As a physician I have many phone conversations with my patients. I am always concerned with confidentiality. It is impossible to be completely confidential on telephone calls - who knows if someone may be listening in on another line. I rarely disclose significant diagnoses or major issues on the phone. However, often there are important matters that require communication.
Today, it occurred to me that I have a dilemma. If there is a collection of many millions of phone calls in the USA, my own telephone calls to patients might be collected. This information may be put to misuse, despite assurances to the contrary. I know that many may cynically no longer believe there is any such thing as patient confidentiality. However, we have to use stringent criteria to maintain this. There is much legislation/malpractice experience to ensure this. We have to abide by HIPAA guidelines. I mentioned this NSA monitoring issue to some colleagues this morning and their eyebrows raised significantly.
I raise this to provoke discussion in other areas where there may be a new liability to telephone conversation. So, should I call my patients? Should I insist they come in for personal visits for anything more than scheduling calls? Should I call in prescriptions to pharmacies? Should I speak to colleagues about patient care on the phone?