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When OTs Wore White Shoes

Confidentiality and Healthcare

Published March 18, 2015 1:57 PM by Debra Karplus

I turned on the television last night, to a channel that exclusively plays reruns of popular old shows. I was delighted to see "The Bob Newhart Show." On air from 1972 to 1978, Bob starred in this sitcom as Dr. Bob Hartley, a psychologist with an endearing assortment of quirky patients who appeared on many of the episodes. I loved that show in the 1970s and it's still charming, 40 years later. In this particular episode, Dr. Hartley and his group therapy patients were invited to appear on a TV show about psychology to demonstrate how the group process works. After much reluctance, Dr. Bob finally agreed with hilariously disastrous results.

A storyline like that would have no credibility today. In 1996, President Bill Clinton passed legislation called the Health Insurance Portability and Accounting Act, which health providers and consumers know as HIPAA. As part of the United States Department of Health and Human Services, details about this legislation can be found at This act has two components, one specific to insurance and the other part related to confidentiality. In the two decades since its signing, most Americans have developed a love- hate relationship with the HIPAA laws. 

For consumers, the HIPAA laws add an extra layer of complexity to navigating the healthcare system that even the most astute patients and their families find to be frustrating. Perhaps you simply want to visit your coworker who has been in a serious accident and ended up in the hospital, but you're not sure if that person is still a patient there. If the person has been discharged, you will have a very tough time finding out where he went. Maybe he returned home or ended up in a rehabilitation facility, but don't even think that the hospital will give you any clue, because legally it cannot. 

For those of us who are healthcare providers, it simply means we need to be much more careful than we've ever been with the myriad of information we are entrusted with every day that we work as occupational therapists. I remember being in a patient's room at a nursing home, in the early 1990s, pre-HIPAA. The patient's roommate had family visiting. One of the visitors asked me about my patient, "What's wrong with him?" I was quick to respond, "You'll have to ask him." 

It wasn't that many years ago, that many people, including me, had their social security number printed on their driver's license and on checks. No one with any sense would ever do that today! But when it comes to protecting information, we live in a very strange era. On the one hand, we know to give out as little information as possible. Yet, ironically, there is much we can found out about virtual strangers about whom we know little, via a web search; my speeding ticket in 2001 is public information to anyone who is curious.

How has HIPAA legislation impacted you as an OT?

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