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Mindless

Mindless

As a physician treating patients for all kinds of ailments, I commonly encounter people who are undergoing a tremendous amount of mental or physical stress. Stress is without question, the number one factor influencing disease manifestation. Psychosocial trauma is every bit as bad as, maybe more devastating than physical trauma. Most of my adult patients are married. Commonly, I evaluate and treat one of the spouses, with the other being supportive and tolerate of my prescribed therapeutic adventure. Uncommonly I treat both husband and wife. Some of these couples are meant to be together. On the other hand, some are not.

When I arrived in the office Thursday morning, I was greeted by my nurse sitting in her usual nurse's position sporting an unusual looking large smile, "You have been served a subpoena." Those words are always stress provoking, regardless of the nature of the subpoena. "Who served me a subpoena?" She smiled again, "Guess."

Then it dawned on me. For three years or more, I have been caring for a husband and wife who are in the throes of a contentious divorce. This couple has been married for more than ten years, have no children together and live a relatively upper middle class life. They own a business together and still work together in it.

The wife had gotten acutely ill. She had come to the office for treatment. She needed time off from work. I generated a letter to that fact. The estranged husband called the office and spoke to my nurse, demanding that she tell him what was wrong with his wife. He was loud, argumentative and aggressive. My nurse calmly told him that we did not have a release to discuss her medical issues with him, and according to HIPPA laws, we were not able to provide any information to him about her. I think my nurse said, "He lost his mind after that!"

We frequently get calls from spouses wanting information about their husband or wife, we seldom give any information out unless we have permission to do so by the spouse. Sometimes a spouse specifically demands that no information be given to their spouse about anything related to their health. Those patients typically list a friend or family relative for an in case of emergency contact person. When we inform most spouses about HIPPA rules, they normally just apologize to my office staff for calling and taking up their time. Everyone respects the law.

In my thirty years of practice, I have never received a subpoena to demand that I turn over medical records to the court in a divorce where mental health was not in question, there was no illness (poisoning) or trauma (domestic abuse) related to a spouse in the marriage and/or the custody of children were an issue. For those of you who are not judicially inclined, a subpoena or a subpoena duces tecum or subpoena for production of evidence is a court summons ordering the recipient to appear before the court and produce documents or other tangible evidence for use at a hearing or trial. It is a Latin phrase meaning "you will bring with you under penalty of punishment". After identifying the person who sent the subpoena, I realized that it was the husband who was not given any information on the phone about his estranged wife.

In Tennessee, physician–patient privilege assures that the patient maintains a confidential relationship and medical records are immune from subpoena if the plaintiff has not alleged physical or mental injuries or damages. I always advise my patients undergoing any legal action not to waive their physician-patient privilege. Attorneys have a similar privilege. If a patient under my care waives their privilege or they die, the confidentiality is extinguished.

In addition, HIPPA law strictly prevents any dissemination of medical information without the patient's written request to do so. We have patients signing requests for medical records daily about their care and the results of their clinical laboratory testing from other physicians in our community and nationally. Our office has a strict procedure for patients requesting their records for themselves. We do not deviate from the protocol.

I will answer the subpoena by writing a letter to the attorney stating that the wife's physician-privilege has not been waived nor do I have permission from the patient to release her medical records to him under HIPPA laws. If the attorney wishes to pursue the acquisition of the medical records, it is my understanding that the lawyer will have to draft a motion to compel the release of her medical records and a judge will hold a hearing to determine if the release of her medical records are indeed pertinent evidence in their divorce action. I am not an attorney, but I stayed at the Holiday Inn Express when I was on my recent vacation.

It is an unfortunate circumstance that someone's negative emotional energy drives them to create unnecessary burdens and responses for others. The husband in this case is publically showing behaviors affirming the wife's contention that he has lost his mind. My belief is that he has lost his mind. What does losing one's mind mean?

It means that his mind has been hijacked by someone else's mind, and he is listening and taking actions based on someone else's worldview and not his own. Perhaps it is his attorney who has commandeered his mind, only interested in creating fees that have no probative value what-so-ever. Or maybe he has a family member or close friend who has captured his brain, giving him very poor advice. Either way, he's lost his mind.

I hope their divorce litigation mediates and finishes before he becomes mindless; because a mind is a terrible thing to waste.

Doc

Posted by Amanda Sanders at 9:38 AM
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