Gathering Places


Thursday, August 30, 2001

Physicians have
right to privacy, too


THE HAWAII Medical Service Association has sought to impose a new contract on doctors that gives the association access to a participating physician's personal medical records, including "protected by law" health information. The new provision allows HMSA access to certain extra confidential aspects of physician medical records, such as HIV and chemical dependency treatment history.

The Hawaii Medical Association strongly urges HMSA to drop this provision.

Peter Locatelli, M.D., a pediatrician from the Big Island, was astute in noticing this change prior to signing the contract. However, most physicians, like myself, missed this provision prior to signing the contract.

HMSA is the dominant player in the Hawaii medical insurance field. Physicians in the state cannot realistically practice medicine if they do not accept the contract that HMSA dictates. When Locatelli informed the HMSA he wouldn't accept the provision, he was told he would be dropped as a provider.

In the past HMSA has made changes to its contract without prior notification and this is typical of HMSA's manner of dealing with physicians in Hawaii. It gives no notice and did not even meet with its own physician advisers to discuss this provision before adding it to the contract. It certainly has not discussed it with the 1,600-member Hawaii Medical Association, the professional organ- ization for Hawaii's physicians.

THE HMA is particularly concerned about this recent attempt by HMSA to gain more power. The provision to gain access to physician medical records violates federal confidentiality laws. These laws are specific about prohibiting the release of certain aspects of anyone's medical records.

Everyone knows that the confidentiality of medical records is a sacred trust between doctor and patient. If HMSA is able to gain access to the most personal information of Hawaii physicians in their medical records, what is to prevent them from demanding access to patient records at will?

This access to confidential information will have a chilling effect on the treatment of illnesses and diseases. We live in a society where certain personal records are kept confidential to encourage those afflicted to get help and eliminate discrimination.

HMSA STATES that it is trying to ensure that impaired physicians are not allowed to practice. HMSA already has procedures to ensure that physicians with health problems or impairments can be identified and kept off contract. I have worked with HMSA to see that this is effected.

In addition, physicians are subject to the scrutiny of other organizations that have long-standing mechanisms established to address this issue -- the Hawaii Medical Association, all hospitals, the state of Hawaii Board of Medical Examiners, Medicare and Medicaid, to name a few.

HMSA's manner of dealing with doctors reminds me of Vito Corleone's line in the movie, "The Godfather": "I'll make them an offer they can't refuse."

With this attitude it is no wonder that Hawaii's physicians find it difficult to challenge this organization, which is rightfully called an 800-pound gorilla squatting in Hawaii's medical community.

Gerald McKenna, M.D., is president-elect
of the Hawaii Medical Association.

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