An "Advance Directive" for Patient Privacy

Dec 07, 2010, 09:54 ET from Association of American Physicians and Surgeons (AAPS)

TUCSON, Ariz., Dec. 7, 2010 /PRNewswire-USNewswire/ -- If you go to a hospital, you will probably be asked, aggressively, about your advance directive to withhold or withdraw treatment. But you will not be asked—or probably allowed—to sign a statement to protect your confidentiality.

While you are in the hospital, your record will probably be scrutinized by a variety of "reviewers" you will never know about. Their job is not to protect you, but to watch out for the hospital's bottom line.

The "advance directive" ( written by Dr. Frank Polidora, an orthopedic surgeon in Hazleton, Pa., reads:

"No reviewer, especially an outside reviewer, is to review my chart without first discussing with me and my family why he or she wants to review my chart.

"The reviewer must explain to me and my family, in writing and in person, the reason for reviewing my chart, and what benefit I would gain from such a review or what harm, including to my health or sense of well-being, that such a review could cause.

"The reviewer must then obtain express written consent from me to review my chart…."

Hospital administrators were not pleased by this, or by Dr. Polidora's other efforts to advocate for his patients. The hospital went so far as to attack his patients in its battle to enforce rigid Medicare rules, as he describes in an article in the winter 2010 issue of The Journal of American Physicians and Surgeons (

Dr. Polidora's hospital privileges "lapsed," so his practice is now restricted to his office.

"Many other physicians are also leaving hospital staffs because Medicare rules make it impossible to practice good medicine there," reports Dr. Jane Orient, executive director of the Association of American Physician and Surgeons (AAPS). "For example, some family physicians can no longer just admit a patient—without the approval of outside consultants hundreds of miles away."

Family members need to exercise extra vigilance when a patient's regular personal physician is unable to attend the patient while in the hospital, she advised. For example, hospitalists, not aware of the patient's status before admission, might prematurely determine that a patient is at the "end of life"—with or without an advance directive.

SOURCE Association of American Physicians and Surgeons (AAPS)