Family Medicine Update

Your life in their pocket: students’ behaviors regarding confidential patient information.

Fam Med. 2009 May;41(5):327-31

Authors: Jethwa S, Bryant P, Singh S, Jones M, Berlin A, Rosenthal J

BACKGROUND AND OBJECTIVES: Physicians are sometimes poor at observing patient confidentiality. Medical students have access to patients and their medical records, but there is little known about how well students respect patients’ confidentiality. Our objective was to study how medical students deal with confidential patient information. METHODS: Qualitative research methods (focus groups, semi-structured interviews, and direct peer observation of student activity) were used to explore the approach of medical students to patient confidentiality in a British medical school. RESULTS: We interviewed 32 students, held focus groups involving 24 students, and undertook direct observation of student activity. The main themes derived from the data included the context within which students practice, variation in students’ attitude and behavior toward patient confidentiality, and the dissonance between confidentiality theory and practice. CONCLUSIONS: While many students practiced in a professional manner, several reported markedly suboptimal performance in themselves or others. These behaviors appear to be driven by students’ own professionalism and behavior learned from senior colleagues. While new technologies pose some particular threats to confidentiality, paper records seem just as vulnerable.

PMID: 19418280 [PubMed - in process]

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Related Articles

Effect of maternal depression and anxiety on use of health services for infants.

Can Fam Physician. 2008 Dec;54(12):1718-1719.e5

Authors: Anderson LN, Campbell MK, daSilva O, Freeman T, Xie B

OBJECTIVE: To evaluate the association between postpartum maternal depressive symptoms or maternal anxiety and health services utilization (HSU) for infants. DESIGN: Telephone survey. SETTING: London-Middlesex region of Ontario. PARTICIPANTS: Mothers of infants 2 to 12 months of age between 2004 and 2005 (N = 655). This sample was drawn from a larger longitudinal cohort of mothers recruited during pregnancy. MAIN OUTCOME MEASURES: Maternal depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale. Anxiety was measured using the State-Trait Anxiety Inventory. Infant HSU outcomes included number of primary care provider (PCP) visits for infants < 6 months of age, number of PCP visits for infants 6 to 12 months of age, emergency department (ED) use, and walk-in clinic (WIC) use. RESULTS: Multivariable regression methods were used to compare HSU for infants. After adjustment for confounders, no significant associations were observed between postpartum maternal depressive symptoms and PCP visits, ED use, or WIC use. Similarly, no significant associations were observed for maternal anxiety and PCP visits, ED use, or WIC use. CONCLUSION: In contrast to some previous studies, this study found no association between postpartum maternal depressive symptoms or anxiety and HSU for infants.

PMID: 19074718 [PubMed - indexed for MEDLINE]

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Bacterial vaginosis – More questions than answers.

Aust Fam Physician. 2009 Jun;38(6):394-7

Authors: Pirotta M, Fethers KA, Bradshaw CS

BACKGROUND: Bacterial vaginosis is the commonest cause of abnormal vaginal discharge in women of reproductive age and is associated with serious pregnancy related sequelae and increased transmission of sexually transmissible infections, including HIV. The aetiology, pathology, microbiology and transmission of bacterial vaginosis remain poorly understood. OBJECTIVE: This article discusses the prevalence, clinical features and possible complications of bacterial vaginosis. It summarises what is known about the aetiology, pathophysiology and treatment of the condition and highlights directions for further research. DISCUSSION: Bacterial vaginosis is characterised by a complex disturbance of the normal vaginal flora with an overgrowth of anaerobic and other micro-organisms and a corresponding decrease in important lactobacillus species. The cause is not known, but observational evidence suggests the possibility of sexual transmission. Bacterial vaginosis is diagnosed by the Amsel or the Nugent method. Recommended treatment is with 7 days of oral metronidazole or vaginal clindamycin. More than 50% of women will experience recurrence of bacterial vaginosis within 6 months. It is not known whether this represents relapse or re-infection. Further research is needed into the aetiology, pathogenesis and optimal treatment of this condition.

PMID: 19521581 [PubMed - in process]

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