There are two issues here:

 

1)      The Patient's right to privacy and to control her/his personal
information

2)      The IBCLC's potential need to share information with a clients
provider

 

I do not always send a Dr's report for my consults.  I know, I know - there
are those of you sitting there shaking your heads.but I have the ability to
determine if it truly is necessary to send a report to a doc to say I helped
your client fix her positioning.  I actually got 'yelled at' by a doc who
was irritated that I wasted his time with a simple Doc report that stated
that moms positioning was now corrected and baby was getting more milk and
hurting mom less.  Maybe that jaded me a bit. I don't know.so please don't
get on me about Dr reports and whether or not I should send them EVERY time.
I know the general opinion - and I do send them most of the time - just not
all the time.

 

There are reasons that people don't want their medical information shared.
It is not up to us to determine whether those reasons are valid or not.
Certainly we can refuse treatment if a mother refuses to allow the sharing
of her information.  In fact, I have a client whose hubby works for the FBI
- he about freaked when she read to him my consent form which has in it the
standard:  I give my written consent for the LC to send any and all
pertinent information to my infant's and my primary health care providers
and to consult with them in any way that she deems appropriate.  I had to
reassure him that in her situation the Dr. needed a report - but that he
could hand carry it which he was happy with.  It limited my ability to share
as needed but it is HIS family.and it is HIS right to refuse.  

 

Now - if I feel a true need to share information (which is not all that
often) then I do.  But most moms I work with have no primary provided, or
they have a temporary Ped but will be seeing this other guy, and then they
still have to choose a final PCP.  It is crazy!  And trying to get faxes in
to Docs at a couple of the local hospitals here is a joke.

 

For some of us we may well be comfortable refusing to help a mother if she
refuses to share her personal and private information.  For me - I look at
the circumstances.  If mom is legal and dad isn't (true story!) and the
consult is a basic no major health issues going on (fix the latch, heal the
mom) then I will respect her wishes to protect her family and help her as
much as I can.  If it is a major situation (been there too) then I will
explain to the mom why it is in her and her baby's best interest for me to
share the information so they can get the best and fastest possible help.
Leaving her in out in the cold is just something I cannot do.  Never have
had to - and hopefully never will.

 

 

Lastly, I want to share a personal issue with you on this very matter.  I
was in a really bad car accident 9 yrs ago.  And I mean BAD.  Permanent
lifelong injuries that I have to deal with because a 17 yr old drunk driver
wasn't paying attention.  Last year (Jan 05), I was rear-ended by a guy who
was rear-ended by an idiot who wasn't paying attention to what he was doing.
It was minor - only about $675 damage to my car - but to me?  Within 2
months I couldn't work much, couldn't teach line-dancing anymore (my other
passion), couldn't drive my stick-shift car because it hurt too much, I was
in agony, despite seeing my massage therapist 1-2 time per WEEK.  By Feb 06,
I was completely out of commission.  I couldn't work at all - the pain I was
in was unbelievable.  My neurologist diagnosed me as temporarily if not
permanently disabled and wanted to do surgery (I said NO!  There had to be
another way).  Well, in my medical records are other minor accidents I was
in here and there and a list of complaints.  Not many - but enough.  NOT
noted in my medical records is the fact that before the accident last Jan
(05), I was doing fine because I had taken it upon myself to take care of my
body so I could work. 

 

Currently, I am working with an atty to settle this last accident - the
other guys insurance company wants my medical records so they can determine
if I really had as many issues as I said I did so they can try to NOT
compensate me appropriately because the accident was minor.  (My atty says I
am now Humpty Dumpty!)  Do I really want them to have my medical records??
Hell no!  Do I think it is fair that they have the right to look at ALL of
my personal information - even that that has nothing to do with my
injuries???  Hell NO!  Do I have a choice if I wasn't even an attempt at a
fair settlement?  Nope.  Luckily for me, I have a good neuron who made it
clear that my issues for last year were due to the 05 accident.  

 

Do I understand why people don't want to sign a consent form?  You bet.
Will I force it?  Nope.  I have even crossed out that line on my form with
both client and I initialing.and I still helped them.

 

 

My 2 cents this early morning.

 

Jaye

 

Ps - Feb 06 I went to the Bowen Therapy Specialist who changed my life and
took away my pain almost completely.  I still have minor discomfort and
usually pain only if I spend to much time at my 'puter.  I have been fully
able to work, and because of that have literally more than doubled my income
from last year.  If you saw my MRI's and other tests you'd all be amazed
that I function at the level I do.guess I am too stubborn to be even
temporarily disabled.  :-)

 

 

 


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