HIPAA-HOPAA
Robert E. Horseman, DDS
We’ve been looking the Health Insurance Portability and Accountability Act (HIPAA) over very carefully. We took an impromptu survey of our patients to ascertain their interest and understanding of the issues involved. The mandatory dozen pages of fine print explaining exactly what those issues are were initially met with wooden incomprehension. The Legalese-to-English Conversion pamphlet explaining the explanation proved to be invaluable, however, giving the evening office cleanup crew something useful to do.
I know we are not alone in our appreciation for a beneficent government that devotes so much time and money dedicated to furthering our best interests. The typical response from patients has been an enthusiastic, “Huh?”
Our only regret is that this privacy issue took so long to be addressed. Years ago, two patients who were genetically programmed to hate each other on sight, met quite by accident in our reception room. When this encounter left the area frigid enough in which to hang meat, we realized privacy had become our top priority next to departing the premises at 5 PM.
An ensuing incident clinched our decision. It has been our custom over the years to tape a day sheet to the operatory wall indicating who is scheduled and what the appointment is for. Not liking surprises, this precludes demanding the seated patient to state clearly who she is and what she wants, a request that annoys some people who unreasonably feel we should know these facts in advance.
Mrs. Farrah Noya, age 47, height 5’ 6 ½”, weight 149, chemically-processed hair and with other possible surgical enhancements, notices the day sheet upon dismissal. At 10:45 AM, according to the sheet, a certain Shania Schwartz, divorcee, age 39 (unconfirmed), height 5’ 4.5”, weight 124 (also unconfirmed), 36-26-48 (ha!), usually encased in a K-Mart knockoff frock and Revlon’s entire line of cosmetics, is due to have an lower cast partial seated.
In what we now acknowledge as a blatant breach of privacy, the day sheet plainly states: 10:45, Schwartz, Shania, seat PLD. Espying this, Mrs. Noya blanches, clutches her bosom as if in cardiac arrest and visibly shaken, flees the office without pausing at the front desk for her free sample of Listerine’s FreshBurst PocketPak.
Within 48 hours, everybody in town knows of Shania Schwartz’ oral falsies, the grapevine extending as far away as Nebraska. As a result, the following transpires:
1. Ms. Schwartz, privacy compromised beyond salvation, leaves town hurriedly, leaving no forwarding address. Her family believes she is headed for McMurdo Station, Antarctica because she takes her muk-luks and a change of Victoria’s Secret thermal briefs with her.
2.
Our office, fearing litigation of monumental
proportions, immediately implements comprehensive privacy strictures. The
Schwartz records are expunged from our files, her new partial is destroyed,
observing meticulously all EPA, OSHA, FBI and HIPAA rules involving disposal of prosthetic
appliances, metal/acrylic, vol.9, sect.4 application 32 between 0345 and 1610
Zulu.
Noting the successful application of the government’s Witness Protection Program, we now have a Patient Protection Program implemented. Patients upon dismissal are issued a paper sack with eye holes to wear while they descend to the parking lot via a firepole installed adjacent to the chair. They are instructed not to return home for 48 hours and then by a circuitous route, speaking to no one in transit.
Our staff now speaks only in whispers using a code devised by Navaho Indians. The day sheet looks like this:
XXXX A.M. XXXX, Mr. XXXX
Electronic submission of claims that held so much promise initially, but evolved into a veritable blabbermouth of privacy invasions, has gone by the board.
We are presently using a barter system, negotiating our services for usable items like quilts, costume jewelry and the occasional chicken or small pig.
NOTE: All of the above is to be held in strictest confidence and should you reveal the contents thereof, you will be terminated (HIPAA, p. 93, vol. 7, line 16).
Originally published in the Journal of the California Dental Association, 09/03.