Your health: An ounce of prevention

You just got back from a midterm that you know you failed.
Walking down your hall in a daze, you are greeted by your
roommate.

“Dude, sorry about what happened,” he says with a
smirk.

You get to your room and notice the answering machine blinking.
The lone message blurts out, “Hi, this is Dr. Smith, I was
just wondering if the cream we gave you is taking care of that rash
down there, and if it still hurts when you pee, give us a
call.”

You look behind you and find half of your floor at the doorway
laughing.

For many of us, keeping our personal lives private is important.
Nowhere is this need for privacy more apparent than with medical
records.

According to the Health Insurance Portability and Accountability
Act, a patient must authorize the release of medical information to
a third party ““ an insurance company ““ for purposes not
related to healthcare.

Patients can also request extra measures to ensure
confidentiality. For example, you can request a doctor to call a
specific number when he or she wishes to contact you.

Many UCLA students have their health insurance provided under
the Student Health Insurance Plans.

Although a student pays UCLA directly for these services, an
outside insurance provider is then chosen by the student or
assigned by default.

It is important to determine who your insurance provider is
through SHIP and obtain a copy of the provider’s privacy
practices. This document details situations in which your medical
records may be disclosed and shows you how to restrict
disclosure.

California has strong privacy laws, particularly when dealing
with minors and at-risk populations, like the lesbian, gay,
bisexual and transgender community.

Despite legislative protection, there are other ways health
status can be revealed to unwanted parties ““ including
parents.

College students are often covered by their parents’
medical insurance. Even though parents are usually denied access to
their adult children’s medical records, insurance bills can
be a problem.

The appearance of unexpected or frequent doctor visits or tests
on medical bills can prompt your parents to confront you about
health issues you do not want them to know about.

If you want to avoid such situations, consider alternatives to
your health care provider like free STD-testing clinics or Planned
Parenthood, which offers reproductive health-related services and
can provide sliding scale or out-of-pocket payment options.

Also, be aware of where bills are mailed and who has access to
them.

A health care provider must create an area of trust so a patient
can be honest about issues of health, well-being and safety.

Laws and ethical guidelines ensure complete confidentiality
during patient-physician encounters. Exceptions occur when
individuals are in danger of harming themselves or others, as in
the case of suicide or substance abuse.

One should also pay attention to the subtleties of medical
terminology. Confidential is not the same as anonymous.

A confidential HIV test entails recording a patient’s name
along with the results. With a waiver, your physician can be
notified, and the results of the test can be transferred onto your
permanent medical records. Once in your records, it can potentially
be viewed by other parties.

On the other hand, an anonymous HIV test does not involve giving
a name. The results are known only by the person who is being
tested.

But a health care provider is required by law to report certain
diseases and health conditions to the appropriate authorities. All
of these reportable diseases, including most sexually transmitted
and communicable diseases like syphilis, hepatitis and
tuberculosis, are seen to pose potential threats to the
community.

While an extensive system has been set up to guarantee your
right to privacy, keep in mind the exceptions to the rules and
other ways your information can be “leaked out” the
next time you seek medical care.

Your rash will thank you.

Espejo is a second-year medical student at the David Geffen
School of Medicine and a writer for The Diagnosis, an organization
comprised of UCLA medical students. The Diagnosis is coordinated by
Daniel Zaghi, a second-year medical student. Send questions to
[email protected].