“Old Fashioned”
Dr. Justin Ilsley
10/15/13
My patients have commented that they like the fact that I handwrite my chart notes. Many of them have concerns about who is privy to that information such as insurance companies or unknown scavengers looking for personal data. I actually have one cash-paying patient who has insurance coverage but prefers to “stay off the grid.” It may seem paranoid but the concern may not be unfounded. I have heard many stories such as one regarding my patient’s ineligibility to participate in a new insurance because she had been diagnosed with a preexisting condition: anemia diagnosis five years before applying. Although it seems that the insurance underwriters can use just about any reason to exclude people from joining their company, this particular issue will likely be resolved if the Health Care Reform Act survives. Regardless, there is also abundant evidence of hackers getting into heavily guarded files from Russia (for personal and financial data) and China (for confidential government and research data, as well as manufacturer intellectual property). It makes one a bit uneasy when it seems that virtually anything connected thru the Web can be breached.
In his latest book, The Future, Al Gore briefly mentions a new facility in Utah being built by the NSA to store and monitor “every telephone call, email, text message, Google search, or other electronic communication (whether encrypted or not) sent to or from any American citizen.” (The Future, p87). Although the information collected by the NSA will not be made public, we have seen major cybersecurity breaches in recent years within classified government agencies such as those exposed by the WiKi leaks and more recently the NSA surveillance leaked by Edward Snowden. Although the purpose of these leaks may have had self-described altruistic intensions, it is clear that stored data is in danger of being exploited.
With all of our social media interconnecting and following our every move anyway, some people feel like there is no point in protecting our personal information. It is as if we are resisting an inevitable tide. My friend and neighbor, who is a software designer and lawyer commented, “Perhaps having all of our information out there will level the playing field. We won’t have anything left to hide. Perhaps there will be less discrimination because we will all have everything on the table.” I hope that could one day be true but we humans do have a strong history of discrimination. We have frequently used people’s past secrets to exploit them, or somehow gain power over them. And just as we are warning our teenagers of the huge ramifications of hot headed facebook posts or scantily clad pictures downloaded to the web, I am already feeling how out of control we are with the information that gets released into the digital world. It seems to have such a forever-ness. We don’t have any control over how our information is used or stored and we can’t really change it once it is out there.
Anyway, I’m not sure where we as a culture are headed with all of the data collection. Your medical information should be kept private but it may not always stay that way, especially once it has all gone digital. For the time being, I will continue writing my chart notes by hand. I really like the personal connection. Writing on paper helps me feel just a little more human even if it is a bit old fashioned.