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In a comment on a recent post, a reader chimed in on the subject of unique patient identification numbers:

I look forward to someone figuring out a way to uniquely identify patients AND doctors. My family practice doctor has the same first and last name as a local internal medicine doctor. They have different middle names, their clinics have different names, and they work in different cities. Yet somehow the clerks who enter xray & lab data into computers manage to send results to the wrong office. In the real world, what that means is that currently my doctor sometimes doesn’t get test results because the report gets sent to the wrong doctor. In the future, my doctor won’t get those test results when the NOTIFICATION goes to the wrong doctor. Prevent this by programming this future system to generate the “check results” feature based on who orders the test, not based on the testing facility sending a notice that results are ready.

I couldn’t agree more.

My last name is not very common – made less common because of the letter “s” at the end.  People often leave that off, believing that I am somehow mistaken on the spelling of my last name.  This means that my whole life I’ve had to specify “with an S” whenever people take down my name.  My office staff has had to learn this line as well – seeing first-hand how often people just seem to think they don’t know the proper spelling of my last name.

About five years ago, a doctor with the same last name minus the “s” joined another primary care practice in town.  He’s a real nice guy, and I used to think highly of him.  But now, it seems, he has engaged in identity theft.  No, I don’t really think that he intentionally steals my identity, but others seem to want to hand it to him.  All of those bone-heads who are disgruntled at the “s” at the end of my name have their need for s-less last names satisfied with him, and so they assume he is me.

The net result of this is that he gets a substantial percentage of my mail.  Discharge summaries, consults, and labs are sent to him instead of me.  My patients in the hospital are put in under his name, denying me access to their information (via HIPAA).  This even happens (my patients tell me) when my patients explicitly say “That’s ROBERT, and his name has an S at the end of it.”  The brain-dead person at the hospital or other physicians office (who probably was traumatized by the letter S in the past) ignores that and sends the note to the s-less physician.

While this has caused significant frustration on my part, and caused me to have to spend much time tracking down my patients’ records, there is another problem that is more significant.  Unauthorized people are seeing my patients’ records.  Through the idiocy confusion of the people at the hospital/consultant office, my patients are having their records sent to others, exposing their personal information to eyes that are not supposed to see them.

This happens a lot for me, and I suspect it happens even more when doctors share the exact same last name.  How many notes to Dr. Smith, Johnson, or Jones are sent to the OB/GYN instead of the psychologist?  I am sure that number is huge.  What if a neighbor or former spouse of my patient works at the other doctor’s office?  Unauthorized access is not just an inconvenience, it is a risky mistake.

What am I driving at?

1. The letter S is your friend.  Don’t be scared of it.
2. I know how to spell my last name.  I’ve had lots of practice.  Trust me.
3. Don’t go to a doctor “John Smith” if you have anything you don’t want others to know.
4. Fear about the privacy violations in an electronic system ignore the enormous problems with a non-electronic system.  We can be very strict with our privacy policies, but if other morons healthcare workers are not careful, we are at their mercy.

We need a system that guards against this free-for-all.  It is a much bigger problem than most people realize.

Thanks for reading.

Sincerely,

Dr. Robs

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