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Author Topic: Medical privacy for the over 65 set  (Read 6276 times)

Docliberty

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Medical privacy for the over 65 set
« Reply #15 on: August 08, 2004, 02:12:23 pm »

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Here's the deal: if you are a physican who wants to "opt out"-- i.e. have nothing to do with--Medicare, you must agree not to charge any registered Medicare patient (most seniors) for your services. In other words, the only way a non-Medicare physician can legally treat a Medicare senior is to do it gratis. And believe it or not, some freedom-loving MDs have chosen to do exactly that

That is the only way that I have found too but get this, in some cases, Medicare considers that fraud because you are enticing patients with a reduced fee.

Welcome rivertam.  Nice to have another fellow professional here and the medical perspective.  (I'm a chiropractor)  The discussions get pretty good sometimes.  Have you considered chiropractic as a change of profession?  Contact me privately if you are interested.
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"I won't be wronged, I won't be insulted, and I won't be laid a hand on.  I don't do these things to other people and I require the same from them."  Marion Morrison

"I do not fear my government.  I fear what my government will cause me to become."   Docliberty

"Every normal man must be tempted at times to spit on his hands, hoist the black flag, and begin to slit throats." H. L. Mencken

Claire

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Medical privacy for the over 65 set
« Reply #16 on: August 08, 2004, 03:12:17 pm »

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And BTW Claire, would it be all right for me to put a link to your home page under People I Admire?
In company with Twyla Tharp and Oriana Fallaci? How could I object!? Thank you.

Eclectic tastes you show there on that blog. An ice-skating waitress who used to be an internist? By golly, I don't think I've met one of those all week.  :rolleyes:  
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Just as the flattery of friends often leads us astray, so the insults of enemies often do us good. -- St. Augustine, Confessions, Book IX, Chapter 8


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unstructuredreality

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Medical privacy for the over 65 set
« Reply #17 on: August 09, 2004, 12:09:40 am »

More doctors should be handed this form http://aapsonline.org/confiden/patientadvisory.htm I haven't used my real name at a doctor in a good 4 years- since the time I became aware that whatever you say to the doc is open to prying eyes.  Say I have depression, does that mean I need to be put away somewhere to be "healed"?   I think not.  Even those who lobby for such things, like those that say that depressed people are more likely to commit gun crimes.  Believe me now or later, but anything you tell the doc can be used against you.  There is no doctor/patient priveledge when it comes to possible crime.  Same thing with psychiatrists.  The only thing that should be told to healthcare professionals is your personal medical history, like asthma, heart palpitations, etc.  They are now hired snitches unless you can find a doctor who is your trusted friend.   Same thing with attorneys/lawyers.  Only tell them what is pertinent to your treatment.  If you need x rays or blood work, use a fake name, but make sure you pay the bills you receive.  Debt and non payment make them even more curious about you and even though technically the name the bill is sent to may be yours, the collection department could care less.  If you receive the bill, in the collection folk's eyes, you are the one that has to be responsible for the costs.  I have given at least 5 names when in the hospital.  When billing time came, I plead that I don't have the money, using a prepaid cellphone of course.  Generally, the amount drops to something reasonable and I pay the bill, but not with anything that has my name or address on it.  My dna or bloodwork probably fits 5 people.  Who are they to go after and log?  The point being, shop around for a doctor who will take up front money/deposit for treatment and be aware of what the doctor says you have, ie. heart palpitations, diabetes, or any other affliction, while you are healthy.  You will find in the near future, RFID chips being implanted or placed around your wrist to help them identify you, resist.  If you have no choice, the name and information you have given will mean nothing.  ***Edited this sentence about RFID on the ceilings after fact checking, no pertinant value- thanks Docliberty***.  Think about it, you have no recourse unless you pull teeth, whether or not you are legally entitled to your full medical records.  It takes legal action to see what the doctors see.  Sometimes with a little creativity and persuasion you may be able to make copies, but that is rare and you need to be persistent and savvy.  It is a dirty game and recourse is up to you!

This form could serve as a reminder that your medical information is yours, not your multitude of doctor's.  Fight hard.  You can get it back.
« Last Edit: August 09, 2004, 09:22:33 am by unstructuredreality »
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rockchucker

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Medical privacy for the over 65 set
« Reply #18 on: August 09, 2004, 12:33:50 am »

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Here's the deal: if you are a physican who wants to "opt out"-- i.e. have nothing to do with--Medicare, you must agree not to charge any registered Medicare patient (most seniors) for your services.
The AAPS site also has this article about the "Country Doctor" route for avoiding the reporting requirements.
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... it is poor civic hygiene to install technologies that could someday
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Docliberty

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Medical privacy for the over 65 set
« Reply #19 on: August 09, 2004, 08:53:26 am »

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The next time you are in a hospital look up at the ceilings and you will notice plastic rods sticking out from the ceiling. These are RFID.

Hi unstructured.  Those "plastic rods" are receiviing antennas, but not for RFID.  They are for cardiac telemetry units worn by heart patients that allow them to be mobile while in the hospitol.  If someone told you they were RFID receivers, either they didn't know what RFID was or they were messin with you.

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QUOTE (rivertam @ Aug 8 2004, 07:41 AM)
Here's the deal: if you are a physican who wants to "opt out"-- i.e. have nothing to do with--Medicare, you must agree not to charge any registered Medicare patient (most seniors) for your services.

The AAPS site also has this article about the "Country Doctor" route for avoiding the reporting requirements.

That is for opting out of HIPAA not Medicare.  Both intrusive programs but not interchangable.  You can only opt out of HIPAA if you don't file any claims electronically.  Medicare requires that you file claims electronically. (but for the moment they are still accepting paper claims because they haven't yet gotten thear act togather.)
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"I won't be wronged, I won't be insulted, and I won't be laid a hand on.  I don't do these things to other people and I require the same from them."  Marion Morrison

"I do not fear my government.  I fear what my government will cause me to become."   Docliberty

"Every normal man must be tempted at times to spit on his hands, hoist the black flag, and begin to slit throats." H. L. Mencken

unstructuredreality

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Medical privacy for the over 65 set
« Reply #20 on: August 09, 2004, 09:13:24 am »

Hey Doc,

you are right and actually I know what you are referencing now.  I think the doctor that told me they were RFID was an idiot anyway.  At least he knows the term RFID because it's being used more and more in hospitals from what I read only of course.  The funny thing about his comments were that I said nothing to him about them so unless he was mentally disturbed, I can't say he was yanking my chain, he just volunteered the information to everyone in the room.  Me, looking up to a man with so much education and experience tended to take his word for it.  He was quite a talker.  :)  Maybe he was about to fall off of the deep end with paranoia.

Thanks for clearing it up! I deleted the sentence for accuracy :)

Here's something interesting:
http://zdnet.com.com/2100-1103_2-5285815.html
" The chip is an ID tag, Fulcher emphasized. When a person with an embedded chip passes near a scanner, the dormant chip simply wakes up and issues an ID number. The administrator of the security systems and databases determines how the information is used. A person has to stand within a few feet of a scanner for the tag to wake up. Thus, the tags can be used to follow someone's steps only when they are near scanners. The company's hand scanners can ping chips about 12 inches away, although the devices for counting salmon are 10 to 12 feet away from the fish.

Also, VeriChip is working on an implant that will contain a Global Positioning System. Such a device would allow an individual with a scanner to pinpoint someone's position on the globe.

The lab device, however, is relatively large right now, about the size of a pacemaker."

and

Wireless technology isn't new to the medical community. For years, doctors have been using laptops and PDAs with Wi-Fi connectivity to record patient records. In addition, many hospitals have experimented with various forms of wireless devices to monitor patient activity. A recent startup called Exavera Technologies has taken this wireless migration one step further. It just introduced a product line called eShepherd. This product line combines Wi-Fi and radio-frequency-identification (RFID) technologies. Together, these devices promise to monitor the locations and activities of patients while improving hospital workflow.

The eShepherd product line is a secure broadband-wireless, information-delivery system that's specifically designed for healthcare. It combines a high-speed Wi-Fi (IEEE 802.11a/b/g) network with the company's Vera-T Series. This family of intelligent bracelets, staff badges, and asset tags is based on wireless RFID technology. By working with existing hospital information systems (HISs), eShepherd provides positive patient identification; the real-time location of patients, staff, and assets; and information delivery at the bedside point of care.

Unlike barcode-formatted patient bracelets, eShepherd's RFID bracelets contain a subset of the patient's electronic medical record. This critical information includes a photograph for positive identification. It also contains medical history, such as insurance information, vital signs, physician contact data, and current medications. In addition to this intelligence, the bracelet communicates automatically with the hospital's information system. This communication is done through the company's wireless-broadband premise router, thereby eliminating the need for scanning.

These capabilities help to make the flow of data transparent to both patients and caregivers. eShepherd works with a hospital's HIS and wireless input devices, such as PDAs, tablet PCs, and laptops. In doing so, it enables real-time, point-of-care read and write access to the information contained in both the bracelet and the hospital's database.

The company's secure broadband-wireless system also should minimize patient-identification errors. Such errors can compromise patient safety and increase hospital operating costs. The system also can immediately locate hospital assets like empty beds, wheelchairs, and IV pumps. This feature can potentially save thousands of dollars in operating costs.

By enabling paperless record management while ensuring the proper authorization of network users, eShepherd also helps hospitals meet the security and privacy regulations set by the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

I guess my quesion would be, where will these scanners be as they get smaller?  With the medical professionals themselves or placed around the hospitals like those plastic things on the ceilings?
« Last Edit: August 09, 2004, 09:32:08 am by unstructuredreality »
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Docliberty

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Medical privacy for the over 65 set
« Reply #21 on: August 09, 2004, 08:25:36 pm »

This is one instance where I support the use of RFID chips.  (Now you guys put away those feathers and that tar and hear me out)  One of the biggest problems in hospitals is getting the right meds or right procedure and the right patient togather.  RFID chips in that ultra chic bracelet that they give you when you check in will help ensure that he who goes in for a vasectomy does not end up with his left foot amputated.  Those folks in the hospital need all the help they can get.
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"I won't be wronged, I won't be insulted, and I won't be laid a hand on.  I don't do these things to other people and I require the same from them."  Marion Morrison

"I do not fear my government.  I fear what my government will cause me to become."   Docliberty

"Every normal man must be tempted at times to spit on his hands, hoist the black flag, and begin to slit throats." H. L. Mencken

unstructuredreality

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Medical privacy for the over 65 set
« Reply #22 on: August 09, 2004, 09:47:39 pm »

No tar and feathers from me.  Do you think they will be as acccurate as is being touted.  Say some smart guy comes into the hospital with a device that will render them useless or inaccurate.  I would assume the doctor would rely on his/her previous knowledge and training, but in a few generations, do you see a reliance on these types of technologies.  I guess I equate it to the "new cashiers".  Money and cash is simple stuff to master, but some of these clerks, without the aid of the computerized cash register are lost, and I mean lost.  I'm not saying a cashier and a doctor are even close to equal, but as time goes on and folks in the hospitals come to rely on this technology, couldn't the possibility of error increase?  I know now, that people are mistagged even with the low tech bracelets.  Another thing I'm concerned about is the irresponsible and inept tagging of folks who have nothing to do with the treatment involved.  For instance, someone is tagged wrongly for heart disease when in reality, he/she is having a kidney removed.  It happens now, and the family of a  friend of my mother's is in a legal process now because of just such a situation.  Will RFID remedy these situations or make them more routine because of the inherent reliance on technology?  I appreciate and respect all who work in the stressful medical environment and realize that it is indeed about the most stressful place to work.  I hope to God however that common sense rules and a reliance on such things won't take the place of common sense, no matter how busy a professional is.  My point being, everyone should be aware of these things and not rely on them instead of a brain.  Accidents will always happen, but when a technology takes the place of a brain, bad things happen in my opinion.  Hackers too, will have their own ideas about it.

Peace and Good Day
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Docliberty

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Medical privacy for the over 65 set
« Reply #23 on: August 10, 2004, 08:19:13 am »

Nothing is perfect but it will be better than what they have today.  The mis-tagging problem is one reason the tag will include a refereance to the patient's picture.  There will still be screw-ups, but there will be fewer of them.

Any hacker that wants to mess with a hospital information system runs the risk of being harmed by his own hack.  Not the smartest move he could make.

BTW, I am still in favor of messing with RFID's elsewhere.  I look forward to seeing the face of the Wal-mart store manager when he receives 1500 lawn tractors to replace the 1500 mis-tagged razor blades that he sold last month.  
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"I won't be wronged, I won't be insulted, and I won't be laid a hand on.  I don't do these things to other people and I require the same from them."  Marion Morrison

"I do not fear my government.  I fear what my government will cause me to become."   Docliberty

"Every normal man must be tempted at times to spit on his hands, hoist the black flag, and begin to slit throats." H. L. Mencken

Augustwest

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Medical privacy for the over 65 set
« Reply #24 on: August 10, 2004, 10:33:48 am »

Not sure I was ever aware what a burden Medicare was on both Doctors and "beneficiaries." Can't say I'm surprised though.

Welcome River! :-)

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Yeah, but she's our witch. ::KERCHUNK:: So cut her the hell down!
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