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Q: Veterans Hospital doctor patient privacy ( Answered,   1 Comment )
Subject: Veterans Hospital doctor patient privacy
Category: Miscellaneous
Asked by: jameraquanza2-ga
List Price: $10.00
Posted: 01 Nov 2006 13:31 PST
Expires: 01 Dec 2006 13:31 PST
Question ID: 779186
What are the patient doctor privacy regulations for the VA when it
comes to illegal substances? My doctor noticed an increase in liver
enzyme values and a high white blood cell count when they did a blood
test as a standard procedure. My doctor doesnt know that its from me
currently being on testosterone enanthate and dbol. He wants me to
take another blood test and have my abdomen scanned but i dont want to
run him in circles and would rather just tell him. What can he do if I
tell him im taking steroids?

Request for Question Clarification by nenna-ga on 01 Nov 2006 13:54 PST
Are you currently in the military or discharged?


Clarification of Question by jameraquanza2-ga on 01 Nov 2006 13:56 PST
Subject: Re: Veterans Hospital doctor patient privacy
Answered By: sublime1-ga on 01 Nov 2006 14:55 PST

I worked in the field of mental health for 25+ years, and the
requirements for patient confidentiality are essentially the
same as in the medical field. A large proportion of those who
have a diagnosis of mental illness are 'dual-diagnosed', or
also have a diagnosis of drug or alcohol use. This information
is highly confidential, and the only concern of a professional
in the medical field is the possibility of assisting the patient
in becoming rehabilitated.

As for the military, this is evidenced by the language of the
this directive from the Department of Defense, titled,
'Rehabilitation and Referral Services for Alcohol and Drug Abusers':

"Personnel who are to be discharged for drug and alcohol abuse
 may be referred for rehabilitation to a VA facility when
 mutually agreed upon by the referring Agency and the VA facility.
 Within the legal requirements of patient confidentiality and
 release of information, the VA facility shall be provided
 appropriate records, such as a copy of the member's Military
 Service record, and the nature of the member's discharge. 
 The member shall be informed of this opportunity for
 rehabilitation.  Alcohol or drug-dependent Service members
 who are evaluated as not having potential for further useful
 service, if discharged, are to be evaluated by a physician,
 provided with appropriate care to include detoxification if
 needed, and referred to a VA facility for further rehabilitation"

Their only real concern is rehabilitation. Also notice the
reference to "legal requirements of patient confidentiality and
release of information".

An entire page is devoted to outlining these requirements on
this page from the AMA website, prepared by the American Medical
Association, Office of General Counsel, Division of Health Law:

"Physicians have always had a duty to keep their patients'
 confidences. In essence, the physician's duty to maintain
 confidentiality means that a physician may not disclose any
 medical information revealed by a patient or discovered by
 a physician in connection with the treatment of a patient."

This allows for trust between the patient and the treatment
provider which allows the patient to be confident in offering
full disclosure of all information which might impact the
outcome of treatment. This benefits both the patient and the

"There are exceptions to the rule, such as where a patient
 threatens bodily harm to himself or herself or to another

These exceptions refer to suicidal or homicidal intentions, 
and do not leave room for judgmental perceptions that clients
are harming themselves by the use of drugs or alcohol.

All information that is shared with others, which is usually
limited to other treatment providers, must be accompanied by
a "release of information" or ROI, which is signed by the
patient, and includes the following:

- Patient's name and identifying information;
- Address of the health care professional or institution
  directed to release the information;
- Description of the information to be released;
- Identity of the party to be furnished the information;
- Language authorizing release of information;
- Signature of patient or authorized individual; and
- Time period for which release remains valid.

And, in summary:

"Any breach in confidentiality - even one that seems minor -
 can result in mistrust and, possibly, a lawsuit and/or
 disciplinary action."

Much more on the page:

So, generally speaking, healthcare professionals are likely to
be much more vigilant than most of their patients in seeking
to preserve the confidentiality of the information which is
disclosed by the patient or discovered in the process of
treatment. It's an integral part of the ethics and legal
requirements of their jobs. Healthcare professionals working
at the VA are no different than those working at other facilities,
in that regard.

Also, you'll be doing your doctor, the healthcare system, and
yourself a favor by providing full disclosure. It will save
everyone the expense of unnecessary tests, and give your
treatment providers a much better overall picture of your


Additional information may be found from further exploration
of the links provided above, as well as those resulting from
the Google searches outlined below.

Searches done, via Google:

"patient confidentiality" "veterans administration" discharged

patient confidentiality law
Subject: Re: Veterans Hospital doctor patient privacy
From: daniel2d-ga on 01 Nov 2006 23:08 PST
Beyond all that - the doctor is treating you and you aren't being
honest with him about your behavior that is having an effect on your
health and his ability to treat you.  Plus  - tax dollars are

Could it be the steriods are having the effect they usually have on
people - affecting their bodies and their minds?

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