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frustrated-one · Mar 21, 2008, 06:33 AM

I am a respected healthcare professional. I visit patients in their homes 40 hours per week and have been doing so for years. I am therefore acquainted with a very large number of people in the community. Recently I went to a clinic to be evaluated for Health Care. I was told that the Dr. (Surgeon) would not treat me unless I attended a Support group with approximately 200 other people with the same problem. I feel like attending would jeopardize my integrity in the community and is a violation of my right to privacy but if I don't attend I will be denied medical care. Any suggestions?

ScottGem · Mar 21, 2008, 06:40 AM

Well its not a HIPAA violation, that's for sure. No one providing you health care is discussing your diagnosis or treatement with someone else without your permission.

My feeling here is that the doctor feels participating in that group is a necessary part of your treatment for whatever the problem is. I think he's within his rights to require it. Just like he could refuse to treat you if you refuse to take some medication he thinks necessary for the treatment.

I think your best option is to get a second opinion. You may question the surgeon's requirements to your local medical board, but I suspect he's got that covered.

ScottGem · Mar 22, 2008, 12:33 PM

Did you check if participant's in the group sign a confidentiality agreement? Even though youj may think you are participating involuntarily, that's not the case. You have a choice to not participate, but that means not getting treatment. So your partiicpation would be deemed voluntary and therefore, any discussion of diagnosis and treatment would be voluntary.

frustrated-one · Mar 24, 2008, 11:11 AM

I have not checked to see if any such confidentiality form has to be signed. I plan on going to the group and keeping my mouth shut. Once I have the treatment I am hiring an attorney. They shouldn't be allowed to force me to reveal to everyone my problem --what happened to patients rights? The bottom line is I don't want people to know about it and they are making me tell people about it in order to get treatment . That's really the bottom line. My rights are being violated and so is my integrity in the community. Hope my actions will prevent others in the future from having to go through it. Thanks for trying to help me. I do appreciate your time.

Wondergirl · Mar 24, 2008, 11:26 AM

I grew up in a town of 500, so I understand where you are coming from. There are no secrets in a small town! Even if a confidentiality form is signed by each participant, I wouldn't trust that for secrecy. It would be just too juicy a gossip item for someone that the visiting nurse has X problem.

How far away would you have to go to find a different doctor to treat you, or isn't that an option? Is a support group that important for this diagnosis? Perhaps the doctor, if you ask him again, would consider an alternative for you because of your special circumstances? As a healthcare person, he should understand your predicament.

J_9 · Mar 24, 2008, 11:27 AM

Have you tried to find out if there is the same group outside of your community that you can participate in?

All-in-all, this is apparently a requirement of your treatment, therefore not a HIPAA violation. Am I wrong in assuming that this is a mental health are addiction issue? Please forgive me if I am.

Again, I would try to seek out the group therapy required somewhere outside of your community.

ScottGem · Mar 24, 2008, 11:48 AM

I perfectly understand your feelings here. But frankly I don't think you have any legal recourse, nor will you find an attorney to represent you in this matter.

Have you discussed this with your doctor? What has he said with respect to your concerns? Have you investigated alternative groups or treatments?

frustrated-one · Mar 24, 2008, 01:56 PM

I just can't believe that in today's day and age you can still force someone to reveal medical problems to perfect strangers. What kind of society do we live in. What about patients rights. I hope I can change things and I am certainly going to try.

Wondergirl · Mar 24, 2008, 01:59 PM

Originally Posted by frustrated-one

I just can't believe that in todays day and age you can still force someone to reveal medical problems to perfect strangers. What kind of society do we live in. What about patients rights. I hope I can change things and I am certainly going to try.

I thought the whole point was that they AREN'T perfect strangers. And you aren't being forced to do anything. You still have options--a different doctor in a different location. And I don't understand why this doctor is so adamant about your joining the support group. Doesn't he understand the problems involved?

Wondergirl · Mar 24, 2008, 02:04 PM

All I get from the staff at the clinic is that it is a requirement. I probably would have to drive 2 to 3 hours to get the same treatment.

Sure, staff will stick to the policy so they don't get fired. Have you talked to the doctor himself though? He isn't totally bound by clinic policies, is he?

Would you still have to join a support group if you sought treatment 2-3 hours away? Maybe, in the long run and despite the traveling, that would be easier.

LearningAsIGo · Apr 3, 2008, 08:05 AM

Originally Posted by frustrated-one

I have not checked to see if any such confidentiality form has to be signed. I plan on going to the group and keeping my mouth shut. Once I have the treatment I am hiring an attorney. They shouldnt be allowed to force me to reveal to everyone my problem --what happened to patients rights?? The bottom line is I dont want people to know about it and they are making me tell people about it in order to get treatment . Thats really the bottom line. My rights are being violated and so is my integrity in the community. Hope my actions will prevent others in the future from having to go through it. Thanks for trying to help me. I do appreciate your time.

I understand that this is coming from frustration, but you do not have legal recourse here. First, though the doctor requires it in his standard of care, it is voluntary for you to go to the group. To go THEN hire an attorney would be putting the horse before the cart. If you feel this strongly, I recommed two things:
1. Research other physicians and see if they require the same actions for treatment. If not, consider transferring care.
2. Speak to a lawyer FIRST about your rights to privacy. Get their professional opinion FIRST, then decide if group is right for you.

The entire point for any group therapy is to eventually get every person to open up, not "keep their mouth shut". Otherwise, you're just sitting there while everyone one else opens up... it really isn't fair to them. In group, a level of trust is built amongst the participants. Legally, they often sign confidentiality reports PLUS there is a "family" mentality. They won't spill on you because you could spill on them... So if you listen but don't participate you're causing distrust as well as not gaining anything by the experience.

My whole point is this: Don't go to the group if you aren't ready to accept and commit to what it is BEFORE starting.

Besides, I bet other prominent people in the community have been in your shoes already. Who's to say a doctor or lawyer in your area isn't part of it now? Luckily, you haven't heard about it because their group members have maintained their right to privacy. ;)
Its very difficult for health-care professionals to have to treat themselves. You're used to treating others and spending your time helping, not being helped. Don't let that make you feel insecure ~ we've all been there at some point.