To not want FIL as my GP!

[curlycats]

Had to NC for this as DH knows my usual username.

Before I start off, FIL is a lovely man and nothing is too much trouble. My problem isn't with him, it's with my DH.

I'm pregnant with our first child and FIL just texted me to remember to take my iron tablets. I found this quite weird so texted him back asking if DH had told him about my low hemoglobin count? Turns out DH has showed my maternity notes to FIL several times. I contronted him just now when he got in the door.

My maternity notes - as I am sure they all do - have lots of personal stuff in it; it mentions I've had a miscarriage before I met DH and describes my anxiety attacks etc. I felt so betrayed finding out he'd show all this to FIL without even telling me.

DH is now pissed off because "he only wants the best for the child and that FIL can look out for any potential issues and give advice if needed". Please tell me I am not the one being unfair!

YANBU, that’s a massive boundary to overstep. YOU are the one who is pregnant, those are YOUR notes - he has no claim over them just because you’re pregnant with his baby. It’s still your body exclusively, and your personal and private medical information. I would be absolutely furious.

^FIL was not acting in his capacity as a GP towards the OP as she is not HIS patient. There is therefore no breaking of "patient confidentiality".

I really do not follow that logic. I've worked in patient records. If we'd all followed the logic of "well they're not my patient therefore I'm not breaking confidentiality" we'd all have been reading everything.

Whatever clearance we had, you only looked at what you needed to look at. If you were in doubt, you didn't look. Being a GP is one of those jobs that you cannot really pick up and put down. The FIL was clearly asked to look at the notes in the context of him having clinical knowledge, otherwise there would have been no need. So there has been a breach of trust and confidentiality. There's a distinct doubt over whether he needed to look at all so he really should have checked directly with the OP. He's just assumed his son can speak for his DIL on important medical matters.^

Agree with that analysis. I have worked previously in professional regulation - GMC/GDC etc. HCPs are generally advised not to to treat family members either - "treat" - has a very wide definition; going as far as giving an opinion in these circumstances. My DH is a dentist and point blank refuses to give ad hoc advice (apart from generic common sense you could find on the internet - clean your teeth) unless the friend comes into the practice/registers as a patient/he takes a medical history and carries out an examination. Only exclusions are carrying out emergency treatment - ie when a child's friend knocked theur front teeth out - that is permitted by GDC and insurers. He has, on ocassion, given me a quick check up when I have missed one but prefers not to and would not carry out treatment - I am a registered patient of the practice. He will do check ups on our children - again, justifiable, as they are very young and more compliant in opening their mouths with him but would not carry out treatment. They are also patients if the practice and all of this is done in the practice - not randomly at home. I would be raging with him if he decided to share my notes with someone else without my consent, whatever his motivations.

The GDC/GMC are really cracking down on this ad hoc/informal advice as (a) there are consent issues (b) there are objectivity/relationship issues (c) this can lead to serious prescribing issues (one of the reasons George Osborne's brother was struck off.

All of the regulatory bodies are very big on "insight" - not understanding/accepting their is a regulatory breach ("Oh - it's jjst my DIL's notes. Her DH said she wouldn't mind) is viewed as worse than than the initial breech, hence why most HCPs now just don't even consider "just giving an opinion" Particularly when the "patient" isn't even there to consent.

Both your dh and your fil are at fault here. I was initially going to say just direct your anger at dh but having read the above replies it seems fil should also have declined to look without checking that you consent.

This is seriously disrespectful of your personal dignity and autonomy. It bodes very ill for your future relationship. Are dh and fil going to conspire behind your back and overuse you if your dc are poorly and there are a number of options that you discuss with your own gp?

I'd be buying myself a lock-box and ostentatiously be putting my notes in it and locking it in front of DH.

To be honest I'd be tempted to do this myself but I think the better way is to have a serious talk with your DH about how it's your sensitive medical history in there, that he shouldn't have shown it to FIL without your explicit permission and see if he can understand why its upsetting to you that he did.

If he can't understand that after a calm conversation then I think you need some urgent counselling as there's a major issue with his respect for you and your feelings and that's only going to get worse when you add a newborn to the mix.

I would be livid with both DH and FIL. You have every right to be absolutely furious!

I don't think I could put into words how angry I'd be. And not at FIL (who, rightly or wrongly, trusted his son when the latter said he'd cleared it with his wife), but my DH. Just who does he think he is? There's a team of professionals looking after you- why does he have any reason to think it's in any way necessary for a GP to look at your notes? They're nowhere near as qualified to comment, surely? And that's no slight on GP's btw, it's just babies and pregnancy is only one small part of their normal role.

Being generous to your DH, the only close to reasonable explanation is potentially him being anxious or worried about the pregnancy/birth and this is his way of trying to deal with it or get reassurance from someone he trusts. But that doesn't make this ok- if he is worried he needs to do what everyone else who doesn't have a doctor in the family does and TALK ABOUT IT.

Your DH is definitely in the wrong. The fact that FIL texted you shows that he thought you knew he'd been seeing the notes. Your DH lied to him and hid it from you. Really horrible and surely he knew it would eventually get back to you!

"The thing is, as is very clearly stated in all information governance training, which everyone has to take is that You are only ever have permission to access the information you need to do your job in caring for the patient. FIL had no job to do caring for the patient. As a relative and future grandfather of course he cares and is interested but he absolutely should have known that he was doing the wrong thing reading the OP's notes unless she herself said it was OK. Which she hadn't."

Again, he wasn't doing his job in caring for a patient, he thought he was doing his son a favour in looking at his DIL's notes.

"I really do not follow that logic. I've worked in patient records. If we'd all followed the logic of "well they're not my patient therefore I'm not breaking confidentiality" we'd all have been reading everything."

I'm not in medical record but work as a doctor. He was not accessing records in his workplace, that is why she is not a patient, she is his DIL. If he WAS accessing her notes in HIS general practice, he would 100% be breaking confidentiality.

This appears to be the main confusion in accusing FIL of professional misconduct, he was handed notes from his son, not going through confidential records he accessed from work. That DOES NOT take away from the fact he should've checked with OP first and as a GP should have known to seek explicit consent however it does not amount to professional misconduct.

This appears to be the main confusion in accusing FIL of professional misconduct, he was handed notes from his son, not going through confidential records he accessed from work.

Information Governance isn't something that you selectively apply though. The questions for checking competence in my Trust actually ask about what you do if you stumble across confidential information in a public place (e.g.dropped handover sheet on a bus etc) and the answer is hand it in and report to an appropriate person NOT have good browse through out of curiosity.

OP's DH hasn't had confidentiality training but FIL must have done and should have known it was wrong to read without permission but he did anyway.

the answer is hand it in and report to an appropriate person NOT have good browse through out of curiosity

Yes. Confidentiality does not just apply in the workplace and whilst you are being paid to be a GP. Whilst I personally would not even attempt to go to the GMC with this issue I do think it is, morally and ethically, wrong. Did he need to look at this information? No. Then he shouldn't have.

If o.p had asked fil to have a look through her notes and offer any advice or explain anything she didn't understand would this still have been a confidentiality breach as he is not her g.p. or actively involved in her care at all. If a friend or family member asks for advice from someone they know should the h.c.p. say no, they need to speak with their own doctor or nurse. .

FIL should have asked for your permission first otherwise it’s a massive breach of confidentiality and he will be aware of that. YANBU, twat move from your DH.

I would be giving dp the silent treatment. For at least a couple of months for this.
Tell him you will attend next scans/appointments on your own as you can’t trust him not to broadcast, and will be having a different birth partner because Fil doesn’t need to know the ins and outs of that either.

Even if you don’t mean it just threaten him he needs to know how serious this is!

If o.p had asked fil to have a look through her notes and offer any advice or explain anything she didn't understand would this still have been a confidentiality breach as he is not her g.p. or actively involved in her care at all

That's not a confidentiality breach, the OP is allowed to share and discuss her health information with anyone she chooses.

It is generally regarded as high risk and a very bad idea for doctors and other professionals to provide treatment or advice to friends and relatives as they won't have the same degree of detachment as they would with a patient in normal circumstance.
GMC guidance advises against it unless there is no alternative (emergency situations etc).

It's possible a doctor could get in trouble for that but the circumstances would be key. Advising an anaemic relative to take iron supplements may be OK in itself although because of the lack of objectivity there's a risk a doctor might dismiss something that an unrelated doctor might not.

OP, if this was me I would be making BIG noises about contacting the GMC. They need to realise that this is serious, and not just because you are upset. It is serious because they fucked up.

Thanks Breakfast, are doctors and nurses given any advice on dealing with social media, for instance advising someone not to go to a&e, telling them to take painkillers at certain times, general stuff but if they declare themselves as an h.c.p. and the person deteriorated what could happen, I'm thinking about some threads that give out medical advice.

I find this behaviour quite bizarre. Unless either of you had concerns why would he for one second think that you would want your medical notes shared with your fil. Is your hb showing other signs of controlling behaviour

Men dont think the same way. The baby, although part of a biological processes within the womens body, can be seen as a separate entity. So DH wanted the most medically knowledgable person he knows to offer support. Doesnt quite get that there is a line to be trod where the baby has little to do with him until the mother is ready (including 3am breastfeeding etc. if that is what is going to happen) and his support should be to the mother only.

Of course privacy has now been breached and a discussion about that needs to take place. Clearly, if DH would want things about him to be kept private then the OP needs to emphasis the hypocrisy in this (assumes the OP has never discussed her DHs health with anyone....).