life

Access to Medical Information Is Governed by Complex Rules

Dear Abby by by Abigail Van Buren
by Abigail Van Buren
Dear Abby | April 28th, 2009 | Letter 1 of 2

DEAR READERS: After the letter from "Frantic Mom in Philadelphia" (Jan. 30) was published, several physicians wrote to express concern that I was suggesting that doctors violate the HIPAA laws by talking to families without consent. This is not what I was suggesting. The goal of HIPAA (Health Insurance Portability and Accountability Act) is to protect patient information and standardize the transmission of patient health information between health organizations.

The Health and Human Services Office for Civil Rights Web site (www.hhs.gov/ocr/hipaa) offers a variety of resources to help people understand HIPAA. The rules are complex and -- like any rules -- can have unintended consequences. They were NOT meant to discourage doctor-family communication, but only to give patients some control over their medical information.

Doctors are well within their rights to encourage patients to give consent for sharing information with family members, and they need to explain why it's important. Collaboration is needed when families are deeply involved in their loved ones' care. Research has shown that when family members are involved, patients with serious mental illness stay better longer and have fewer relapses. The patient and therapist TOGETHER can specify what information can and cannot be shared.

Parents like "Frantic Mom in Philadelphia" become more anxious and depressed when they have no information on how to help their children, which creates additional family stress.

Parents who are financially supporting a child over the age of 21 may decide the conditions under which they will continue their support and pay for treatment. They may decide that one of those conditions is that they have some basic information from the patient and therapist about how they can help. I am NOT suggesting that the family should get access to their son's full records, but only that they should be given basic information on how to help and what to expect.

If an adult child objects to doctor-family communication, many families wrote to let me know that NAMI, the National Alliance on Mental Illness, offers a wealth of information and support for families and friends of people coping with the challenges of mental illness. NAMI's Web site is www.nami.org, and its toll-free helpline is (800) 950-6264.

life

Dear Abby for April 28, 2009

Dear Abby by by Abigail Van Buren
by Abigail Van Buren
Dear Abby | April 28th, 2009 | Letter 2 of 2

DEAR ABBY: Over the past few years I have noticed a trend in the recorded phone messages of businesses I deal with over the course of a day. It is the use of the phrase, "We'll get back to you at our earliest convenience."

Abby, is it just me, or does that phrase imply that it's about their convenience and not their customers'? There was a time when the sentiment was, "We'll help you as soon as possible." Am I being too literal here? -- BOB IN COSTA MESA, CALIF.

DEAR BOB: Many businesses rely on automated phone answering systems as a cost-saver because it means they don't have to hire someone to do it. It also allows the business owners to budget their time as they wish -- regardless of the "needs" of the caller.

The fact that this offends you enough that you have written to me indicates that you are old enough to remember when customer service came first. Younger people may not be as sensitive to it as you are. But I agree with you that given a choice I, too, would prefer to deal with a human being.

There ain't nothin' like that personal touch. (Beep!)

life

Girl Wants to Turn Empathy for the Disabled Into Action

Dear Abby by by Abigail Van Buren
by Abigail Van Buren
Dear Abby | April 27th, 2009 | Letter 1 of 3

DEAR ABBY: I am a 13-year-old girl, soon to graduate from elementary school. Please don't judge me by my age because I have an important question.

Recently, I picked up the newspaper, glanced at the front page and an article caught my eye. It was about a disabled man who had been kidnapped and taken to an apartment where he was beaten. It was one of the most disgusting things I have ever read.

Not long after that, I saw another article. This time it was about a mentally challenged man who was lured from his bus stop to a deserted street, then beaten and robbed. Knowing these things happen makes me sad, angry and turns my stomach.

I want to do something to help stop these acts of violence, but I don't know what. Joining a group or donating doesn't seem to be enough. I would like to help the disabled directly. Do you have any ideas? -- CARES DEEPLY IN ONTARIO, CANADA

DEAR CARES DEEPLY: You are a sensitive, right-minded young lady, and for that I commend you. I do have some ideas you might find interesting. You could:

1. Collect gently used children's clothing and donate the garments to a homeless shelter.

2. Volunteer some time each month to befriend a developmentally disabled child. The special education department at your school might be able to help you with this.

3. Collect signatures for a petition to increase the penalties for those who commit crimes against mentally ill and homeless people. Talk about your feelings at school and at your place of worship and see if friends would be interested in joining you in your efforts. Remember, one small spark can start a prairie fire.

life

Dear Abby for April 27, 2009

Dear Abby by by Abigail Van Buren
by Abigail Van Buren
Dear Abby | April 27th, 2009 | Letter 2 of 3

DEAR ABBY: I am a 31-year-old man. I have been seeing a wonderful woman for about seven months, and it's starting to get serious. I need advice, though, on how much we should tell each other about our sexual histories.

Seven years ago, the end of a romantic relationship sent me into a deep depression. I spiraled downward for a long time, during which I engaged the services of prostitutes. Finally, with the help of my family and a therapist, I was able to take medication and recover from the depression. I was later tested for STDs and was lucky not to have contracted any.

I am not implying that I'm not responsible for what I did at the time. I'm ashamed of the situations in which I placed myself. Abby, should I tell my girlfriend about this at some point as our relationship progresses, possibly toward marriage? If so, how much detail should I give her? I don't want to start a life with her based on lies. -- WANTS TO MAKE PEACE WITH THE PAST IN WISCONSIN

DEAR WANTS TO MAKE PEACE: Let me ask you this -- how much detail do you want HER to give YOU? From my perspective, if you are considering marrying this woman, it is more important for her to know about your history of depression than that you turned to "professionals" for more than advice. You are STD-free and are no longer interested in pay-as-you-go flings.

If you are asked to name names -- which I doubt you will be -- tell the lady that there have been episodes in your life that you "are not proud of." If that's not enough information for her, then tell her the truth and let her deal with it.

life

Dear Abby for April 27, 2009

Dear Abby by by Abigail Van Buren
by Abigail Van Buren
Dear Abby | April 27th, 2009 | Letter 3 of 3

Abby shares more than 100 of her favorite recipes in two booklets: "Abby's Favorite Recipes" and "More Favorite Recipes by Dear Abby." Send a business-size, self-addressed envelope, plus check or money order for $12 (U.S. funds)

life

Shuffled Credit Cards Are Passed Along Unnoticed

Dear Abby by by Abigail Van Buren
by Abigail Van Buren
Dear Abby | April 26th, 2009 | Letter 1 of 2

DEAR ABBY: A few weeks ago, my family and I went to one of our favorite restaurants for lunch. Afterward, I glanced at the check, gave my credit card to the server, signed the receipt and left.

That night I looked at the receipt before filing it away and noticed that the first item listed was for a beer that we hadn't ordered. It was not my check! My daughter suggested that I look at my credit card, and the card wasn't mine, either.

I immediately phoned the credit card company and was told my card had been used for 10 other purchases. They canceled it immediately and said a new card was on the way. In the meantime, my daughter phoned every hotel in the area and eventually located the person who had my card. He was dumbfounded when he looked at the card in his possession and realized it wasn't his.

Please remind your readers that they need to keep an eye on their credit cards and advise employers to do a better job of training their employees. I failed to look at my card in the restaurant when it was returned to me. Not one vendor from whom a purchase was made examined the name on the card and the signature. I admit I made an error, but it was compounded by a multitude of individuals along the way. -- ALFRED ON MAUI

DEAR ALFRED: Thank you for the reminder about how important it is to take a moment to check to ensure that the credit card you are handed back is your own. It is also wise to carefully review the restaurant tab when it arrives because mistakes can happen -- as I have learned from personal experience.

One day, my husband and I were having a light brunch at a neighborhood restaurant. When our bill came -- it was for $22.30 -- my husband looked at it as he always does. When the credit card receipt was handed to him for his signature, he looked at it, exclaimed, "This is the most expensive brunch we've ever had!" and passed it to me. We had been charged $2,230. When he showed the receipt to the owner, the man immediately went to the cashier -- who informed him that a key had "stuck" when she tried to push it.

Many establishments encourage their servers to address customers by name when they bring a check to the table. Not only is it friendlier, it can also avert a mix-up. However, a restaurant should not be blamed entirely for a screw-up like this one because the ultimate responsibility lies with the person being handed the credit card. Because many of them look alike, the better part of wisdom is to check to ensure it is your own before putting it away.

life

Dear Abby for April 26, 2009

Dear Abby by by Abigail Van Buren
by Abigail Van Buren
Dear Abby | April 26th, 2009 | Letter 2 of 2

DEAR ABBY: I have been invited to a bridal shower for my future sister-in-law and her sister. They are both being married, and a "joint shower" is being held for them. I have never met my future sister-in-law's sister. Should I buy a gift for her, even though I don't know her? -- SHOWER FOR TWO

DEAR SHOWER FOR TWO: To buy your future sister-in-law's sister a token gift would be a warm and generous way to acknowledge that she is becoming a member of your extended family. Are you obligated to do it? No. Should you do it anyway? Mm-hmm. Trust me.

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