Implementation of HIPAA

This happened years ago but it's become relevant in the last few days.

I called my urologist and he wasn't in and I told the woman on the phone
I wanted to leave a message. I didn't even have the chance to tell her
what the message would be when she said I couldn't do it because of
HIPAA.

This is a big office with 5 or 10 doctors and I think more than one
person answering the phone. Am I correct that her answer was totally brainless, or is there some excuse for it?


I"m pretty smart but I'm slow so I had no comeback. 30 minutes later I
sent the offic a fax with a cover letter in big print that said I waive
my HIPAA rights, and iirc the doctor got back to me.

Why this matters: Because of this and 2, 3, maybe 4 other things,
mostly practice-, office-related and not doctor-related (but two that I
learned about after I left were doctor-related), when my doctor changed
to a subspecialty that only included people with cancer, I went looking elsewhere for a urologist. I had an absurd problem at the hospital
where the next one worked, and when he moved out of town, I went looking
again. The current one practices alone, has one P.A. and some clerical
staff, has no portal and no email address. I'm supposed to communicate
with him by FAX. He has been delegating most of my appointments to the
PA who lists as her medical school Anne Arundel Community College*** and
no other experience or education is listed. HOw she got certified as a
PA I don't know. (Maybe she's not?) (She's not on Linkedin, but is on
Medstar (and a couple other places with even less information)) My last
2 appointments were with her during which she presecribed a strong
antibiotic (and now says I have to take it again in 6 weeks even though
it seems to have worked. "to be sure". ) and has no scheduled a "bladder scraping" without asking enough questions IMO. Maybe she reviews what
she does with him but she never says so, and I was too slow-witted to
think to ask, and now even if she said yes, I'd think she was just
saying that to make me happy.

For all this and one other reason, I don't trust them and I think I
should look again, and the only place left is the first place I
described, so I want to know how stupid or ridiculous it was to tell me
I can't leave a message for my doctor.

And would you leave the current practice if you were me?




Extra info for the curious:
***Anne Arundel CC did have a PA program until 2 years ago but after 26
years had to stop becaues the new rules requre all the schools to offer
masters degrees, and it's a community college, doesn't even off
bachelor's degrees. But even with AACC, you had to get a Bachelors at
U of Maryland Baltimore, or even maybe a masters, and nothing online
says she did any of that.

At least now it seems to take at least 6 years: https://college.mayo.edu/academics/explore-health-care-careers/careers-a-z/physician-assistant/
The typical pathway to becoming a certified PA (PA-C) includes:
Obtaining a bachelor�s degree, with an emphasis in the sciences.
Most universities have pre-PA degrees.
Completing a physician assistant program that has been accredited by
the Accreditation Review Commission on Education for the Physician
Assistant (ARC-PA). These programs are typically two years in length,
focus on both classroom education and clinical rotations, and result in
a master�s degree in PA studies.
Completing a licensure requirement. After successful completion of
a PA program, candidates must pass the Physician Assistant National
Certifying Examination (PANCE) from the National Commission on
Certification of Physician Assistants (NCCPA). Once certified, PAs can
practice under the credentials of Physician Assistant-Certified (PA-C).

Or maybe 4-6 years:
https://www.aapa.org/career-central/become-a-pa/
To become a PA, you must graduate from an ARC-PA accredited entry-level
PA program. Most entry-level PA programs require applicants to have an undergraduate degree. However, some PA programs offer a pre-professional
phase that is open to recent high school graduates and students with
some college credit. Programs with a pre-professional phase range from
4-6 years in length and require students to complete undergraduate
course work before they enter the professional phase of their training.

--
I think you can tell, but just to be sure:
I am not a lawyer.

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On Thu, 1 Aug 2024 06:58:32 -0700 (PDT), micky wrote:

This happened years ago but it's become relevant in the last few days.

I called my urologist and he wasn't in and I told the woman on the phone
I wanted to leave a message. I didn't even have the chance to tell her
what the message would be when she said I couldn't do it because of
HIPAA.

This is a big office with 5 or 10 doctors and I think more than one
person answering the phone. Am I correct that her answer was totally brainless, or is there some excuse for it?

You're correct: her answer was totally brainless.

HIPAA places restrictions on disclosures by health care providers and
insurers. The actual patient is free to reveal any of their own
medical data that they may choose.

--
Stan Brown, Tehachapi, California, USA https://BrownMath.com/
Shikata ga nai...

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In misc.legal.moderated, on Fri, 2 Aug 2024 09:09:47 -0700 (PDT), Stan
Brown <[email protected]> wrote:

On Thu, 1 Aug 2024 06:58:32 -0700 (PDT), micky wrote:

This happened years ago but it's become relevant in the last few days.

I called my urologist and he wasn't in and I told the woman on the phone
I wanted to leave a message. I didn't even have the chance to tell her
what the message would be when she said I couldn't do it because of
HIPAA.

This is a big office with 5 or 10 doctors and I think more than one
person answering the phone. Am I correct that her answer was totally
brainless, or is there some excuse for it?

You're correct: her answer was totally brainless.

HIPAA places restrictions on disclosures by health care providers and >insurers. The actual patient is free to reveal any of their own
medical data that they may choose.

Thanks. This was the most legal issue but in a way this was the least
of the problems they gave me. One Friday morning after a procedure that
they did, I was in pain and I called them and told the receptionist
about the pain and again the receptionist said my doctor wasn't in, and
then there was silence from her. So I said, Don't you have other
doctors? So she told me to come in at 4 and some technician treated me
and asked what my level of pain was, and I said 3 and he said, That's
not what you told us when you called. I never told them a number
because they never asked, and maybe the pain level changed since then,
and maybe I'm afraid it will get worse over the weekend, and it's none
of his business.
After him a woman saw me next and gave me some Uribel, and after I
asked about it, she told me Uribel didn't require a prescription. But
it does. It worked, so I'm not complaining too much about that. I
never did see a doctor that day, They had a large treatment room whichy
seemed to be a clinic for people like me, but I had to work to get it
out of them.

Another time was much worse. After a procedure they did, I was in a lot
of pain and the doctor said they had to do another procedure (to rectify
or complete the first one) and they were trying to bring the equipment
to Baltimore. I told him I'd go wherever the equipment was, but he
didn't agree and still kept me waiting another 3 days, a total of 8
days.

There was another problem with the practice I don't remember now, but
the doctor was no great shakes either. He told me a green-light laser treatment would last me my whole life (I was about 70) but later I
learned it's really only about 5 years. For me it was 4. Plus at the
start, he had me on Flomax, tamsulosin, for months and made it sound
like this would reverse my problem, might be all I need, but later
seemed to say I was dawdling and should have gone through with the laser treatment months earlier. I was only doing what he said.

He took me off tansulosin after the laser procedure but my current
urologist says that's a mistake.

This practice has hundreds of urologists all over central Maryland and
iirc even in to Pennsylvania and Virginia. And every place I wanted to
go until I thought of Johns Hopkins was affiliated with them.


The absurd problem at the second place, Johns Hopkins Hospital,
world-famous, was that I was having a 2nd laser treatment of the
prostate and they didn't say anything about needing a ride home, but
when I got there at 5:30 in the morning, she asked who my ride was. And
I had arranged one and she took her phone number, and 20 minutes later
they said she didn't answer the phone. Why are they calling her at 5:45
in the morning? When they could have called her yesterday? It's enough
she's doing me a favor, she shouldn't have to wake up at 5:45 in order
to pick me up at 10 or 11. Fortunately for my friend she turns off her
phone at night, but unfortunately for me, they told me if they couldn't
reach her they would cancel my procedure. I gave them another number, a married couple, and the woman was up at 6:15 and she was smart enough to
say, Yes, I'm picking him up. And then at 6:30 my doctor shows up and
tells me he's probably going to keep me overnight (and he did). Well
then I don't need a ride because the anesthesia will have worn off.

I can prevent this JHH problem from happening again and JHH has what
must be a big clinic with 8 urologists in a north suburb of Baltimore,
so I don't have to go back to the first place after all. Thank
goodness.

Sorry for the rant, and I think it's hard to believe these stories are
true, but it explains the importance of the originat question.

--
I think you can tell, but just to be sure:
I am not a lawyer.

--- SoupGate-Win32 v1.05
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"micky" wrote in message news:[email protected]...

Implementation of HIPAA

This happened years ago but it's become relevant in the last few days.

I called my urologist and he wasn't in and I told the woman on the phone
I wanted to leave a message. I didn't even have the chance to tell her
what the message would be when she said I couldn't do it because of
HIPAA.

This is a big office with 5 or 10 doctors and I think more than one
person answering the phone. Am I correct that her answer was totally >brainless, or is there some excuse for it?

I"m pretty smart but I'm slow so I had no comeback. 30 minutes later I
sent the offic a fax with a cover letter in big print that said I waive
my HIPAA rights, and iirc the doctor got back to me.

Why this matters: Because of this and 2, 3, maybe 4 other things,
mostly practice-, office-related and not doctor-related (but two that I >learned about after I left were doctor-related), when my doctor changed
to a subspecialty that only included people with cancer, I went looking >elsewhere for a urologist. I had an absurd problem at the hospital
where the next one worked, and when he moved out of town, I went looking >again. The current one practices alone, has one P.A. and some clerical >staff, has no portal and no email address. I'm supposed to communicate
with him by FAX. He has been delegating most of my appointments to the
PA who lists as her medical school Anne Arundel Community College*** and
no other experience or education is listed. HOw she got certified as a
PA I don't know. (Maybe she's not?) (She's not on Linkedin, but is on
Medstar (and a couple other places with even less information)) My last
2 appointments were with her during which she presecribed a strong
antibiotic (and now says I have to take it again in 6 weeks even though
it seems to have worked. "to be sure". ) and has no scheduled a "bladder >scraping" without asking enough questions IMO. Maybe she reviews what
she does with him but she never says so, and I was too slow-witted to
think to ask, and now even if she said yes, I'd think she was just
saying that to make me happy.

For all this and one other reason, I don't trust them and I think I
should look again, and the only place left is the first place I
described, so I want to know how stupid or ridiculous it was to tell me
I can't leave a message for my doctor.

And would you leave the current practice if you were me?

Well right off the bat, I don't think I would stay with a doctor that
requires all communications be via fax. Most of my doctors today (including
my urologist) have an online portal where you can send and receive messages, make appointments, etc. Some of them do still use fax to send and receive prescription orders to pharmacies, but I don't know anyone who forces
patients to communicate this way.

And I'm pretty sure you have to have a four-year degree before you can even enter a PA program, at least in the US.


--

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On 8/3/2024 12:15 PM, Rick wrote:

And I'm pretty sure you have to have a four-year degree before you can
even enter a PA program, at least in the US.

--

This is for the US

PA = Physician's Assistant
NP = Nurse Praticianer


For PA

https://www.aapa.org/about/what-is-a-pa/


Prospective PAs can choose from among 308 accredited master’s degree
level programs in the U.S. Programs take 3 academic years or 27 months,
and PA candidates are also required to engage in 2,000 hours of clinical rotations as well as passing a certification exam, among other requirements.

For NP

https://www.nursingworld.org/content-hub/resources/becoming-a-nurse/what-is-nurse-practitioner

You can choose from two options when considering nurse practitioner
schooling — a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP). An MSN program usually takes two years to complete, and
a DNP program is typically four years.

Difference between NP and PA

https://www.usa.edu/blog/np-vs-pa/

---------------------------------------------------

I had an independent NP as my primary for about three years. She was a neighbor and was able to take my wife and myself on as patients with no
wait. Her husband was an MD.

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"Roy" wrote in message news:v8n1ne$3t7cm$[email protected]...

On 8/3/2024 12:15 PM, Rick wrote:

And I'm pretty sure you have to have a four-year degree before you can
even enter a PA program, at least in the US.


--

This is for the US

PA = Physician's Assistant
NP = Nurse Praticianer

For PA

https://www.aapa.org/about/what-is-a-pa/

Prospective PAs can choose from among 308 accredited master’s degree level >programs in the U.S. Programs take 3 academic years or 27 months, and PA >candidates are also required to engage in 2,000 hours of clinical rotations >as well as passing a certification exam, among other requirements.

For NP

https://www.nursingworld.org/content-hub/resources/becoming-a-nurse/what-is-nurse-practitioner

You can choose from two options when considering nurse practitioner
schooling — a Master of Science in Nursing (MSN) or a Doctor of Nursing >Practice (DNP). An MSN program usually takes two years to complete, and a
DNP program is typically four years.

Difference between NP and PA

https://www.usa.edu/blog/np-vs-pa/

---------------------------------------------------

I had an independent NP as my primary for about three years. She was a >neighbor and was able to take my wife and myself on as patients with no
wait. Her husband was an MD.

I've been to numerous NPs and PAs over the years, and I've found in many
cases they are as good if not better than the full doctors they work for.
The way I think about is that NPs are basically registered nurses who have taken additional training which permits them to diagnose conditions and prescribe medication. PAs are effectively junior level doctors who have
taken pretty much the same medical courses as full doctors but don't go
through residency or rotations. I have heard some people describe it that PAs, like doctors, tend to focus their attention more on the medical
condition they are treating while NPs focus more on the patient and the patient's needs.

--

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On 8/5/2024 7:34 AM, Rick wrote:

...

I've been to numerous NPs and PAs over the years, and I've found in many cases they are as good if not better than the full doctors they work
for. The way I think about is that NPs are basically registered nurses
who have taken additional training which permits them to diagnose
conditions and prescribe medication.  PAs are effectively junior level doctors who have taken pretty much the same medical courses as full
doctors but don't go through residency or rotations.   I have heard some people describe it that PAs, like doctors, tend to focus their attention
more on the medical condition they are treating while NPs focus more on
the patient and the patient's needs.

--

NPs can operate independent of a doctor in many states. They also tend
to have a specialty and get additional training.. The one I went to was
FNP-C (certified family nurse practitioner).

PAs tend to work within a medical practice. They also have specialties
just like an MD.

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