Put GINA back in the bottle.

This morning I received from a disability carrier a request for their subscriber’s medical records along with the following:

“The Genetic Information Nondiscrimination Act of 2008 (GINA) prohibits employers and other entities covered by GINA Title II from requesting or requiring genetic information of an individual or family member of the individual, except as specifically allowed by this law. To comply with this law, we are asking that you not provide any genetic information when responding to this request for medical information.

”‘Genetic information’ as defined by GINA, includes an individual's family medical history, the results of an individual’s or family member’s genetic tests, the fact that an individual or individual’s family member sought or received genetic services, and genetic information of a fetus carried by an individual or an individual's family member or an embryo lawfully held by an individual or family member receiving assistive reproductive services.”

I believe employers should avoid discrimination based on genetic information, but medical evaluations include family history, even genetic testing. I can envision situations in which the courts would hold us liable for failure to include such information in the patient record, and now for including it. We should not once again allow bureaucrats or insurance companies to force us between a rock and a hard place just so they can get a job done for free by patsy physicians who would rather cave in to every demand than take the time to push back.

Physicians should not have to revise how we practice our profession just to assure separation of yet another kind of information from the rest of the record.

When I respond to an authorization by a patient to release their medical record I should release the entire record. If the party requesting the record wants to redact, let them hire someone to do it. It is not my job.

(I hasten to add that this does not constitute legal advice. Consult an attorney.)


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