privacy laws and doctors

[bluesubaru]

so assume a person whom is a friend of mine did a suboxone detox program (voluntary) and then went to a pain management doctor and was seeing this pain doctor (legit pain issues) for several months, everything going well...

...could the holy roller doctor at the treatment center cause problems for this person happily existing, seeing a pain doctor and would this individual have any legal recourse in preventing this said doctor from causing problems with new pain doctor?

[Dances with Smack]

so assume a person whom is a friend of mine did a suboxone detox program (voluntary) and then went to a pain management doctor and was seeing this pain doctor (legit pain issues) for several months, everything going well...

...could the holy roller doctor at the treatment center cause problems for this person happily existing, seeing a pain doctor and would this individual have any legal recourse in preventing this said doctor from causing problems with new pain doctor?

In this hypothetical scenario, it would be likely that the PM doc would find out about the subs before he agrees to see this 'person' who went to sub detox. It is standard practice (around these parts, anyways) for the doc to get ALL prescription records before the initial visit...just to see if you're on the level about what you've been taking, and who all has prescribed drugs to you.

So, if the 'subs' doc decided to drop a dime on this dude after a few months of treatment...the PM doc would probably be offended...'how dare you imply that I didn't know about THAT'...

That's the way I see it going down...

...but hell, I could be wrong.

[Suboxstitute]

Welll - it depends. My sub doc happens to be in the same large university health system/HMO as all my other docs.

I specially declined to sign a release for them to exhange info with my primary doc - not that she was still writing scipts for opiates, but because I wanted to be the to tell her.

So, later, I go in for an unrelated complaint. The nurse starts reading my med list from the computer, and the first one was "suboxone" (the second one was an old hydro script, and the nurse didn't think anything of it, since she wasn't familar with sub at all. )

I lost it there for a second, and said "I specially did NOT sign a release for Dr. Sub to talk to Dr. Primary Care. How do you have this information" ...... Well, I learned that any and all scripts written by ANYONE in the system are entered in the record, so there went myprivacy and I had to tell my primary care doc the whole thing/ she was cool about it, said she was glad I was getting help and then flagged my chart "NO OPIATES EVER"

hELPFUL TIP: I use a completely different pharm for subs, AND only the subs, and everything else is at a different pharm. So if a pain doctor or anyone asked me for a complete pharmacy record, I'd offer up Pharmacty "B" - that list contains contains only what I'd want a PM to see, whatever than means for you.

Also helps if I ever need pain meds (just had roxicet after major oral surgery/surgeon NOT in the same network) - btw the pain meds did not do a thing for me even after stopping bupe for five days prior - even on the TENTH day of no bupe (and I'm on 4-6mg per day) .....they didn't help much w/ the terrible pain I was in and certainly didn't get me high, even though I tried 4-5 at a time, which used to work!

The Lonnnnnnng half life is all I can say about bupe. It strikes again!

But how would holy-roller sub doc even know SWIM was seeing a PM doc, unless they are in the same HMO/health network OR the sub is on your pharmacy records?? May be too late, but anything you woul not want a PM doc, or any doc for that matter pick a doc a) from a different "system" and ALSO get your subs from a separate pharnacy? The sub doctor still has to have your permission to release info to your PM doc - at least that is how it worked for me. It was the darn script that got me "called out" not the doctors talking.

[TheMentor]

I know here in AL, the doctors have access to view ALL controlled substances prescribed to you regardless of switching Pharmacies or not.
My doctor came in one visit and had a list of Vicoprofin and Oxy/APAP rx I had over a 2 years ago and a list of all Pharmacies I had filled mine at over a year's time. (6 or so)


And as someone said in another thread, HIPPA laws are only there to make us feel our privacy is intact. A doctor can get around HIPPA several ways.

The HIPAA Privacy Rule permits a covered entity to disclose PHI, including psychotherapy notes, when the covered entity has a good faith belief that the disclosure: (1) is necessary to prevent or lessen a serious and imminent threat to the health or safety of the patient or others and (2) is to a person(s) reasonably able to prevent or lessen the threat. This may include, depending on the circumstances, disclosure to law enforcement, family members, the target of the threat, or others who the covered entity has a good faith belief can mitigate the threat. The disclosure also must be consistent with applicable law and standards of ethical conduct. See 45 CFR § 164.512(j)(1)(i). For example, consistent with other law and ethical standards, a mental health provider whose teenage patient has made a credible threat to inflict serious and imminent bodily harm on one or more fellow students may alert law enforcement, a parent or other family member, school administrators or campus police, or others the provider believes may be able to prevent or lessen the chance of harm. In such cases, the covered entity is presumed to have acted in good faith where its belief is based upon the covered entity’s actual knowledge (i.e., based on the covered entity’s own interaction with the patient) or in reliance on a credible representation by a person with apparent knowledge or authority (i.e., based on a credible report from a family member or other person). See 45 CFR § 164.512(j)(4).

I forgot what else was said specifically, but it was along the lines of one doctor could share to your current doctor information that may prevent overdose, etc.
Don't quote me.

[jill]

I haven't read the responses here, -- I just wanted to remind everyone that some laws have changed since this was first posted 3 years ago.

So, if you are looking for something specific and current, perhaps re-post in this thread. HTH.

[Dr. McKay]

I had the same scenario where I was on subutex froma detox doc, then I had back surgery and went to a pain management doc.

The pain doc knew I was going to the sub doc but still put me on Opana Er and IR . The doc was very careful with me as far as upping the dosage, and he told me that he was going to get me off the Opana as soon as possible as my back heals up. After about 3 months he started becoming a big dickhead towards me for some reason , but he did not lower my medictaion. He just seemed to have this attitude towards me and his nurse/front desk people were also acting very stragely towards me, so I decided to switch docs . The new doc never asked me for records from my old doc and he never got them on his own since he never even asked me much of anything about the old doc .
The new place was very sympothetic to me about my condition and really "took care of me".

This was all before my state had a persription monitoring system. so my newer doc knew nothing about the subs.

Next move forward about 2.5 years and I changed docs again. this doc never asked for records from previous doc either nor did he even ask the doc name.

He just looked at my MRI reports and I showed him my pill bottles , and then he kept me on my current meds and he has slowly given me increases to my pain medicine over the past 6-8 months.

So at this point the Subs are so buried in my past that it will never show up since I used to pay cash for the sub doc and at the pharmacies for the subs.

[seven10kids]

didnt read responses either but...

a doctor has to get you to sign a release form to get your records. They can verbally ask you whatever they want. Also, if you are in a state with RX monitoring, they could have your entire fill/refill history on hand. Didnt realize until i was shown by my doctor at an appt. Some states, like CA, have a pretty much voluntary system to monitor prescriptions. Some pharmacies use it and some dont. It just matters where you FILL. On my print out, it didnt show any of the meds the doctor wrote for me, but he got all bent because it showed a norco fill a half year prior. I thought it was no big deal, didnt even take them. Thought I was supposed to be on those on top of what he was giving me. He didnt flip out but just said that all RXs for narcotic meds need to be written by him and no one else. If i had a question to call him and he would prefer that ALL prescriptions be written by him.

So all and all we are really losing a lot of our privacy. Everything is going to computer databases. Even meds that needed to be written on a triplicate every month and now allowed to be filled though a computer system that is like a fax to the pharmacy to fill whatever the doctor wants. That way i guess it gets rid of a lot of forgery and gets the doctors ready for a complete change over to digital prescriptions. My doctor HATES the idea and doesnt trust it (for good reason). He said he will write it out for as long as he legally can.

They are locking it down though in every direction. Be safe. If you slip up, you are going to lose BOTH doctors. See what contracts you are under. Read them carefully. Ask questions. Pose it as a hypothetical. Laws are getting insane. If anything, it is best to play really stupid or naive to the situation and you will get the most info, then when you have the info you can add the information you really know and see what happens.

Rule of thumb is: only see one doctor, if you have to ask, its probably not a good idea. They are going to say: "How are you in a treatment program while you are being RXed narcotics?" either on or the other, right?