Why your GP doesn’t have a Facebook sharing attitude

The success of Facebook is based on sharing content with friends and family. I’m a fan of social media but in healthcare sharing of information is often a no-go zone.

Doctors don’t like sharing patient information with third parties for various reasons: they have sworn an oath, must adhere to a code of conduct and have an ethical and legal obligation to safeguard the privacy of their patients.

The patient-doctor relationship is built on trust: patients need to feel safe to share their concerns with a doctor. Unfortunately in Australia there are a few worrying cracks in the system, such as the access of insurance companies to health records.

Life insurance industry

Last week I had the opportunity to present the concerns of the Royal Australian College of General Practitioners (RACGP) at the Inquiry into the Life Insurance Industry of the Joint Parliamentary Committee on Corporations and Financial Services in Canberra.

The issue is well summarised in this ABC News article ‘Doctors resisting health records being sent to insurance companies’. Based on feedback from GPs, the RACGP recommends in its submission into the inquiry that insurers should not be allowed to ask for full patient health records.

This is an example of inappropriate sharing of information with a third party (which differs from sharing between health professionals) and can have serious ramifications.

Inquiry in Life Insurance Industry
Last week I had the opportunity to present the RACGP submission at the Parliamentary Inquiry into the Life Insurance Industry.

5 reasons not to share

There are five reasons why third parties such as insurance companies should never have access to health records:

# One

People often don’t understand that ticking a box on the life insurance application form means that insurers can have access to their health records, including confidential information that has been shared with doctors, often over many years, and may not be relevant to the insurance company.

In the experience of GPs many people withdraw their consent once they are aware of the possible repercussions, and in some cases discuss with their GP to submit a targeted, more relevant medical report instead.

# Two

The therapeutic trust relationship between a GP and a patient could be affected.

Patient knowledge of the issues they may face after disclosing symptoms or seeking treatment, particularly for mental health issues, is likely to discourage disclosure and help-seeking, which adversely affects patient wellbeing.

# Three

Understanding that medical records can be requested by an insurer may lead GPs to under-document or under-identify patients at risk in efforts to make sure the patient’s access to insurance is not affected.

GPs have advised that they feel they are placed in a difficult situation where they need to ensure adequate documentation of their consultation with patients while also considering the broader impact this may have on their patient. This in turn may have medicolegal ramifications for doctors.

# Four

Insurers not only have access to but also store thousands and thousands of health records. This raises all sorts of questions with regards to data usage and standards around security, privacy and confidentiality.

# Five

Many GPs are concerned about the risks of misinterpretation by insurers when reviewing a patient’s consultation notes.

Medical consultation notes are a comprehensive written record of concerns, symptoms, examinations, investigations, treatments and planned reviews. They function as an aide memoir and are not made for the assessment of risk for insurance purposes.

Suggested solutions

There should be a tightening of the requirements around requests for full medical records by insurers. With patient consent, doctors should only be asked to provide a targeted and relevant report to the insurer.

There is also a clear need for greater patient education on consent and the release of health information to insurance companies.

7 thoughts on “Why your GP doesn’t have a Facebook sharing attitude


    The issue here is about Consent. Doctors have long shared patient information when they write a referral letter when they teach the next generation of Doctors and in difficult cases. Sharing of patient information is consented for the purpose of the greater good and the patient is a party to that greater good. Where would our knowledge be without the sharing of case studies and patient information donated by our patients in order to teach, to learn to demonstrate and to expand knowledge?

    This consent occurs in the setting of the therapeutic relationship that exists between treating Doctor and Patient. It has been a hallowed contract since Hippocrates first scratched out his oath.

    The issue with the insurers being that this is a 3rd party to this relationship. The motivating intent is not one of altruism or healing but of actuaries, probability risks and money. Essentially the relationship between Doctor and Patient is now triangulated and as we know from psychology this becomes in the case of unequal power and different values a dysfunctional relationship.

    There is a very difficult issue between legal contracts social contracts and the healing relationship. Inserting any 3rd party into that is likely to be problematic. More so when the patient who owns their privacy does not consent properly.

    The insurance industry needs to pick up its game and the casualisation of privacy needs to be examined ethically. The Government of any party also needs to be held to account here. With a call to transparency in the Big Data of Health care for the greater good. Doctors and especially GPs are trying to articulate this ethical battle for patient information whilst the Big Data boffins of the day salivate at the value of getting patient data. DATA is worth a lot of money. But the DATA belongs to the patient and this push into our consultation rooms is stretching the therapeutic relationship boundary.

    I sincerely hope that consumers are able to examine these issues very closely and hold those who would inappropriately use DATA for values other than healing to account.

    Unfortunately, the voice of the minority is often drowned out in political spin.

    It’s not about sharing of data as much as it is about altruism, consent and the intent of Hippocrates to bound the therapeutic relationship between Doctor and Patient as sacred.

    GPs are calling on these powerful agencies to be ethically accountable. I hope that patients are mobilised by this too and understand the very difficult nexus of data sharing with consent.


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