Aibu to think my Gp broke patient confidentiality?

[hellsbellstree]

I've nc to not out myself, and I know this is a sensitive subject.

I attended a Gp appointment and after booking in I took a seat in the waiting room.

There was a couple of patients already waiting, and I took notice of the board on the wall that bleeps and displays the patients name and Gp room number and name, indicating to go through.

I had been told a few weeks ago the dr that I would be seeing, and I knew what other dr was on as his name came up to call one of the other women through to their appt. I've seen him before so recognised his name, and I think he is a locum.

I then was called to my appointment, and it was with the Gp that I'd been told I would see, and he is in charge of the practice.

This Gp is very old school, and a bit arrogant, he had another Gp possibly training, sitting in the corner. He didn't mention who this person was or whether I minded their presence. I wasn't fussed by this person as I just wanted to get on with the appointment and I didn't mind them being there.

Sorry to ramble. Next thing I know the locum walks into the room clutching forms and asking the Gp I was seeing if these were the correct forms for referral for a termination, that his patient is waiting and he needed to know which part he needs to sign.

So I'm sitting there whilst my Gp then proceeds to say how he never signs termination forms, will never do the referral, but yes that is the correct form and told the locum what needed signing etc. The locum leaves the room and the Gp then starts a rant to the other person in the room (trainee Gp?) why he won't sign these forms and how he had learnt the hard way......

So aibu to think this is a complete break of confidentiality? I felt so enraged on behalf of the locum's patient.

Shall I complain or am I being a bit over the top?

Confidentiality has been breached. You should report it.

It probably never occurred to them that you would have taken in the name of the person seeing the locum from the board. Did you know them? Not sure I would have remembered tbh.

It is breaching confidentiality as you would have seen the woman in the waiting room and seen her name on the screen. Imagine if you had known the woman, you (if you were a gossip!!) could have spread it around your friendship group, work colleagues, family etc. It could have ruined her life especially if she was doing it without her partner's knowledge.

Personally when I am at the GP's I don't pay much notice to anyone else's names bleeping up?

I often wouldn't be able to tell you if it was a man or a woman who went in to see Dr Locum!

I am however with a big practice and you often have several Dr and a few nurses taking appointments at the same time so lots of names / lots of Dr's!

There was so much wrong with your GP visit, that I'm not sure where to start.

Before the consultation you should certainly have been asked if you agreed to having a spectator in with you during your consultation, in fact you signing a cosent form would have been best.
You should have been introduced to the spectator, with brief reasons for them attending.

The locum should not have interupted your consultation at all.

What if you had been beginning to tell of a traumatic event or crime, and his interuption had halted and stopped your disclosure, not to mention breaching your own confidentuality?

The locum should have had basic paperwork explained to him before he sees any patients.

The GP and the locum should not have been discussing another patient's treatment in your hearing. For instance, the other patient could have been a family member of yours, and the implications of you knowing of her treatment far reaching.

The GP should not have been discussing anything with the spectator during your consultation, because he should have been focused on you.

You should make a complaint, though I suspect you will just get a bland apology. If this is a training practice, their behaviour is beyond belief.

what strikes me as callous....

say the OP was there to discuss a miscarriage, or a third miscarriage, or infertility....

should she even have to HEAR that the person in the consulting room next to her is being referred for a termination?

This is just wrong. Totally inappropriate.

It reminds me of a local hospital near where I lived in the late 80s.... they had one "gynae" type ward where patients with miscarriages were placed in beds next to people having terminations. It was not inconceivable in that ward that someone having their fifth miscarriage could be in a bed next to a person having their fifth termination.

Absolutely insensitive.

Yes, it was utterly inappropriate, but with an attitude like this complaining will do no good; if he's as arrogant as you say he might even de-register you from the surgery for "daring" to challenge his behaviour

Frankly I'd be registering with a different surgery as soon as I could

OP YANBU.

The locum's patient might have been Mrs Amber Brown... Or Miss Kyra Jones, aged 15, and you might have been her form tutor at the local school. Or her mum's best friend.

It is really bad.

I don't think the locum is BU to ask about forms - anyone who's worked in a new place will know what a bugger it is remembering which form to use when - but he could have rung through internally to see if the senior partner was with a patient or knocked and "oooh sorry, can I see you before your next patient" or gone through to reception or practice manager who would likely also have known, and asked discreetly.

Also the GP is massively U to discuss his own private views on termination in front of you like that. What if you had been there to discuss having one yourself, or feeling depressed after having had one, or you'd just MC? Bang out of order!

I would change practices if possible as I wouldn't want someone so sloppy and bigoted dealing with my health. I am very lucky that my own GP surgery is fantastic!

(Vaguely relevant) I had a Day Procedure (gynae-related) some years ago at our local hospital, a new and modern one at that. The blasted ward was mixed!!!! I was next to a dear old chap in his pyjamas. I was bleeding quite a bit, and the nurse came up and bellowed out "I'll bring you an extra-large sanitary towel Mrs Spiders. Won't be a minute!" I could've died. He was trying his best to bury his head in the newspaper. They still have mixed wards for Assessment up there. In this day and age! No dignity.

If he said their name it is. If not it is not a breach at all.

Why raltheraffe? The point is the OP already knew the name of the patient.

It's still a breach of confidentiality (and arguably the DPA as the name of a patient and the locum would be 'held' information).
The locum should have referred to "one of these forms" and not mentioned what it was, or asked if the GP could come into the corridor a minute. Data protection guidance makes clear that if data could be easily put with other data to result in breach of confidentiality, it needs to be properly protected to prevent that happening.

The GP should have both introduced the student and not ranted about his personal beliefs in front of a patient.

Also the practice should make clear to patients which GPs will or won't sign forms for terminations, so women can book appts as appropriate.

Complain!

Complain directly to the GMC and BMA

I think it's an appalling breach of confidentiality and you should absolutely complain. They had no way of knowing that you didn't know the locum's patient.

It sounds horrible. When I had a student attending my G appointment, I'm sure I was asked if I minded and I either signed a form to agree or was at least given something in writing to explain what was happening. Sounds like they are sloppy with procedures.

I don't know if the locum should or shouldn't have walked in but it doesn't sound right. Suppose you had been in the middle of an examination, for instance?

Discussing what forms he needed signing so clearly that you understood exactly what he was there for was unnecessary. He could have just handed the forms to the doctor and asked him if they were the correct forms for "this procedure". If he needed to be any clearer, he should have phoned the doctor from his consulting room and asked the question by phone.

Discussing something as sensitive as a termination in from of another patient is completely horrific. Suppose you were attending because of a suspected miscarriage, pregnancy problems, infertility problems? Suppose you yourself had a termination in the past?

I would complain but bypass the surgery themselves as it sounds as if your complaint wouldn't be taken seriously by them anyway.

IMO GPs don't know the meaning of the word confidential. The minute they put your name on the marquee, or call it out in the waiting room, or send you a letter with their surgery frank on the envelope, they've broken confidentiality. After that, all bets are off really.

That's a point quietbat. I assume GP surgeries have to have a Caldicott Guardian too. Although it'll probably be the Practice Manager or the senior GP the OP saw so she may not have any luck.

Every year in my information governance training there's a WWYD scenario involving discussing sensitive patient info of unnamed patients in public areas where you could be overheard by other patients. The answer is never that it's OK. And that's without the patient name flashed up on a board in the waiting room and the discussion he had with the observer after.

WRT to the observer what happens in my surgery is that there is a sign informing you that Dr X has a student/trainee observing and that if you don't want them in your appointment to speak to reception. Often I would then be asked by the GP outside the room if I am happy for the observer to be there. And then, without exception, I am introduced to them by name with an explanation of who they are and why they are there. That last thing would be the very minimum I would expect so I would add that to any complaint to.

Yes, I worked until very recently in an organisation with equally high standards of confidentiality to a GP surgery, and I would count this as a breach of the confidentiality of the patient asking for a termination and also several counts of bad practice by the GP you were seeing - not asking permission to have someone else in the room, talking about their views on terminations in front of you, all the things you found concerning yourself.

Where does one complain to if one wants to go outside/above the practice? I think you should do this because a) you mention that the GP's wife is the head of the practice, and b) in my experience casual bad practice like this is not isolated, so it's likely that this behaviour is well tolerated within the practice and they need to be set straight by someone with higher standards who does not work there themselves.

I would always go with complaining to the surgery first. If you don't get anywhere, then I would guess the PCT and/or the ICO is probably the next port of call.

The receptionists at our surgery usually tell us if there'll be a student involved at the time of making the appointment and ask if we're happy with that. If not they'd book an appointment with another doctor, or organise for the student to not be there, I assume (I always say it's fine as I haven't got any reason not to so I don't know).

I'd be shocked to have a GP consultation interrupted at all. That's really unprofessional, as you could never know what the patient is there for. You'd pop in between patients, surely. It's even worse when it's to talk about something sensitive that affects another patient, and even worse to have the GP rant about not doing the referral for a termination to you during your appointment. Definitely report your GP to the relevant authorities (not his wife!).

Yep, confidentiality broken for sure.

Complain, or maybe 'offer a suggestion'.

Frankly, they should be glad you are flagging it up with them and not the General Medical Council.

For someone to take a moral standpoint against termination (fair enough) but then have no issues in allowing such intimate patient details to become, essentially public knowledge, is absurd.

My mw was a lovely lady but slapdash with patient information. She had a massive diary open on her desk with all her appointments for the day written in thick black capital letters along with the number of weeks pg they were. You could read it from the other side of the room. One day I picked a name from it and said "Wow, I didn't know Michelle was pregnant!" She did a little yelp, closed it and told me to pretend I hadn't seen it. :o No idea who Michelle was. Just wanted her to know I could read all the info from where I was sat. It was closed on my next appointment.

Sorry about the smiley face. It shouldn't be there.

Vitabrits - on a few occasions I've had to tell patients in advance that I may be receiving a phone call and I may ask them to go outside. It's very rare, eg discussion with a coroner and you need the medical notes in front of you, or trying to catch another speciality doctor about another patient. There really, really isn't a way around it sometimes. I expect the call though and I let people know.

OP - lots of things wrong there, as others have pointed out.

Not sure what the alternatives are to people's names being called out or displayed. A ticket system as in Clarks?