Interview – What Happens To A Sex Worker’s Medical Records?

Hi all,
This is my last post for a few days because I have other publications due but I hope you enjoy tonight’s blog.

I have had the privilege to get to know Marie Bismark over the last few months who happens to not only be a lawyer BUT a Doctor as well (say whut??). Marie Bismark is based at the University of Melbourne and most of her research focuses on working with patients to help improve the healthcare system. She is passionate about women’s health and sexual and reproductive rights, and has been a volunteer with Family Planning since 2006.

So who better than to ask a few questions about what happens to your medical records when you are a sex worker?

So here we go……my comments are in bold and Marie’s answers are in italics. Enjoy!

1. What are the legal requirements of health providers with respect to patient medical records?

“Doctors have to:

1) keep your record in a safe and secure place to prevent unauthorised access

2) make sure your record is accurate. If you think there is an error in your record you can ask them to add a note recording the correct information. (They are not allowed to go back and delete what they have already written, but they should ensure the right information is clearly recorded.)

3) tell you what the information will be used for and who can access it (if you ask) [I would get into the habit of asking!]

4) tell you if they are collecting information about you from someone else (eg a partner or family member) and make sure that information is accurate

More information is available here: http://www.oaic.gov.au/privacy/privacy-resources/privacy-business-resources/health-information-and-the-privacy-act-1988-a-short-guide-for-the-private-health-sector-january-2002″
2. Are there any special requirements of health providers with respect to particular medical information that is highly sensitive? Ie. HIV/AIDS, STDs.
In most cases you should be allowed to use a pseudonym rather than your real name when accessing medical care. Some doctors will create a separate file for recording sensitive information so that it doesn’t end up mixed in with your general medical record – you can ask your doctor if this is something they are able to do. [WOW! I HAD NO IDEA THAT YOU COULD DO THIS!!!!!]

Doctors are required by law to notify the Department of Health if a patient has a “notifiable infectious disease”. For example, in Victoria they must notify AIDS and HIV. If you search “notifiable disease” with the name of your State you should be able to find your local list of these “notifiable diseases”. Depending on the nature of the infection, the Department may then undertake a process of contact tracing to see if anyone else requires treatment (a topic for another post). [AT THIS POINT, I WOULD ALSO CONSULT A LAWYER JUST IN CASE ANY FORM OF DISCRIMINATION ARISES.]

3. What is the process involved with a patient wishing to obtain their medical record?

“The process for getting a copy of your medical record can be different for different doctors. The easiest approach is to let the receptionist or doctor know that you would like a copy of your records and ask if there’s a form you need to fill in. Or you can send them a request in writing. (Doctors sometimes get anxious that you want to make a complaint if you ask for your records, so it can be helpful to reassure them that you would just like to have a copy for your own records, if that is the case.) Usually, the hospital or medical practice will provide you with a photocopy of your records within 30 days.

There are some rare situations where a doctor can withhold all or part of your medical record. For example, if the record contains personal information about another person (eg comments about another patient who was in hospital with you) or if it would present a serious risk to your health to see the record. Sometimes doctors try to withhold a record when they are not allowed to, so if they say “no” it may be worth getting some advice from a lawyer or patient advocate.

Occasionally there will be a fee to copy particular documents, but this should be reasonable.
4. When, if at all, can medical information be disclosed between medical providers?

“Doctors are usually allowed to share information with each other for the purposes of providing you with good care. If you do not want your doctor to send information to another doctor (eg if you do not want a specialist to send a letter to your GP) you should make this clear at the beginning of the consultation and check that they will respect your wishes.”

5. Who is primarily responsible for keeping medical information and for how long?

“Doctors have a responsibility to make sure the information in your medical record is accurate. If you disagree with anything they have written you can ask for it to be corrected. If they agree that they have made a mistake, they will add a correction to the medical record. If they disagree, they should still add your point of view to the record so that anyone else reading it can see that you requested a correction.”

6. Does a medical record need to disclose that a person is a sex worker? Are there any obligations to disclose this information?

“You do not have to tell your doctor what you do for a living. I prefer not to tell doctors that I do medico-legal work because they treat me differently, so I usually just say something vague but truthful when they ask about my job. e.g. “I do some part-time work at the University” or “I do some teaching” or “I’m mostly at home with my kids”.

However, there are times when your occupation might be relevant to making an accurate diagnosis. So, for a simple uncomplicated consultation, less information is fine. But if you are really sick, or have symptoms that are hard to explain, your doctor might be able to help you better if they know more about you and the kinds of health risks you might have been exposed to through your work.”

7. What is the process involved in making a complaint with respect to what is contained in your medical records?

“If you have a concern about your medical record, it is always a good idea to complain directly to the doctor, hospital or clinic first. Clearly explain your concerns (take a friend with you or put it in writing) and explain what you would like them to do to make things right.

If that doesn’t work, your local health complaints commissioner may be able to help – check their website – or try the Australian Information Commissioner.
So there you go!

If you have any further questions or are experiencing difficulty with respect to your medical records – you know where to find me! If I need to consult further with Marie Bismark on your question, I will do so.

See you in a few days.

KVA
@kvalegal

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