Mom's PA caught on the street violating HIPAA. Now what?

CharlieSue,

This PA has to answer to a doctor. I would find out who that is and complain. He has to know the PA he oversees is going against HIPPA regulations.

Thank you all; I know what we'll do now.... Actually, this was strike two with this PA (strike one was pretty awful), so will be talking to a new Dr. in the clinic across the highway from them, who is doing some house calls and taking Medicaid and Medicare patients. Mom says she doesn't want any doctor, but she has other meds to manage besides the pain meds she's quit taking - no pain in 3 weeks, must be a God thing!

Unprofessional conduct to have a "front of the building" conversation that could be overheard but may not be a violation of HIPPA. Did she use your mother's name? Was it another medical person she was talking to? Was it obvious to everyone that she was speaking about your mother? Or was it just assumed by the person overhearing the conversation that it was your mother she was referring to? I would mention it to the PA and tell her what you were told and let her know you are concerned about confidentiality but wouldn't immediately jump ship to finding a new medical care provider.

No brainer for me: clear - public, yet! - breach of patient confidentiality. Automatic complaint to her professional governing body and her employer.

Meanwhile, this might sound strange but it's true, in terms of medical services for your mother it doesn't matter and if it suits her to retain the same PA she should go right ahead and do that. There are two separate issues: is her treatment and support of your mother good? Yes. Should you formally report her lapse in professional conduct? Also, yes. It's nothing personal. It's just process. AND the PA will probably be all the more careful because of this.

In terms of trusting the PA with her information, the cat is out of the bag as far as your mother's concerned - if anybody in the town didn't know she was coming off px pain meds, they do now! It's too late. So why deprive herself *as well* of someone whose skills and service she values?

My first thought was to (a) find another doctor, or (b) discuss the issue with the supervising doctor.   On second thought, and given the difficulty of getting your mother to another doctor, and the small town constraints, I thought of something else.

How do you know that the "friend" actually knows who the PA is, other than having observed her coming and going at your mother's house?   And how close was this "friend" to have heard that alleged conversation?  

Further, does this "friend" know for a fact that the "people" were NOT medical professionals and that this was a HIPAA breach?   If so, this could change the whole interpretation of the scene.

Unless it can be verified that the "people" weren't in fact other medical professionals, I think it's very "iffy" to rely on this second hand observation.

Given the small town and other constraints, I would try to find an acceptable and graceful way to address this.  You could ruin her career, and she might actually have been seeking the advice of other med pros.

Either call the PA and raise the issue (better in person though so you can watch her facial expression), or contact her and tell her that you  need to discuss, in person, an issue regarding your mother's care.

Then raise the issue with the PA and give her a chance to explain what the "friend" observed (she must have been fairly close to hear the conversation.)

I'm assuming that neither you or your mother advised the PA that your mother had d'c'ed the pain meds?  Were they meds that could be d'c'ed w/o weaning off them?

I'm finding it hard to believe a dedicated PA could be indiscreet in discussing someone's health out in the open, which is why I wonder if these were other medical people.  That makes a big difference.

Find out more before discontinuing treatment with the doctor.    PAs spend a lot of time getting their degree, money to get their FDA license, and I question whether someone who goes through that would really be so indiscreet as to discuss a patient with nonmedical people.

I hope you can find out more quickly, explain the situation to your mother, and resolve the concerns each of you have.  And, in the future, perhaps your mother should advise her PA and/or doctor when she D'C's pain meds.

"A friend of my mom's heard her PA talking to people in front of the building about how she was trying to get my mom off her pain meds."

Who reported this to you? The friend? Mom?

I would be very careful about accepting this as the real story.

Call the doctor and discuss the possibility that the PA was gossiping about a patient.

"Unlike nurse practitioners, physician assistants are unable to practice independently in any state. The very nature of their position requires they be supervised by a physician and maintain a relationship with their supervising physician"

The way I read the above is that she answers to a doctor. So that doctor should be able to continue filling Moms prescriptions. I would report her to the doctor. Besides it being a HIPPA violation, it was very unprofessional. As a Secretary for a Visiting Nurse Assc, I was made aware of what I could and couldn't do in reference to HIPPA and our clients.

For a Nurse Practitioner, it depends on the State they are in if they need to be associated with a doctor.