Sunday, February 12, 2012

Confidentiality at Amritsar Medical Facilities

Is pretty much non-existant. In the last 13 months I've been to 3 different phlebotomy labs, 3 different private doctors offices, and 4 different private hospitals. I'm hoping I didn't miss any of them but it's been a long time so it could be more. When it comes to confidentiality, there isn't very much in any of them.

In some facilities a file is made for you the first time you visit. In some cases you have to pay for the file to be paid up front. As you continue to visit the office you bring the file with you and they store lab reports and information about you and your treatment. These things aren't seen by other patients unless they are standing over your shoulder looking - which they do - but, I've seen and heard doctors openly discussing patient information in the waiting room, in front of other customers, etc.

I've written some about my medical experiences here but it's important you all know I'm not the only one they treat this way. In the US I was accustomed to your medical information only being discussed in private with a medical professional (nurse or doctor) and then it wasn't discussed if other patients were around but on occasion may be discussed if another nurse was nearby. One example of that would be if you were getting your weight checked before entering the doctors office and the scales were near the nurses station the nurse assisting you would still openly report your weight sometimes. Anything beyond that was never discussed in front of anyone except the nurse and doctor you were working with that day.

Here in Amritsar it's not at all uncommon to hear the doctor discussing genitalia, diseases, and more in the waiting area in front of all of his patients. When you're in a treatment room it's not uncommon for the nurses to bring other patients back into the same room so they can wait their turn. If this doesn't happen because the office is small, there is usually a glass wall up so that patients in the waiting room can see when the last person is leaving the treatment room. Many doctors offices - some I walked right back out of that are not included in the counts above - have a wall that is half glass with the treatment area in full view. Most have a curtain but that is not adequate protection for your confidentiality.

So you can imagine while I was being treated earlier this week and was taken back for an ultrasound that I was hardly surprised, though still very uncomfortable, that the male technician who had been working on the machine was in the room with me and my body was used to show the images on the screen so the technician could make further adjustments. By the time this happened I had gotten used to having several women patients in the room while I had previous ultrasounds with only a curtain to hide the lower half of my body with the upper half completely exposed (Thank God I didn't have to remove my shirt.)

The curtain is used more to stand behind while you fix your pants and they do give you a sheet to cover up with, a sheet they don't change between customers, so that your body isn't showing to anyone that you're aware of. Once you're done and you get your pants fixed you go to the desk, in the same room and the next woman gets ready for her ultrasound while the doctor or his helper explain to you what you need to do, how your insides looked, are you okay, etc. It's rare to be in that room alone with the doctor and this is not the only facility I've been in that operated that way.

When I went to Fortis Escorts there were 3 other male patients in the doctors office with me while he discussed my medical issues and at another scanning facility there were 2 female patients waiting in the room for me to get done. At two of the doctors offices I went to they had the glass wall. I never needed to be examined in those but I have seen other people being examined. Or at least part of them because the curtain does not cover anything. I have walked out of several facilities where the glass wall was in full view of the road and while entering I could see women or children exposed and laying on the treatment beds.

Be prepared if you have to see a doctor here to have your medical issues exposed in some way. I've also had women clinic workers (who are not nurses) tell me of other patients and their treatments as well. In other instances I've seen male customers walk into a room where females were being given shots and having their bottoms partially exposed with no one seeming to be concerned for their privacy. Also this week I had one of the nurses (one I like, she's a sweet lady) call her daughter so that she could talk to me because she wants us to meet. Of course, now the daughter knows about my treatment and such I'm sure since this is the same nurse that told me about another patient.

Of course, you can insist on being in the room alone and the doctor will try to make it happen but that doesn't stop patients who are used to the things I mentioned already from just walking in. I've also seen (at Fortis Escorts) an exam room in use with a light on indicating it was in use and a sign on the door saying "do not enter" be opened and patients walk in. Nurses tried to keep them out but you let their backs be turned and patients were still ignoring the signs and walking in. I did notice though that with the glass wall facilities, patients don't walk in...but I'm sure that's because they can see the doctor is actually busy.

7 comments:

  1. Hi Kristy, as you know I have had a similar experience when my husband and I took Amrik to a pediatrician last week. If the medical staff can't control other patients from entering the examination room whist a patient is receiving treatment, then they need to employ security guards to stand out side and control the rude and ignorant people from entering the room.

    Nicky Singh

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  2. Wow! I had to visit a physician in AP when I visited last but it was a slow day so I was the only patient being seen at the time so I wasn't subjected to such an issue. I really hope that your medical issues are resolved and that you don't have to go through any more uncomfortable experiences for that to be accomplished. I really feel for your situation and only wish I could do something to help.

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  3. As I'm sure you know we have Health Insurance Portability and Accountability Act of 1996 (HIPAA) in the US which provides federal protections for personal health
    information held by covered entities and gives patients an array of
    rights with respect to privacy. You know 'privacy' as we know it in the US just doesn't exist in India- we are thought of as being 'selfish' when we demand our idea of 'privacy'. The pharmacy is another place (in addition to hospitals & clinics) where your purchase is made public knowledge & is available for the the perusal of all the employees from the techs to the cashier. Buy any sort of psychiatric med or 'family planning' device/medication & be prepared to be openly gawked & giggled at by all.

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  4. I guess it also must vary from place to place, I never really had any confidentiality issues in Bangalore, the one and only exeption being once when I went to Fortis whcih was back then Wockhardt hospital and had many nurses and Dr come in the exam room without knocking to tell the radiologist about some other patient's medical issues. All the other places i never had anybody walk on me, or come in while I was in. But in Lucknow I had to go in for a fever I had myself years ago, with my future in-laws I just met for the first time 3 days before, and the Dr's office was small, crowded and the exam room was just divided from the waiting area by a opaque glass pannel, I could hear all that was going on in there...gasp!

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  5. Yeah it's just sad. People know better than to walk into a room after they've been told not to. It's just a prime example of how selfish people here can be.

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  6. Yeah I've seen that too. Which is why it surprised me the doctor and nurses were openly talking to several patients about their genetalia right in the middle of the waiting room. No sensitivity at all...at least not until several NRI's walked in. I have a post coming about how much he changed his behavior then.

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  7. That's really good that it's better in Bangalore. I'm starting to slowly figure out that Amritsar is just one of the worst cities in India in most ways. I do know of one city worse so far in some ways though which is surprising to me.

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