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| I'm Your Doctor, You Have My Word This Is Private! |
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| Courier? Take this unenclosed medical record of sexual dysfunction with that stool sample, would you? |
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This is Dark Cloud on Wednesday, April 21, 2004. During my interminable judicial probation I held a number of benthic level jobs. One was as the famed medical courier, by which is meant I got to carry medical supplies and x-rays and urine samples and worse from hospital to lab to hospital from Ft. Collins to south Denver and from Estes Park to Sterling. When you do jobs like this, you spend a lot of time driving and, despite strongly fighting the temptation, you begin to think. Among the many things I thought about was: is this job necessary? I worked for one of the many courier companies that populate the Denver region and service the medical community. Couldn’t, I thought, hospitals and clinics and doctors and labs easily and far more cheaply set up an inter-medical courier service or expand the restricted ones they already had? Wouldn’t that be better than farming this stuff out? And wouldn’t it be safer with employees that are bonded and screened? I mention this because I was at the time a convicted felon. And when you do this sort of work, you get to see - whether you want to or not - the records that are supposed to be in envelopes but which often are not. Names, disease, medication and sometimes credit card numbers. It is easy to see the concern. Why would they outsource this sort of thing? Why not just have hospital employees in official vehicles do this job? I was once given an x-ray in a hospital by a nurse and called back on the cell phone thirty minutes later saying it was needed back in their surgury now. I was 'that damned courier' who made a mistake. Outsourcing, in medicine as elsewhere, should be looked upon not entirely as a cheaper way of doing good business, but as an excuse for in-house problems (“those damned couriers….”), padding for incompetence or actual mistake. Rest assured, hospitals will blame their HR department or lab service people, who will blame the companies they hired, who will blame the couriers themselves for lying on their job applications. But surely, everyone knows the intent of third party integrators and why hospitals hire them. Because they can, and because it is cheaper. If they had bonded people only, people carefully screened and skilled, they’d have to pay what full-time bonded employees would get, including benefits. There is risk carrying the samples and fluids of diseased people, and let me assure you they are not always packed well. So, how to keep the costs down? Get a guy who needs cash, isn’t likely to bitch about bennies, and will take the risk. Preferably, someone else’s guy. That was me. Anyway, remember this when doctors assure you information is confidential, because they are perfectly willing to put a paperclip on a clump of patient records and send it around the state without an envelope in the hands of a felon. That’s not what they’re supposed to do, but medical office staffs are not always populated by dedicated saints. Sometimes, they’ve got temp workers as well, who possibly aren’t bonded either. Not that being bonded is surety of safety. Your medical records can be an open book. And not just in the private sector. Years previous, while in the same legal limbo, I was a temp worker assigned to a regional government health office where I sorted and filed papers. I got to view essentially the same sort of stuff, and it was so clearly wrong for me to have this job that I both quit it and wrote a letter to the head of that government department explaining that I, or anyone living in a half-way house, should not be allowed access to such files about anyone. The implication was that somewhat sturdier requirements should be made of their temporary labor companies. I got a nice reply and a sort of thanks and assurances they'd tighten up. But I was offered the job again at a later date. I knew people who would, well, look to profit from such sorts of info. In fact, during this period, I could well imagine current housemates who would, if in my job, notify friends that they knew where eighty year old men lived alone or with elderly wives, who were on heavy meds - street profitable meds - and who might also have some valuable things about. Worse, I knew some of these people in the files, and not being in Medicine or bonded or anything to prevent talking about the contents other than good intentions, I wondered who else had seen, was then seeing, would in the future see such personal and private pieces of paper. Who was pregnant. Who'd had an abortion. Who had AIDS. I cheerfully announced always who I was and my legal status, and I was hardly ever asked for proof. It was apparently an unspoken agreement between the courier companies and the hospitals, a don’t ask, don’t tell type of deal. The world is full of them. Lots of businesses do it, not all for sordid reasons, and so do other entities seeking nothing more than plausible denial. And my temp agency worked hard for me, and I was treated fine by the courier company. It isn't about me, though. Consider: I actually got a temporary job with a company that made the electronic ankle bracelets used for home arrest. It involved nothing private or intrusive, just office work, but at the end of the first or second day, based on a conversation I was having, I inquired if they knew I was a convicted felon living in a half-way house. Why no, they did not. Thirty minutes later I was escorted outside. Needless to say, I marched into my Temporary Labor office to inquire how that had happened. “Why did you tell them?” my assignment boss asked. “Everything was fine!” I wasn't safe for ankle bracelets, but I was okay with your prostate info and your wife's tranquilizer prescriptions. And where you live. |
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