[standardUser]

This is a very important point. Individuals should be able to censor aspects of their own medical records. It's not just mental illness. Getting regularly tested for STDs/AIDS or having evidence that could be interpreted as a pre-existing condition are other aspects of a person's medical history that can cause problems with potential employers or insurers.

[mrestko]

This goes back to the central thesis of the article: that interference from non-physicians (i.e. insurers, billers) are destroying the usefulness of notes.

Physicians are bound by both a professional duty and oath as well as legal liability to keep your medical information in the strictest of confidence. But it is nearly impossible to know in advance when a particular piece of medical information will become important for the treatment of a patient. Hiding it because of concerns about insurance or employment is not a solution--it's an indication that insurance and employment have undue influence on or access to a professional record.

[thomasfedb]

I think this comment really hits it on the head.

Your medical record is meant to be a confidential record read only by those who are sworn to care for and protect you, and by nobody else for no other purpose.

As a student doctor it's alarming to think that people do not feel they can trust their doctor with their medical history. I wonder if this is particularly a problem with the US healthcare system.

[dublin]

I trust a few (definitely not most) doctors with medical information about me. I trust no EMRs, ever. I've worked with too many of them and seen how they're abused. Security and privacy in healthcare are a joke, and I say that as someone who once did massive-scale managed care systems for Fortune 50 companies. Anything I would deem personal and private I want to exist only in a paper record.

[rlucas]

You and all your colleagues should be aware of the Medical Information Bureau and IMS health.

Despite all of the kabuki theater about HIPAA and black covers on clipboards and whatnot, every single medical fact that is even considered for payment by an insurance company gets hoovered up into various industry databases and shared with any insurer who bothers to ask.

[int_19h]

> This goes back to the central thesis of the article: that interference from non-physicians (i.e. insurers, billers) are destroying the usefulness of notes.

I think there's a big difference between third parties interfering with those notes for some profit motive, and the person who those notes are about interfering for privacy reasons, no matter how misguided.

[camtarn]

Here in the UK, I believe that sexual health clinics keep a separate clinic-local file on you, which is never linked to your main file unless you consent. Any correspondence or samples that go out of the clinic are labelled only with your clinic ID, not your name.