Doctors and Guns Redux
- Thread starter Aguila Blanca
- Start date
I would like to see documentation on this claim. I live in New York State and have never heard this allegation about State police reviewing a central data base of prescriptions searching for drugs prescribed for mental illness. Many drugs used to treat mental illness such as anti depressants are also used to treat pain and to quit smoking. Just because someone is prescribed one of those drugs doesnt mean they are being treated for a psychological condition.
Frank Ettin
Administrator
You saying that is not documentation. You need to supply evidence -- documentation from a reliable source. Your claim is meaningless.JimPage said:
Frank Ettin
Administrator
FITASC said:
I have no need to peruse anything, nor do I intend to. It's his claim, so it's his burden of proof. See the "burden of proof fallacy."
Chris_B said:
It may not be the point but I think it is relevant. Personally I don't think the government should be strip mining your medical records for information. If it gets to the point where the government is prosecuting you for information they shouldn't have had access to in the first place (IMHO), then there are bigger issues at stake than what you said to your doctor...
Sorry, I don't have proof. I have read news reports of pistol license holders having their licenses revoked for psychiatric treatment prescriptions. All I can offer is what has been published which I don't save.
If we are limited to discussing only what meets courtroom standards, we a limiting discussion to the extreme. I appreciate your expertise, Frank, but I think it is often misdirected and inappropriate in its application.
If we are limited to discussing only what meets courtroom standards, we a limiting discussion to the extreme. I appreciate your expertise, Frank, but I think it is often misdirected and inappropriate in its application.
im not limiting you to what would meet qualification for expert testimony, but you cant make a claim that New York State Police are illegally violating HIPPA laws to mine for those who are prescribed medications which could potentially be used for psychological conditions, and not be able to back it up with something. I think what is confusing you is stories of people who have been reported by a health professional that they are a danger to themselves or others under the New York State Health Act. That has happened. I have never come across anything about New York State Police combing a data base of prescribed medications looking for anyone who has been prescribed something that could be used for a psychological condition. The numbers of people who take medications like that for psychological conditions, nerve pain, to quit smoking and other off label uses is tremendous.
Frank Ettin
Administrator
JimPage said:
People "know" a lot of things that aren't true. That's often because they are relying on their recollections of things they've heard from some forgotten source or read "somewhere."
But recollections can be faulty and sources unreliable. And people have ways of "remembering" things that are consistent with their prejudices and preconceived notions (see "confirmation bias"). And it seems that the more something suits their prejudices or preconceived notions, the more casual they are about evidence.
And it's important in a serious discussion of important matters that those discussions are based on good information. Introducing false information as if it were true into such discussion can not possibly help lead to meaningful or useful conclusions.
If such things have happened it doesn't necessarily mean that (post 31):JimPage said:
JimPage said:
Furthermore it's unclear that any such database could be constructed in compliance with HIPAA. And even if it could be, providing access to such database by a state police agency raises further HIPAA problems.
Frank Ettin: "Does a central database of prescriptions even exist anywhere? I'm not aware of any such database, and a good deal of my practice was health care law. Indeed if such a database did exist it could be very helpful in identifying drug abusers and patient's who might be at risk of serious, adverse drug interactions by having been prescribed incompatible medication by different doctors; but both of these continue to be knotty problems.
Furthermore it's unclear that any such database could be constructed in compliance with HIPAA. And even if it could be, providing access to such database by a state police agency raises further HIPAA problems."
I don't have proof to provide but I have been told by the VA doctor that all narcotic prescriptions at least are on a single database so that they will be able to trace those who try to get multiple prescriptions from several doctors. That sounds reasonable to me. The news cited some (at least three as I recall) instances of NYSP confiscating pistols of those with prescriptions to drugs used for mental patients. There was discussion of HIPPA, but I saw no final resolution of the cases.
Furthermore it's unclear that any such database could be constructed in compliance with HIPAA. And even if it could be, providing access to such database by a state police agency raises further HIPAA problems."
I don't have proof to provide but I have been told by the VA doctor that all narcotic prescriptions at least are on a single database so that they will be able to trace those who try to get multiple prescriptions from several doctors. That sounds reasonable to me. The news cited some (at least three as I recall) instances of NYSP confiscating pistols of those with prescriptions to drugs used for mental patients. There was discussion of HIPPA, but I saw no final resolution of the cases.
Frank Ettin
Administrator
There probably is a central database for that VA facility, or even one that covers multiple VA facilities. A multi-location group medical practice will customarily now have a medical record database covering all physicians who practice in that group because patients might be seen by multiple doctors in that group. Indeed in today's world of medical care there are integrated provider groups systems (generally one or more hospital with associated ancillary medical facilities together with groups of physicians who practice at those facilities) which maintain medical record databases shared by the hospitals and physicians which practice as part of that group system. However, those various databases are unique to each system that maintains them, and other groups of providers do not have access.JimPage said:
All that does not mean that there is a single database of all prescriptions written for everyone in a particular State. Nor does it mean that a state police agency has access to such non-existent single database, or the multiple databases that do exist, for the purposes of some sort of data mining.
That might be, but it begs the question of how the NYSP acquired the information.JimPage said:
In any case, in post 31 you wrote:
JimPage said:
If it is not in fact true that NYSP search a [non-existent] database for prescription drug information, how does claiming that to be true further a serious discussion?
In my state, such a database exists...for narcotics drugs, at least. Pharmacies report narcotic prescription to the database. But, how the database works (or is intended to work) is not exactly what is described by Jim. If I suspect a patient in my care to be abusing the system in an attempt to get excessive narcotics, I can search the database using the patient's name and birth date to see prescriptions, amounts, prescribing provider, places they were filled, etc.
Now, whether it can be searched by government entities is a question to which I don't have the answer. And I also don't know that it can be searched "in reverse" (i.e.- input a certain drug name and see a list of people who have or have had prescriptions filled for it). My suspicion is that it COULD be searched that way by a determined hacker and/or an overreaching governmental authority.
Now, whether it can be searched by government entities is a question to which I don't have the answer. And I also don't know that it can be searched "in reverse" (i.e.- input a certain drug name and see a list of people who have or have had prescriptions filled for it). My suspicion is that it COULD be searched that way by a determined hacker and/or an overreaching governmental authority.
Frank Ettin
Administrator
jmhyer said:
I gather then that you're a physician or some other provider of medical care. So perhaps such databases exist in some States. As a provider you would be in a position to have personal knowledge.
And if they work as you've described, they could be operating in conformity with HIPAA. But HIPAA does regulate the permissible uses and disclosures of protected health information without the consent of, or opportunity to object by, the patient (45 CFR 164.512). While 45 CFR 164.512 does authorize very limited disclosure of protected health information to law enforcement, such disclosure is subject to strict requirements as the information which may be disclosed and the circumstances and purposes for which it may be disclosed. HIPAA would not permit a law enforcement agency to access such a database for a fishing expedition.
I appreciate the clarification such as it is. It would be nice to actually find out where those news reports came from. But I have observed the press to be wrong often, particularly when politics is involved.While it is incumbent on the person making the claim to provide proof, I would like to point out that in cases involving govt agencies "doing things they shouldn't" that there is often NO PROOF until there has been an actual CONVICTION in court.
The best that may be able to be provided is other people, making the same, or similar accusation.
Which, while possibly quite true, is NOT proof, either.
Nor does it mean that the alleged abuse is NOT going on. Only that there is no documentable proof, at this time.
The best that may be able to be provided is other people, making the same, or similar accusation.
Which, while possibly quite true, is NOT proof, either.
Nor does it mean that the alleged abuse is NOT going on. Only that there is no documentable proof, at this time.
Frank Ettin
Administrator
There must always be some decent evidence or documentation. "It's the government and we don't like them" is never enough.44 AMP said:
And sources matter. A bunch of guys in the bar, or Alex Jones, or similar sources aren't reliable. The Wall Street Journal is another matter.
People (both gun people and anti-gun people) believe a lot of things that aren't true in part because they don't understand the difference between evidence and guesses and in part because of confirmation bias.
Aguila Blanca
Staff
Frank, the whole question of evidence when dealing with a government agency as huge as the Social Insecurity Administration or the Veterans Administration is very dicey. I know with absolute certainty, as a result of frequenting the local VA hospital for most of my primary health care, that part of the intake before each appointment (along with taking my temperature and blood pressure) is to ask if I'm feeling depressed today, "even a little bit." And yet other members here, who go to other VA facilities, report that they have not been asked that question.
I can't prove or document that what I'm reporting is true, but it has happened enough times that I am acutely aware of it, and I assure you that I'm not making it up. On the other hand, the question is posed in such a routine way that people who perhaps weren't already aware of this issue may, in actuality, have been asked the question, answered it, and not had it register strongly enough to remember it.
Or it's possible that different VA regions follow different guidelines, or even that some facilities DON'T follow guidelines. (Where's my shocked face? Oh, yes ...
)
I can't prove or document that what I'm reporting is true, but it has happened enough times that I am acutely aware of it, and I assure you that I'm not making it up. On the other hand, the question is posed in such a routine way that people who perhaps weren't already aware of this issue may, in actuality, have been asked the question, answered it, and not had it register strongly enough to remember it.
Or it's possible that different VA regions follow different guidelines, or even that some facilities DON'T follow guidelines. (Where's my shocked face? Oh, yes ...
)Shenna9220
New member
Aguilar you have it spot on and it goes beyond the VA. If your primary health insurer is Medicare or Medicaid, they are required to asked about your mental health. I know this because during my last checkup the nurse started asking the questions on and I inquired why and was told the gov. Requires they ask. My understanding for the Fl law that was struck down was that the gov. Wanted to/did add the gun safety. Fl. Was just trying to get in front of it. All of this is just more stuff the new administration will have to fix, it's just going to take more than a month to get it done
Frank Ettin
Administrator
Often it's difficult to determine with evidence exactly what is going on and why. But the fact that it's difficult to find evidence to prove a supposition doesn't turn a suspicion into a fact or a guess into reality.Aguila Blanca said:
Which means what? Is asking that kind of screening question a bad idea? Is it inconsistent with the standard of care expect of competent physicians? Is there a good "art of care" rationale for that sort of routine question?Aguila Blanca said:
It would be worthwhile to have some input from a physician on that issue.