The MIB only contains information from the records of disability or life insurance companies. The MIB does NOT contain any information that medical insurance companies, hospitals, HMO's, etc. have within their databases. If you have applied for life or disability insurance, did not reveal your medical history in full on the application and your entire medical condition is not diagnosed as a result of the physical the carrier's doc performs on you, your complete medical history will not be in the database of the MIB. However, this does not mean the information doesn't exist on many other databases that are open to abuse.
> One of the most incidious practices that is occuring presently is the sale by large drugstore chains of certain customer lists that contain the names and exact prescriptions of users of certain drugs to pharmeceutical companies. Caveat Emptor!
Posted by Deborah14 on October 24, 2000, at 0:20:09
In reply to Re: Privacy Concerns: Info on MIB » Deborah14, posted by Greg on October 23, 2000, at 20:07:02
Greg:
If you would like, I'll elaborate further in a later post. However, in the meantime, please see the case Weld and Kelly v. CVS Pharmacy, Inc., Elensys, and Glaxo Wellcome, et al., which is now a class action certified in Massachusetts.In addition, most health insurance carriers in the United States now employ what are called Prescription Benefit Managers (PBMs) such as PharmaCare, PCS Health Care Systems, Inc. and MedCo. What is extremely troubling is that PCS Health Care Systems is owned by Eli Lilly and Medco is owned by Merck. The following are examples of medical privacy abuses that have occurred within the past couple of years:
1) The PBM that is contracted by the health insurance carrier receives copies of the patient's medications from the insurance company who reimburses the pharmacy for the prescription. Then the PBM contacts the patient's physician directly and advises the physician that their patient does not meet the criteria to receive the drug and that the doctor must stop prescribing the medication or taper the patient off the prescription. The doctor is then requested to fill out a form, sign it and send it back to the PBM indicating what course of action they are going to take. (see case of Dr. Louis Halfkin, a psychiatrist at Harvard Pilgrim Health Care of New England and PharmaCare)
2) In the case of Merck and Eli Lilly, they were receiving information from their corporate owned PBMs, Medco and PCS Health Systems, Inc. about patients who were being prescribed competing pharmaceutical company's medications. The prescribing physicians were then receiving calls from the PBM compliance agents who were falsely identifying themselves as the patient's pharmacist and requesting that the doctor switch the patient to the competing drug companies medication (i.e. medications manufactured by Merck or Eli Lilly). Hubert H. Humphrey III, attorney general of Minnesota, lead a 17 state consumer protection settlement with Merck and Eli Lilly to amend these practices. The practice affected 41 million Americans.Have you ever received a letter from the PBM contracted by your health insurance carrier saying they will no longer pay for a particular medication your have been prescribed and that your physician will now has to switch to an approved medication from their list. I have. How do you think the PBM knows what medication you are taking? They know because in order for your pharmacy to be reimbursed for the medication your physician has prescribed and in order for you to have to pay the pharmacy only a copay for purchasing that medication, the pharmacy must reveal to your insurance company, many times through the PBM, that information. That is exactly what the computer is doing everytime you go into your neighborhood CVS, Walgreens or RiteAid, etc. The data is being transmitted to the PBM. Have you ever gone into the pharmacy early to refill a prescription because you have run out and the pharmacist has declined to refill the presciption. Primary Reason: PBM! The PBM is managing your health care, not your physician.
3) The worst abuse of this system is now with the purchase of pharmaceuticals offered on-line or through the mail through a PBM contracted by your insurance co. In return for lower prices, usually a 90 day supply for the same copay as a thirty day supply, your health care and medical records privacy is being managed and invaded by the PBM.What is especially disconcerting for people suffering from mental illnesses is that they often have worked years with their pdocs to find just the right combination of medications to controll their symptoms. Sometimes, the particular combination is very drug specific and there is no substitute in the same family that works as effectively or effectively at all. Never mind that the insurance company won't pay for therapy, but what happens when someone who doesn't know you and isn't a physician but rather a clerk who is reading from a list and spouting the insurance company's "party line" is telling your physician what medications you can or cannot take. This is occuring everyday in our health care system. It is occuring to manage costs and not illnesses. Patients' medical privacy is being invaded when insurance companies through PBMs are entering computerized records under the guise of cost controls and prescribing medications in lieu of physicians.
Posted by shellie on October 24, 2000, at 0:25:10
In reply to Re: Privacy Concerns: Info on MIB » Deborah14, posted by Greg on October 23, 2000, at 20:07:02
Greg, I think it was about a year or maybe two years ago that some of the larger chains were selling lists of customers on certain meds to marketing companies. On the east coast the chain CVS was one. For instance, if you used insulin, they might sell your name to a company who sold products related to diabetes, who would then directly market you. When the practise became known publicly they stopped, but I don't recall that they were considered to have broken the law. I don't recall any class action suits, etc., which one would expect if what they had done was unlawful. I think it was more under the category of unethical, but I'm not sure why not unlawful. Shellie
Posted by stjames on October 24, 2000, at 1:57:18
In reply to Re: Privacy Concerns: Info on MIB » Greg, posted by shellie on October 24, 2000, at 0:25:10
If you use a credit card there is a chance your buying patterns
are sold to marketers. My HMO uses a 3d party to approve meds for
co pay. So there is another place my information is passed around.We had great privacy decades ago where you paid your doc in full, meds too,
and submitted the bills to your insurance. Now with HMO's your file is shared.
I came to the conclusion that in many cases privacy is an illusion. I spoke freely
to my pdoc back when I was paying the bill and no insurance was involved. I don't now
with the HMO pdoc. He also makes it clear he writes as generally as possible in my chart.James
Posted by Deborah14 on October 24, 2000, at 13:24:26
In reply to Re: Privacy Concerns: Info on MIB, posted by stjames on October 24, 2000, at 1:57:18
Shellie:
The case you are referring to is Weld and Kelly v. CVS Pharmacy, Inc., Elensys, and Glaxo Wellcome, et al. It now a state class action lawsuit certified in Massachusetts. You can find it on the web. For similiar types of issues read my post from today to AndrewB on this issue.
CVS even used private medical information of their own employees by obtaining the info through their PBM (Patient Benefit Management co.) Again see the case of Harvard Pilgrim Healthcare of New England and Pharmco discussed in the aforementioned post.
This is just the tip of the iceberg.
Posted by pullmarine on October 24, 2000, at 15:29:38
In reply to Re: Privacy Concerns: Info on MIB » Deborah14, posted by Greg on October 23, 2000, at 20:07:02
> Deborah,
>
> Can you be more specific about the other databases that are open to abuse? No offense meant, but that comment was a little vague.
>
> I contacted my pharmacy after reading your post and they assure me that it is against the law for them to provide any information about me or the meds I use without my written permission to anyone other than my doctors and my insurance company.There was an article a couple of weeks ago about CVS or Rite Aid (or was it both) selling information about patients and their meds to pfarmaceutical companies.
john
One rule of thumb for me is to always read what you sign before doing so.
>
> Greg
>
> > The MIB only contains information from the records of disability or life insurance companies. The MIB does NOT contain any information that medical insurance companies, hospitals, HMO's, etc. have within their databases. If you have applied for life or disability insurance, did not reveal your medical history in full on the application and your entire medical condition is not diagnosed as a result of the physical the carrier's doc performs on you, your complete medical history will not be in the database of the MIB. However, this does not mean the information doesn't exist on many other databases that are open to abuse.
> > One of the most incidious practices that is occuring presently is the sale by large drugstore chains of certain customer lists that contain the names and exact prescriptions of users of certain drugs to pharmeceutical companies. Caveat Emptor!
This is the end of the thread.
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