> Russell Chapman <[EMAIL PROTECTED]> wrote:
> >Deborah Harrell wrote:
> >Well, I say she's got big titanium ovaries...and my
> >prior decisions to limit documentation to frex
> "Spent
> >30 minutes discussing severe mental distress from
> >sexual abuse" are soooo justified (although that's
> >more because of my distrust of A. insurance
> >companies and B. secured access for records kept
> >electronically).
> Excuse my ignorance, but what stops this
> practitioner from creating
> documentation like your example, and then releasing
> it as the record of therapy?
> (Assuming of course, that she has not previously
> conceded the existence
> of a more comprehensive document).
Interestingly, I _have_ heard of therapists who have 2
records for each patient: the official (subpoenable)
one, and the 'extended version' for just such a
contingency.
I think that if you tried to make a new record, they
could date the ink/paper; our computer experts might
know if you could insert such a record electronically
without detection.
> I guess the principle (that patients can talk freely
> because it won't be
> revealed) is still compromised by this approach.
> I wonder if you were subpoena'd one day and produced
> the one liner
> record, would they believe you had complied with the
> court's instruction, or would the court assume you
> were trying to thwart them.
In my case, since I did locum tenens rather than had a
personal private practice, I would have had no access
to those records in years. My personal stance is that
unless another person was endangered*, what a patient
told me was confidential. Period.
*If someone says they want to kill another, frex, my
duty to the intended victim outweighs that to the
patient; STDs and other communicable diseases like TB
have long been considered as dangerous enough to
potential infectees that the right of the patient to
privacy is overriden by the danger to those around
them. Other conditions qualify as well.
I was stunned in my early clinical days to find that a
patient whose depression I had documented _lost part
of her insurance coverage_ because of it. (Well, they
wanted a higher premium and she couldn't afford it, so
had to opt for less coverage.)
Debbi
who learned the hard way
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