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by Nancy Rechtman

Unintended consequences. I'm sure you're familiar with that phrase. Usually stemming from the most benign of intentions, the consequences of these seemingly benevolent actions are not always exactly as the originator of those intentions had hoped. If you follow my drift.

For example, two children are outside playing ball. "I'm going to hit the ball farther than you've ever seen before!" shouts out Child #1. "Oh yeah. Prove it!" taunts Child #2, hurling a lightning-fast pitch at the other child. Wham! They both look up in awe, thrilled at the speed and arc of the ball. Until…until… it smashes through the neighbor's kitchen window, shattering glass all over the countertops. Unintended consequences. Along with the consequences when Child #1's parents hear of this and dole out punishment never anticipated by either child.

Another example:

You are doing a load of laundry. Your son, who you are always pleading with to straighten up his room, decides he will pick up his clothes off the floor and add them to the wash. He thinks he will surprise you with his initiative and thoughtfulness and tosses in his red T-shirts after you leave the laundry room. When you remove your clothes from the washer you discover that your white pants and tops are now a lovely shade of rose. Once again, good intentions, unintended consequences.

If you have had any contact with the medical profession in the past few years, and have found yourself signing even more forms than before each time you walk through the door of a doctor's office, you are probably aware of HIPAA, the Health Insurance Portability and Accountability Act of 1996. It was mandated that the healthcare industry be compliant by April of 2003. Basically, this act had the best of intentions. It was passed by Congress in an effort "to protect the privacy and security of individually identifiable health information." Supposedly these regulations would save the health care industry money, keep patient information secure and allow patients better access to their own information. Sounds great, doesn't it? We need our privacy protected these days, don't we? And who wouldn't want better access to our own health information?

Let me bring to your attention some real-life examples of the unintended consequences of this act:

Example #1:

A woman brought her elderly mother to the doctor's office for an exam. When the daughter stood up to accompany her mother to the examining room, she was told she had to wait in the outside waiting room. Her mother told the nurse she needed her daughter to help her with her clothing and getting onto the exam table. The nurse said it didn't matter what she wanted, they had to comply with the privacy act. There were other patients who might not want the daughter seeing them in the inside waiting room if she were allowed to accompany her mother to the examining room so she would have to wait where she was. As if she might not have already seen them in the outside waiting room.

Example #2:

A man needed to get a tetanus shot due to being scraped by a rusty nail - yes, this is a true story. He went to an urgent care clinic where they would not accept his insurance so he (actually, his wife), later filed the claim with their insurance company. Several weeks later, the insurance company sent the entire claim back in the mail, informing the couple that they were unable to read the clinic's ID number and needed the name of the doctor who saw him at the clinic as it was all illegible. (Duh # 1 - couldn't they just call or dash off a quick letter asking for the information instead of sending all the forms back? Duh #2 - what a shock, - they couldn't read a doctor's handwriting?!) Anyway, the wife called the clinic to get the information in order to re-file the claim. Well, she was told, they could give her the federal ID number. But no, they could not give her the doctor's name. Why not? Because she wasn't the patient. There was a privacy act to comply with. But, she told them, she had the form in front of her with the date, time, diagnosis, insanely high cost of getting the shot, and an illegible scrawl - all she needed was the name. Sorry, her husband had to make the call since he was the patient.

Example #3

A woman brought her mother to a hospital for outpatient surgery. Since the procedure would take most of the day, she left and called the hospital in the afternoon to find out when she could pick her mother up. She was told that they weren't allowed to tell her if her mother was a patient at the hospital, due to the privacy act. "I know she's at the hospital, I dropped her off there this morning," the woman said - or yelled - I‘m not sure. "I just need to know what time to pick her up." Again, she was told that they were sorry, but they could not tell her if her mother was actually there.

Now, everybody meant well, first in enacting this law, then in attempting to carry it out. But I have spoken to other patients, families of patients and medical personnel and all are extremely frustrated by these unintended consequences, even though they were initially created by those with the best of intentions. Maybe some common sense is in order when laws are created. Why not allow us to accompany family members when they need help, give us a doctor's name if we happen to be married to the patient and obviously have all the other information, or just let us know when to pick up a family member when we are the ones who brought them to and from a medical facility in the first place? Maybe we can work out some sort of cryptic code so they know it's OK to give us the information. Or maybe a secret handshake. Let's just come up with something that would, for once, actually make our lives easier instead of more complicated. Of course, who knows what the unintended consequences of that could be…

Please let me know your reactions to these columns as I would enjoy hearing what bugs you, too. You can reach me at

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Copyright Nancy Machlis Rechtman, all rights reserved. Small excerpts of the column may be republished as long as appropriate credit is given. To request permission to publish larger portions or the entire column, e-mail