doctor – patient confidentiality in three acts

This week I have seen too many doctors.  Amoebas for one friend, malaria for me.  While I would rather not have gone at all, these varied visits opened my eyes to new perspectives on a subject that is germane to both my work and life here.

Doctor-Patient confidentiality.  The Holy Grail of North American medicine.

Act #1:  Sitting with a doctor in the “consultation room”, a friend described – in detail – the nature, number and consistency of her bowel movements. Nothing unusual yet, right?  Turn your head … did you notice the half-dozen other patients waiting for their turn to do the same?

Good thing she wasn’t talking about anything personal!

Act #2:  My turn.  My malaria yet un-diagnosed, I had a great PRIVATE consultation with the hospital’s chief doctor.  He remembered me from when I had accompanied another friend.  I mentioned that I hadn’t seen my friend for a few days, so didn’t know how he was doing.

“Oh he’s all better! His latest malaria test results came out showing no infection at all!  I will see him again soon though to make sure,” proclaimed my doctor.

Oh really? Thanks for sharing!

This kind of relationship does have its benefits.  Here, when someone gets sick his or her friends and family gather round to speed recovery. This is just part of the weft that keeps the social fabric intact.

Act #3: Me again. Medical test requisitions in hand, I headed off to the top lab in the city to be poked and prodded. The technician explained the process to me but was interrupted by the receptionist who yelled at him – from down the hall – that he was telling me all the wrong information!  He yelled back my medical complaints – heard by all those awaiting their turn to “pee in a cup” – and received clarifications on what he should do

Are we having fun yet?

This last visit made me wonder what would happen if I wanted to see a doctor about a very PRIVATE matter.

Since I was at the lab on December 1st – International AIDS Day – I thought “what if I wanted to get tested for HIV?”  Knowing that my getting tested or my results could become common knowledge, would I go?

A major barrier to HIV/AIDS testing is, in fact, the fear of exposure – once an individual tests positive they are frequently stigmatized by many in their community.  Thus labeled life becomes a lot more difficult. Just going for a test can make others gossip about your morals or assume that you are infected.  This stops many from getting tested at all.

So, I’ll definitely miss doctor-patient confidentiality.  Knowing that a lack of privacy could make someone chose to not get tested for a life-threatening illness is more than I care to accept right now.


~ by Greg Spira on December 2, 2009.

3 Responses to “doctor – patient confidentiality in three acts”

  1. Wow, I never even thought about confidentiality (or lack of) as a barrier to people getting treatment. Thanks for the post, and hope you get better soon!

  2. That is an excellent point. Fear of being stigmatized is a major roadblock to aid workers in the HIV field.

    • Nadine: I am glad you liked my thoughts on the subject. Fear of stigmatization is a huge barrier to testing programmes. It sounds like you have some experience in this area. What is your connection with the HIV field?

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