You have to be kidding - do you know how valuable this information will be to a cyber hacker that could obtain information and sell it or a government that wishes to look into your history. This is a can of worms that has been opened and we have very little control of the security of this system. :mad:

Goodness! Our medical records in WA state have been electronic for at least five years. I worked for Social Security Disability for 30 years. In 2005 ALL their medical files became electronic. Many people in the Villages are on this program. SSA, the granddaddy of all bureaucracies, worked with doctors, hospitals and clinics nationwide to convert their records to electronic form. This is not 'new' in 2013. It is the 21st century and computers rule! There are far more benefits to electronic records than there are problems with them. The complaining about so many issues on this forum sure gets tiring. We sound like a bunch of 'crotchety old people'!

I am sure anyone who has experienced identity theft doesn't share your opinion. We have enough fraud with medicare without making all that information available to those that wish to make a fast buck. Can't hardly compare the state of Washington having some people on electronic records with the entire country having to be electronic by 2015. Whole different ball game.

So far I have only experienced inconvenience to me the patient as far as medical records. Have yet to see a benefit, but hoping for the best in the future.

I've been told time and again by providers of various medical services (not just MDs, that is) that Medicare is one of the best, if not THE best, payer. Possibly private insurers are more focused on their bottom line than they are on the health needs of their insureds....

Don't fear. I worked at the Medical Information Bureau (look it up) for 27 years and they are, and will be, under the strictest guidelines for release of information. This will not change as long as HIPAA standards exist. Even as a nurse at the hospital I can't look up your information unless I'm actively on the case.

I respect your experience and opinion based on it, but I used to think the IRS was "under the strictest guidelines" to prevent misuse/abuse of our private tax information.

It's the IRS involvement in our medical records that has me concerned. It's not the electronic medical record. It's the misuse of it by politicians using it as a political football to get votes in any way possible under the sun.

:agree::agree: Finally all of my doctors have seen what each other have done, right there on the screen. My in-laws had several doctors each, in the same hospital system, none of whom communicated. it landed my mil in the hospital with a serious blood infection due to being over prescribed very heavy steroids. She almost lost her eyesight, and was on the way to losing her life, all from doctors who never communicated with each other--some out of ego arrogance, some out of ignornce, some out of laziness to look up and read the records. My sil and husband had to nail these doctors to the wall and demand they effect some kind of records communications.

That is inexcusable, and that is what this new system is supposed to prevent. And now we have computers to facilitate that process, and yet people are complaining, making up all sorts of scenarios where this will abort our identity protection, etc.... You may like the old system, but times have changed; there are fewer doctors for more people, and they have to come up with a safe way to transmit patient information internally.

It'll be no satisfaction to you, if the irs can't get a hold of your medical information, if you happen to be dead due to lack of timely record sharing by your doctors.

CFrance - I don't think anyone is arguing if done correctly electronic medical records can save lives. We are concerned about the misuse of the information and I believe it is a legitimate concern. None of our personal information is safe anymore in this electronic age.

Russ_Boston - I respect your position and knowledge; however, I don't believe you are a computer hacker and would therefore not have the ability or inclination to obtain that information.

OUR Mega-Medical Center was hacked.All information was compromised.SSAN's everything including medical info.
I don't know which will be worse that or the Government having access.

I deal with a number of life threatening conditions and have found a lot of incompetent nincompoops who have caused me additional treatments and surgery tro fix their screw ups. I am in the process of suing a dermatology practice here that allows PAs to be in charge of your care. No thanks quack Welby I'd rather see good doctors rather than those whose practices were so bad that they were willing to leave them to start over here!
:eek:

I spent many years programming everything from cash registers to main frame computer systems, your info is not totally safe anywhere...not the motor vehicle system, not the IRS, not retail stores, no one can guarantee your datas' security these days so why obsess on the medical records system which can help you more than financial systems that get hacked every day? You give just as much 'dangerous' info when you open a store credit card.

I am not paranoid by nature, but if I had a condition that could affect future employment or the government would be interested in tracking for whatever reason I would prefer it not be so readily available. My social security, number, address, phone, buying habits are public information - I prefer something as personal as my health record not be.

You really want your health care, which can be life and death stuff, represented by a marketing gimmick?! Well, you're entitled, but I sure don't!

Exactly. Following surgery and after Medicare and the secondary insurance had paid I still owed a balance to the surgeon. His office said that the secondary insurance co. didn't think that particular surgery was worth as much as Medicare allowed, so they only paid a partial amount of their 20% and I was responsible for the remainder. That's one reason we stick with original Medicare and not a Medicare Advantage program run by an insurance co.

Whoops. You responded to me thinking I responded to the issue of records being made available on the internet and I was referring to someone who said Marcus Welby was a marketing gimmick.

Actually, I am for records being available through the computer. We have some very unusual health conditions in our collective family that are not seen often, so having them available on line in an emergency would be to our benefit.

I can understand people wanting privacy but when you have some unusual genetic stuff like we have...folks who aren't up on it need to see the records...STAT.

I would want it for us. It outweighs someone acting on a job. It is a life and death issue.

Everyone should be able to decide for themselves.

For me, the cost/benefit ratio of electronic records is worth it. I've had a spate of bad medical luck in the last couple months and ended up at the hospital in Leesburg and in The Villages, plus ER visits and multiple doctors in both cities, and all of them were able to pull up my charts and test results. For me, the continuity of care is more important and the chance of privacy violations less so.

Admittedly, since I'm still working and covered by group medical, the possibility of being turned down by insurance companies or by a potential employer don't apply to me, but I agree those are legitimate concerns about the system.

In general, I care about my SSN and financial records but don't shred prescription bottles or scrape the labels off before recycling because it doesn't worry me if some random stranger at the sorting plant can see that some random person with the same name as me takes omeprazole.

Tugging the privacy topic sideways a bit -- I do very much wonder how all the online tracking and monitoring is going to come back and bite us. I was trying to set up a free Android phone app recently and never could get it to work so uninstalled it. I then noticed a charge from Google Voice for $25 on my credit card. On my active credit card (I only keep one), which I had not given the app people. I suppose at some point I used Google checkout for online shopping and boy, they saved that info.

That raises a big red flag to me. Anyone else see it?

IF you cared that much about the dermatologist using PA's then WHY did you allow it to happen in the first place? Did you know he/she was a PA? If you knew and allowed it then how can you sue? What happened?

Curious, and this is said in a very mild tone in my head -- why is that a red flag? My inclination as a patient is to trust and put my faith in the training and experience of all medical staff until I have a reason not to. I've seen wonderful PAs before and one that wasn't. But I don't know that going in.

They said that they're sueing them BECAUSE they USE PA's. Not because of the care received. Their words not mine.

Yes, I agree completly about PAs. Many are great.

Why would you sue a Dr. that uses PAs ? What did they do to you ? You had to know it wasn't the Dr. If you didn't want a PA you could have just left.

the 'Dr.' took the biopsy, the lab said it was negative, the PA that I saw the next 2 visits insisted it was OK since the biopsy was negative, however, I showed him that it continued to grow, it was circular with raised edges and a scaly surface. He wouldn't freeze it off since it was 'negative'. It started to ulcerate so I immediately made an appointment elsewhere and wound up in the hospital having surgery that should not have been necessary and complicated by the fact that I am a transplant patient with APS as well.....so what do you think Russ? Oh and on each occasion the PA was accompanied by a female Dr. who stood in the background and never introduced herself.

tell that to the people who don't think a perspective employer would look them up on facebook. and , by the way, if you have a serious health issue and discussed it on any forum anywhere any perspective employer can find that out when they google you!

As I said and I'll say it again. Why sue the practice for using PA's? Why not sue the lab for saying it was negative? All PA's pass all their cases and care onto the doctor for approval and treatment options. If your mole was positive for cancer then sue the lab and doctor - PA had nothing to do with it IMHO.

And of course I wish you well but lawsuits are not the way to better health.

I see at least 20% of my patients who 'chase' cures when there is none to be had. They spend their last years on earth going from doc to doc since they didn't like the most recent prognosis. "There's always a better doctor" is what I hear. But sometimes even that 'better' doc has the same opinion.

That's a shame, but what does that have to do with the PA ? I would think that's the lab's fault.

My guess is that the mole was pre-cancerous and thus negative from the lab. I have seen dermatologists (I worked for two of them up north) who take a 'cautious waiting' treatment option. In other words, keep and eye on it every few months and then treat if necessary. They certainly didn't remove every irregular mole they saw.

PAs and Nurse Practitioners are fully licensed medical providers and using them is standard practice in most primary care settings. Given the shortage of family practice physicians, you will see more and more care delivered by these "mid level" medical providers. The good news is there have been many studies publish in medical journals including JAMA that have shown Nurse Practioners deliver equal and often superior quality of care when compared to physicians and their patients have better health outcomes than physicians, especially when it comes to treating chronic diseases like diabetes, heart disease and asthma.

While one can sue any provider, mid-level or physician for malpractice, I seriously doubt anyone would be successful in suing simply because a licensed mid-level provided care, unless of course the mid-level misrepresented themselves as a physician.

I think some of the confusion may be that Physicians Assistants are not licensed or used or seen in all states. In Ohio we have a completely different category called Nurse Practitioners and they do NOT have the powers that PA's have. It is something like a doctor's degree in nursing..but not exactly..being a Nurse Practitioner , they cannot practice unless under the direction of an MD in Ohio.

I had not heard of PA's until I moved here and I still am not clear what they can or cannot do. Our dermatologist always looked us over himself in Ohio.

AND no reputable MD of any kind sold " product" in their office as many dermatologists do here. It really puts me off.

Not What You're Told When You Visit TVHC
 

That's NOT what I was told when I visited the Colony Cottage office. The "greeter" asked what village I lived in and told me that when a VHC facility was built serving my village, I would get a letter inviting me to visit and become a patient.

I googled "Florida physician scope of practice", but most results were written/published by the P.A. lobbying groups that want state-by-state restrictions lifted on what they can and cannot do. Other results were the legalese of state laws regulating/licensing them.

This article helps a bit:

Battles Erupt Over Filling Doctors' Shoes - WSJ.com

My wife is an NP and I will put her skills and talent up against many doctors.

G-Person...State rules vary all over the country about NPs & PAs. However they ALL are under the supervision of an MD and they have ALL had very comprehensive schooling. Most of them have Master's degrees plus. A lot of the difference between PAs & NPs is merely semantics. And.. most of these people are doing the vast majority of "hands-on" care in today's brave new world of health care. I'm lucky enough to have my very own personal one at home!! :D

Nurse practitioners and physician assistants have a definite place in clinical healthcare. But I think it goes out of bounds to say they are good to take the place of physicians. The education and training are not the same in each profession or para-profession.

It's like saying a paralegal is equal to a lawyer. Would you want a paralegal as your legal defense if prosecuted for a crime? I wouldn't. It would be fine if the paralegal researches and does filings and communicates with me for the lawyer, but not for making my case in trial. There's a reason why state bar exams are strident and difficult to pass.

It's also like saying a medical school graduate or first-year intern can take the place of the board-certified physician. After all, the medical school graduate with new diploma in hand has done 2 solid years of clinical experience in the hospital in addition to the classroom courses in the first couple of years. But there are state and national board exams for licensure, and there are strident board-certification exams for each specialty and subspecialty....for good reason.

I wouldn't want a med school graduate being in charge of my care.....unless an attending physician were right there observing and available for immediate, in-person consult. That is how P.A.'s are licensed and authorized to work, and I hope it stays that way....under the supervision and malpractice insurance of a physician.

I think there's so much wishful thinking about lowering costs of healthcare (and I wish that too), that people are giving in and concluding, "Let's save all that money and get rid of medical school and residency requirements." But I think, as always: You get what you pay for.

the clinical evidence was obvious and contrary and over a period of 10 months showing continued growth....sorry, he was incompetent and the 'overseeing physician' was irresponsible. Doctors aren't special the are just people with specialized education, some are good, some are excellent and some are just plain terrible. I am an informed patient and don't chase cures, I have an incurable condition that has caused me more troubles than I would wish on any five people. One would have to be a moron to stick with a bad doctor, what happens when that 'better' doctor shows how your life was put at risk by the prior one? As for lawsuits, every professional is subject to suit when their service results in damage to their client or his business, over time it helps to weed out the incompetents!

first off, was the sample supplied from the appropriate spot, next they are the clinicians, they kept falling back to the old sample rather than submitting a new one when their eyes and measurements showed it was expanding, and finally, as soon as the next dermatologist saw it...before I pointed it out..immediately said "that's a cancer, we need to remove it immediately". Biopsy was positive and the original report was obtained and it was noted that it had been a 'meager' sample. I would have expected more from such an 'advanced' practice.

Wow, Having worked for a Derm for 2 years that is really hard to believe. But I will if you say it's true. Not sure what you mean by the appropriate spot. We used to take off the entire area all the way to clean margins (I think that is the standard of care even in areas that are not suspected cancer - just to be sure). Was it that large that they only took an area within?

from what I saw along with the new Dr was an image of a small sliver of the raised rim of the circular edge. we both saw the 'meager sample' comment and he agreed as did the plastic surgeon who wound up removing it.

As a Clark's Level 3 melanoma survivor, I had been in the care of a dermatologist up north for forever. When I moved here, I began using a dermatologist whose practice structure is to allow the PA to determine what to biopsy, and when it comes back positive and not with clean margins, then the MD operates. I swear by the PA I use; half to three quarters of the questionable moles come back as what used to be termed as "early evolving melanoma." My body just seems to form these with gusto! IMHO, based on what I've learned from the both dermatologists and the PA, something that is "pre-cancerous" should not be described as "negative"....

I have records sent to the dermatologist up north, who during one of my rare visits there (I live in FL most of the year) he commented that some of what was biopsied may never actually become melanomas and that removing them that early was (pardon the expression) overkill, in his opinion. When I brought this up the PA, the response--which seemed pretty sensible to me--is that in FL we have to be that much more cautious than up north because of sun exposure so much more and so much stronger. And frankly, I'd rather err on the side of caution: "Take it off!"

Thanks for the info.

Now back to the topic:)

Yes, good idea: Back to the topic!

As I understand it, although the propaganda in the Daily Sun obfuscates about structure and ownership, the new health-care system is a for-profit operation of the Developer-- not a "voluntary sponsorship". This is not a criticism. If the Developer can run health-care delivery as well as he runs his other operations, this is a good thing, and he deserves to make a profit. However, to call it a "voluntary sponsorship" implies that the Developer's motives are altruistic.