HIPAA and pediatric dentist

[rupiezum]

DH & I are trying to decide how best to handle something that's really bothering us.

We took DD to her pediatric dentist for a routine checkup recently. DD is almost four; this is her third routine visit to the office. On all previous visits, both DH and I went into the exam room with her, with no objection or comment from the staff. DD does ok, but she is shy and nervous and definitely needs a parent with her for her own comfort level.

On this visit, however, they called DD's name; I took DD's hand and walked back with her, with DH following behind. DH was stopped at the door by the receptionist, who barked "Only one parent!" (I didn't realize what was happening, and was totally focusing on our nervous DD, so I didn't get the whole story until after the appointment.)

DH questioned the receptionist, saying, "Oh, I'm sorry, this has never been a problem before." The receptionist cited HIPAA, saying no parent should go back there, because "they deserve their privacy, too." She said that they weren't going to get into it with me, but 'technically [I] shouldn't be allowed either.' He sat seething in the wating room until we came out, and told the story when we got home.

I have a lot of problems with this... first, the receptionist was rude. Second, she's citing HIPAA incorrectly, as least as understand it. Third, this was never a problem before, and I don't appreciate it being sprung on us without warning. Fourth, I don't want to have them suddenly announce that no one can go back with my DD.

I want to write a letter to the dentist, and have an explicit conversation about this. I want her to explicitly state her policies.

Thoughts, input, etc? I know dentists are for some reason notorious for this crap, and I thought we had found a decent one, but now I'm less than confident. I also don't get why this an issue for dentist but not for pediatricians. Come on now, I'm not going to just hand my child off to someone for medical treatment done without my knowledge or consent - she's THREE for crying out loud!

:

[prairiechild]

What a freaking rude receptionist. HIPAA has nothing to do with how many parents can go with your child.

I would write the dentist a letter and specifically ask about their policies and tell the dentist what happened.

Personally, I would probably not go back to that office if you have any other decent options.

[mollyeilis]

Our new pediatric dentist has that policy too, but at least they aren't pulling pretend HIPAA rules out of their rears. For them, it's to reduce a crowd, and b/c they feel that things generally go smoother with just one nervous parent rather than both.

Then again, our dentist seems to think that privacy laws govern the PATIENTS, rather than THEMSELVES, and have signs saying that HIPAA requires cell phones to be off. Um yeah, THEIR cell phones maybe, so they aren't having a long conversation while imparting private info about their patients, but if they are giving info loud enough so it's audiblr to someone on the other end of another patient or parent's conversation, then that is a problem. But still, it's THEIR problem, not ours...:

Then again, ALL health care people seem to think HIPAA governs us rather than them. What else could explain their asking US to sign forms that say we got info about it? When it should be THEM signing forms and giving them to us, promising that they won't give out info to anyone who doesn't deserve it, etc etc etc...that one gets my goat every single time I have to sign a form, and always say it to the clueless receptionists, who smile blankly...

[Ellien C]

Originally Posted by mollyeilis

Then again, ALL health care people seem to think HIPAA governs us rather than them. What else could explain their asking US to sign forms that say we got info about it? When it should be THEM signing forms and giving them to us, promising that they won't give out info to anyone who doesn't deserve it, etc etc etc...that one gets my goat every single time I have to sign a form, and always say it to the clueless receptionists, who smile blankly...

I never thought about it that way - but you are SO right.

[rupiezum]

Originally Posted by mollyeilis

Our new pediatric dentist has that policy too, but at least they aren't pulling pretend HIPAA rules out of their rears. For them, it's to reduce a crowd, and b/c they feel that things generally go smoother with just one nervous parent rather than both.

Yeah, that's what really chaps my hide - that they are misusing HIPAA in attempt to control parents. If your reason is crowding, fine, then say that. (Although why it's suddenly too crowded, when before it hasn't been, is beyond me)

And ditto on the medical profession's take on HIPAA - hello, missing the point much? ::sigh::

THanks for the input.

[hockeywife]

I work in a dental office and we have our pts sign a HIPPA form saying that they understand that we follow hippa rules and it also releases permission to share your info with insuranse co. and other drs that we refer to. We also have things to follow, ie; shredding certian papers from ins co and such. Anyway, I cant believe thay would not let you both back with her!! Most of the time when we have both parents, one will be right with the child and the other in the door way. It is tight, but if that is what the parents wish, they should accomadate!!! Honestly HIPPA has nothing to do with letting parents in. I would be calling the office and talk to the dentist, or write a letter. HTH

[mollyeilis]

hockeywife, do you see that the dentist should really be having your office staff sign a form and give it to your patients, with the staff and dentist's promise that you won't be sharing info inappropriately?

you might not realize, but by giving yet another form to the patients/parents, and making them sign it, makes it SEEM like the hipaa laws are governing the patients/parents, when actually it's supposed to PROTECT THE PATIENTS.

it's backwards, the way every health care person does it, making the patients sign a form, and makes the everyday person completely misunderstand what the laws are all about.

Combined with the parent limit for dental appointments and our ped dentists insistence that hipaa prevents patients/parents from using their cell phones, it's totally gotten away from the reality that it's for the patients' protection.


And, of course, they are useless about it. Should I really know that the woman's son next to me had had a long-standing infection in a tooth, and that Dr Ben was going to extract it, along with doing some fillings? No, I shouldn't. But I do, because he came out and talked to her right in front of me.

Thank goodness I didn't have my cellphone on, I could have told people about it...waittaminnit.....:


I think it would awesome if anyone who has realized how backwards it has become would bring it to their health care providers' attention. Maybe they would start talking about it, and figure out a better way to do it, so that regular patients would understand that it's for them.

I know what it's about, as I was a chiropractor (interestingly, I was dedicated to protecting my patients' privacy even before the portability act was enacted) and I later worked at drugstore.com and got comprehensive tranining in it. But few others do.

[prairiechild]

Having worked in a Drs office for years, I can tell you we did have to sign forms promising confidentiality. They were not given to the patients, they were kept in our permanent files.

Also, the Drs office staff hates the HIPPA forms as much as the patients do because they take a lot of time especially when you have to explain over and over again why they have to be signed. Having the form signed is a HIPPA requirement.

Sure, we can say they shouldn't require it but they do, and so the staff has to comply.

[mollyeilis]

Then that should be said!

Instead, it's handed to you in an official manner, and truly, it feels to the patient like it's something put on them, not something FOR them.


I was thinking about it last night, and I'm having a hard time figuring out what the Act actually did for patients, other than making it obvious that we have access to our records. Which isn't even totally true, as providers say "we only have to give you what WE feels is needed for continuation of care", and unless you ask for everything and PAY for the copying at whatever so called "reasonable" rate they put on you, you don't end up with your full records, necessarily.

So...beyond records, what did it DO for us?



Sorry I'm going off topic!

[Ruthla]

Um, my understanding is that HIPPA prevents the medical pros from giving out private medical info without the patient's consent. For the case of pediatric patients, it's preventing giving out medical info without the consent of the parent or guardian. Think about it- do you sign the form or does your 3yo?

Secondly, there's no problem with HIPPA if a patient permits anybody (husband, friend, whoever) to go into the dr's office with him or her. The patient has the right to share his/her own medical information with whomever he/she chooses. For example, my Mom can't call up my Dad's doctor and talk about her concerns about his health, but she can go with him to dr's appts and the dr can talk to both of them together. If my Dad would sign the appropriate consent form (which he's probably too stubborn to sign) my Mom would be able to talk to his dr without him being present.

I would absolutely insist on going into the exam room with my young child. Now that my children are a little bit older, and are comfortable with the dentist we see, I ask them if they want me to go back or not. I'd totally respect my 12yo's desire for privacy if she didn't want me to watch her getting her teeth cleaned.

[mollyeilis]

Ruthla, what I personally am saying is that HIPAA is something that governs the medical professionals. IMO, the patient or parent of patient shouldn't have to sign a thing. No one is talking about a 3 year old signing something, and when I'm talking about hipaa, I'm taking a broader view, away from JUST talking about a pediatric practitioner.

And we're saying that dentists ARE citing hipaa as the reason only one person can go back. Since dental offices are generally open rooms where anyone can hear anything, they are saying that having other poeple back there means unrelated people can hear confidential info about other people...

Our dentist is citing hipaa as the reason they want cell phones off, and I call a BS on it, since privacy laws govern THEM, not me.


And, having just recently gone through the ringer (wringer?) trying to even find someone who didn't insist on General Anesthetic blah blah blah, there are certainly dentist out there who will NOT work on your child if you are in the room, whether or not the parent insists. So you wouldn't be able to utilize the services of those dentists, b/c a parents' insistence would get the parent nowhere. Some just won't do certain work with even one parent there... We planned on reminding dentists that DS had watched my laser eye surgery, as well as watching what they did to me to take DS out, and he was just fine, so he could certainly handle a tooth extraction, but it was all moot b/c we found a SANE dentist who realized that everything could be done in office with lidocaine...

[monocyte]

Ugh, Ali, I wonder if we go to the same dentist...we are going next week and I am here to "rearm" myself.

The large pedi practice we go to tried to take DS alone at barely 3 years old and I started to leave and they allowed me in. Then they called him Samantha a few times...UHM, he couldnt look or dress anymore like a boy. I was going to give them one more visit, and request a copy of his records while we are there...

Ok, enough off topic.

What does HIIPA have to do with you being allowed back? Kind of a stretch IMO.

[rupiezum]

Ugh, what a terrible experience... we've been going to an office in Braintree. DH and I are working on a letter so this doesn't get swept under the rug, and we have plenty of time to switch if we need to. It seems like most of the pedi dentists in the area are pretty awful though.