Patient Confidentiality? Not in Texas.

Wednesday, September 29, 2010 | 0

By Joe Paduda
Health Strategy Associates

Q - When is it legal for someone to examine patient records?

A - When they are a legislator seeking to "defend doctors he believes were wrongly the subjects of misconduct investigations by the (Texas Medical) board, which licenses the state's physicians."

According to an article in the Texas Tribune, that's exactly what happened in Texas. As a state legislator, former state Rep. Bill Zedler, R-Arlington, "had authority to obtain and review private patient and physician records. The Texas Medical Board provides such records which also detail patient treatment only by special request and solely for official legislative purposes."

Wait. Did I just write that? How does a state law supersede HIPPA, which mandates confidentiality of patient records?

And it turns out Zedler did NOT review the records for legislative purposes, but rather to assist specific physicians, two of whom were you guessed it large campaign donors. According to the Texas Tribune, Zedler requested records from the Texas Medical Board for:

"Houston anesthesiologist Vladimir Redko and Dallas thoracic surgeon Dr. William Rea, neither of whom were constituents. According to the board's disciplinary orders, both were ultimately sanctioned for "egregious" treatment violations ranging from performing invasive procedures to injecting natural gas and jet fuel into the patients in order to diagnose chemical sensitivities. Records show that the doctors gave Zedler a combined total of $25,000 in the past half-decade and that some contributions were made just weeks before Zedler requested their case files."

Zedler reviewed the medical records himself; while he's not a physician, or nurse, he was a medical equipment salesman, so "I know what appropriate treatment is and isn't," he says. "I sold equipment, so a lot of times my customers were doctors. I've been inside surgical suites before that kind of stuff."

Zedler didn't limit his investigations to the Texas Medical Board. Again, according to the Tribune, "Physician investigators at a separate agency, the Division of Workers' Compensation of the Texas Department of Insurance, recall that Zedler also took great interest in doctors who were under investigation at workers' comp.[emphasis added] Dr. Bill Nemeth, the division's former medical advisor, says Zedler had some success in stopping investigations of the doctors on whose behalf he intervened."

On the basis of his experience selling medical equipment, Zedler took it upon himself to examine what would normally be considered confidential patient records, then contact the state regulatory authorities in an effort to get them to drop investigations of at least two physicians who were significant campaign donors.

And this guy is running for election.

The Texas Tribune article is here:
http://www.texastribune.org/texas-health-resources/texas-medical-board/did-lawmaker-access-private-records-to-help-donors/

Joe Paduda is owner of Health Strategy Associates, a Connecticut employer consulting firm and co-owner of CompPharma, a consortium of pharmacy benefit managers. This column was reprinted with his permission from his blog, http://www.managedcarematters.com