What Really Is Private?

We think everything in our medical records is private, but is it?  Why do health insurers and life insurers get to peruse it at will?  I think about that before I click that stupid EMR button with a CPT code that drags along side someone for life.    A recent USA Today article reveals that a “growing number of hospitals use their patients’ health and financial records to help pitch their most lucrative services, such as cancer, heart and orthopedic care”.   Don’t get me wrong, much of this can be good.  My hospital scans its records to get people to show up for colonoscopies, DEXA scans, and abdominal ultrasound screening.   Of course, they make a ton of money  from the procedures so its obviously not totally altruistic.  It also can be problematic,  like the time a patient called me to yell and complain about sending her a letter to get a mammogram.  I should have known about her double mastectomy.  At first, I didn’t know what she was talking about but then I realized that the hospital sends out these special letters with my name on it.   But let’s get past the problem with mistakes and embarrassments.  Is it ok for hospitals use private medical records to pursue profits?  The article states that many hospitals are targeting those patents with money so they are actually cherry picking.   Not cool.  I guess my issue with this is when mailings are not sent to everyone or are sent out to people for unproven screenings.   For example, if CT scans for screening smokers is not an approved test then hospitals shouldn’t send out a “special cash deal” option which capitalizes on their fears.  The whole thing is creepy, though.  As we doctors try harder and harder to follow HIPAA, letters are flying out to patients with our names on them and we are not in control of what is written.