The Hippocratic Oath: Privacy
The sixth and final covenant of the Hippocratic Oath is called Privacy. My oath states:
That whatsoever I shall see or hear regarding the life of my patients I will keep inviolably in confidence even beyond the patient’s death.
Read previous articles in this series on the covenants of the Hippocratic Oath: Honor, Teaching, Limitations, Availability, and Abjure Harm.
This ethical law is hugely important when a patient visits a doctor. A good doctor is a good listener and someone you bond with as you describe your sickness. The strategy is described by the acronym SOAP, or subjective-objective-assessment-plan. The doctor needs to hear the story in the patient’s words to be accurate while assimilating the symptoms leading to any particular diagnosis.
A one-on-one quiet interview while sitting and looking the patient right in the eye with interest is what the patient should expect. The interview (or history) should be non-rushed. Most of the time, patients who are in pain or afraid of what the diagnosis will be will be right to the point. Patients watch the doctor’s body language and conversation. Trust and caring are what is important to the patient, and that is relayed to the caring doctor, who wants that patient to know that he or she is right there with them throughout the duration of this disease process, start to finish. The word for it is compassionate. Another descriptor is empathetic.
So, confidence is established by a private discussion. This is followed by a caring physical examination which demonstrates that the doctor must follow very basic principles to be sure that there aren’t other issues that you don’t know about. It’s like going to get your tires rotated on your car, checking tire pressure in the process, changing your oil and checking fluid levels of other systems, checking brake pads, etc., all at a very reasonable price. Call it peripheral vision. It makes you feel more confident.
Privacy is very important, because these are the closest issues and physical characteristics patients have, and they don’t want them shared with the rest of the world. This information is vital and must be used without interference. It is truly a matter of life and death. Your personal history, including social history, habits, family history, systems review, and so forth, is private!
The culture now demands that doctors don’t invade your privacy. Hogwash! It’s sloppy work and cuts corners not to! Nothing goes out of the confines of that exam room except to your sacred and guarded medical chart, with God’s approval. And anything leaving that doctor’s office without your approval is malpractice and a breach of the oath.
Medical education and training are national, such that a physician can go to any town in the nation to practice medicine and surgery. That means that if I trained at UC Davis, I could easily practice in Arizona, and know exactly what Arizona doctors and hospitals do. It’s universal, and that’s good for patients.
But once a doctor settles in a city or town somewhere in America, all of that training shifts from “federal” to local. The information and facts about your health are supposed to remain very local, as indicated above. “Federalism” as defined as a result of our rights as free American citizens, is factually expressed as decentralization of power, which is the opposite action from what the command defines. Why should a bureaucrat in Washington DC know that your doctor identified a painless lump at the base of your neck on the right side, just above your collarbone? Your doctor doesn’t need any federal help but thank God that doctor was thorough while examining you. He or she might have just been diagnosed with a treatable lymphoma.
Decentralization of that power is the most essential element of a free society, ultimately bestowing to you and me the best decisions possible, privately. That’s called federalism in medicine. This is another aspect of ethical privacy that helps define the sacredness of this covenant, and breach.
Nowadays, the paltry amount of time a “doctor” spends with you is necessary to determine diagnostic codes called Current Procedural Terminology (CPT) codes which are electronically fired off to thieving third party payors, including “healthcare insurance companies” and Gavin Newsom. Not too long ago I went to an indoctrinated, government-controlled gastroenterologist for a colonoscopy. As a general surgeon, I know exactly what that physician’s job is, and am quite disappointed if I detect anything less than spectacular performance. It brings up profound trust issues and potential danger to my God given body, which I am fully responsible for.
So, in a kidding fashion, my burned-out gastroenterologist twiddled all 10 of his fingers in the air and said to me, “If you’ve got 10 of these, you can be a gastroenterologist, meaning that you can type on a keyboard. There’s a CPT code for examination, a CPT code for a biopsy, a CPT code for anything a physician would do and hopefully get paid for whether he or she carries out the procedure or not. Many of the fundamental procedures that doctors used to get paid for are now denied.
The gastroenterologist is truly a hopeless keyboard warrior and is very aware of what the cheating insurance companies and government are willing to pay for. He “defers” thorough examination by falsely assuming that some other doctor in this assembly line system is responsible. This system is so bad that it’s like ordering from a menu and getting the highest quality food served possible, and it’s lousy food. The gastroenterologist has no choice in your medical and surgical care. Your information, including where you live, your overall behavior, your quality of life, any pre-existing conditions, any as yet undiscovered findings, your habits, your social history, etc. are forwarded by your doctor to others. Lots of facts and fiction move forward, and that is not safe.
In 1996, a federal law was introduced called the Health Insurance Portability and Accountability Act (HIPAA). What hypocrisy! You are told that your information is very, very private. The government made it clear to you, by holding doctors’ offices to task. Think about these words for a second. Portability? That means that your private information, that between you and your doctor, becomes public! Accountability? CPT codes that justify how little the stingy third payor allows for the doctor’s services? This is exactly how you and your doctor are being robbed blind.
There is something else that patients just don’t understand but need to, and it’s called Explanation of Benefits (EOB), and it’s present on any invoice having to do with medical treatment you receive. The bottom entry, called balance due, is where the eyes of the consumer go immediately, which says “what’s the damage here”? If that number is $00.00, as it often is, that document hits the round file.
If one took the time to look through the EOB document, the crooked insurance company, including the state and federal government, let you know how much the doctor charged, and how much that doctor was paid, which brags to you just how much that rip-off saved you. What it doesn’t tell you is just how much money the jackals added to their bank accounts at your and your doctor’s expense. It’s the classic combination of price gouging and price fixing, all right in front of your unsuspecting nose.
Now add to your medical information your financial information. It’s all right there: your assets, liabilities, and financial standing. It’s all there for the harvest. Internet connection equals hack. Your privacy, both medical and financial, is the feeding grounds of greedy crooks and I am here to let you know that you are being ripped off – both your most private physical and behavioral characteristics as well as your personal financial characteristics. Your value becomes the property of the tyrant.
Privacy is fully breached. Newsom and his devious Medi-Cal, Medicare, ETNA, Blue Cross,
Blue Shield, Dignity Health, Sutter Health, Kaiser, UC Davis, etc. all know everything private about you now, and your healthcare laborers are snitches and don’t even know it. You have no privacy. Electronic medical records and billing hack of any wealth you hope to keep in your hands. This system is broken. Think of it this way. Privacy in Newsom’s healthcare world is nothing more than isolation and control of your mind and your pocketbook and crippling you of the opportunity to talk your treatment protocol over with your friends and family and determine the cost of high quality medical and surgical care. Instead, outcomes are dictated by monsters who care nothing about you except to execute you so they can keep more healthcare dollars for themselves.
So now I have hopefully defined for you what these six sacred covenants of the Hippocratic Oath represent, and a comparison of what adherence to all or breach of even one will cause. Quite simply, the success of medical or surgical intervention hinges on whether we treat each other ethically with God-derived standards, or negligently via man-derived standards. Outcome is 100% based on the stress laid upon treatment and prognosis.
Here in California, Gavin Newsom and his tyrannical regime have breached all six. It is time for us to do something (a lot) about it.
The fundamental four questions are posed here as with all the other covenants one final time:
Is medical care affordable?
Is medical care competent?
Is medical care satisfying?
Is medical care safe?
Get involved, get motivated, and help all the rest of us who want good ethical medical practice better than ever before here in California, because it is you who will decide the future history of the medical profession.
Here is a guarantee. By letting many thousands of California physicians know that you understand the process of the monsters stealing our medical system, you will win them back and free them up. And you will be making some amazing friends. Now is the time for action. Now is the time for the doctor-patient bond. Step up, Californian! This is a war for our freedom of medicine. We need the healers on our side. Convince them!