You have everything from Psychology/Psychiatry notes to overdose records that many health staff can pull up from almost any computer.
EDIT: Remember many jobs disqualify you from the job if you have any past psychiatric treatment. Even if you are in your 40s Psych drugs at 13 are a disqualifier. "Paying cash" is what some doctors have resorted to. http://www.idealmedicalcare.org/75-med-students-antidepressa...
That said concerns about the sensitivity of information are absolutely valid and should be at the forefront of EMR systems.
In my experience (UK) access to records is reasonably well restricted to relevant staff. Access is audited in efforts to identify unauthorised access and this is taken extremely seriously; for example opening records for patients not under your direct care with no valid reason.
Further, for particularly sensitive information such as some psychiatric histories, or medical photography of sensitive areas, this is kept behind a secure area within the EMR systems, not generally accessible. Opening it requires signing a declaration that you have either discussed it with the patient and gained consent, or that you do not have consent and you are opening it in the patients best interests in an emergent situation as they are unable to consent (e.g. history of depression with paracetamol (acetaminophen) overdose brought in unconscious by ambulance.
EDIT: left original link tried to clarify.
[0]: "I drive 300 miles to seek care and always pay in cash." http://www.idealmedicalcare.org/75-med-students-antidepressa...
It is also completely off-topic.
I am surrounded by doctor family members and friends (and nearly trained as a doctor) - diagnosis comes from incredibly vague datapoints and so context (and additional data points) are so valuable.
Patients are also often unreliable narrators. Having everything on record (but properly protected) is tantamount to being able to give the best care you can.
It’s not uncommon for teenagers to be misdiagnosed with mental illness or ADHD and either of those are disqualifiers for FAA medical certification, military pilot careers, and likely many other military, law enforcement, and intelligence careers. IIRC, a prolonged history of ADHD treatment is enough to disqualify military entrance for any MOS without waiver. Waivering prior ADHD diagnosis requires a costly and difficult process to undiagnose the patient and prove that he or she no longer has the condition and was incorrectly diagnosed in the first place, at least if you are trying to get FAA certified for a Class 1.
How do you feel about the (I presume underlying notion, at least when it comes to programming jobs) that a "bad" hire is costly and we'd rather let ten potentially great candidates go rather than accidentally hire one very bad candidate?
In practice, I bet places that emphasize that attitude tend to hire people that the interviewers like socially.
Non-disqualifying visual impairments have a relative risk down around 1.2, implying a surprisingly low cutoff for a visual impairment being disqualifying. "Severe behavioral problems due to ageing (dementia)" have a RR 1.45. A category covering epilepsy, narcolepsy, and other conditions causing sudden interruptions/disturbances in consciousness is at 1.84, and those conditions require medical sign-off in every country I checked. Diagnosed alcoholism amortizes to around 2, and that'll get you a breathalyzer or suspended license right quick.
The cutoff for being ticketed is is observed to lie around a relative risk of 4, which is where cell phones come in. The cutoff for being arrested on the spot, being legally drunk, is a relative risk well above 10 and probably up around 40.
Interestingly, almost nothing is as bad as being a teenage male, which carries a relative risk around 7. Teenage females are around 5.5.
That all said... while we can certainly complain about rampant misdiagnosis - I wish I had a dollar for every time someone told me that I'm just addicted to stimulants - my opinion is that this particular rationale for disqualification is absolutely justified. There's a reason I don't drive.
[1] https://www.toi.no/getfile.php/Publikasjoner/T%C3%98I%20rapp...
"That all said... while we can certainly complain about rampant misdiagnosis - I wish I had a dollar for every time someone told me that I'm just addicted to stimulants - my opinion is that this particular rationale for disqualification is absolutely justified."
So, I'm also an ADHD patient, medicated. I've gone back and forth between believing in the diagnosis and thinking maybe I'm just dependent on the medication that I've taken for so many years. It's hard to say now, and of course quitting stimulants requires a LOT of time off work and learning to execute tasks without pharmaceutical aid. So, if you were to take a patient who has been on amphetamine for 10 years and abruptly cut him/her off, the patient would likely go through a period of fatigue, low-interest in activities or work, and struggling getting anything done. I've heard this can take as long as 6 months or a year for certain people. I don't believe you can diagnose ADD/ADHD or any comorbid mental illness in the presence of drug withdrawal. Think of it as a "brain re-training" period. As you can imagine, not many people have the willpower or resources ($) to take time off work and truly "reset" their brains, so they stay on the meds and hope that it works out..
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.
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.
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.
