February 3rd, 2017

Trump’s Hair and his Doctor (And a HIPAA violation?)

Surfing through Trump’s hair.

The New York Times ran a story yesterday about Donald Trump’s long time doctor, Harold Bornstein, and his disclosure that his ridiculous hair is maintained with the male pattern baldness drug Propecia.

President Trump takes medication for three ailments, including a prostate-related drug to promote hair growth, Mr. Trump’s longtime physician, Dr. Harold N. Bornstein, said in a series of recent interviews.

Hair! Trump! What fun! Right? And as a bonus, the drug is also linked to occasional, detrimental, sexual side effects. Trump! And Sex! It sells!

But just one little bitty problem.  It appears from the article that the good Dr. Bernstein might not have had permission to disclose.  Oops.

Bornstein, it seems, has been Trump’s doctor since 1980, giving him a wealth of very personal, and very private, information. But no contact lately.

Well, if doctor and patient didn’t have contact, how could he get permission to divulge information that is very clearly protected by the patient-doctor privilege? From the article:

[Bornstein] said that he had had no contact with Mr. Trump since he became president, and that no one from Mr. Trump’s White House staff had asked for copies of the medical records that he has kept for the last 36 years, or called to discuss them.

And then there is this, supporting the idea that Bornstein didn’t have permission to open his yapper to the press:

At times in the interviews, Dr. Bornstein was moody, ranging from saying that Mr. Trump’s health “is none of your business” to later volunteering facts.

Well, that’s not good, is it?

Privacy is the bedrock of the relationship, for if patients can’t have confidence in the confidentiality of what is said, they may omit things that turn out to be detrimental to their health. And that is bad. Bad. Bad. Bad.

From the Merck Manual, in an overview on the subject:

All people are entitled to confidentiality unless they give permission for disclosure or they clearly can no longer express a preference (for example, if they are severely confused or comatose). A federal law called the Health Insurance Portability and Accountability Act (HIPAA―Health Information Privacy) applies to most health care practitioners and its regulation, known as the Privacy Rule, sets detailed rules regarding privacy, access, and disclosure of information.

Ahh, the Privacy Rule. And here is all you want to know about it.

And a doctor could face criminal penalties, if the government was so inclined, and could likely face action against his license.

If Trump is pissed — and he’s always pissed at something — he could theoretically make a complaint to Health and Human Services and ask for enforcement. And HHS could, in turn, refer the matter to the Department of Justice.

Would HHS and DOJ say no to the boss?

 

 

 

 

August 23rd, 2016

Should Trump’s Doctor Be Sanctioned for Fraud?

Dr. Harold Bornstein

Dr. Harold Bornstein

With the health of the two presidential candidates, aged 68 and 70,  in the news, it’s worth revisiting the statement given out by Donald Trump’s gastroenterologist, Dr. Harold Bornstein. You may remember this from last December for its comical and very Trumpian statement:

“If elected, Mr. Trump, I can state unequivocally, will be the healthiest individual ever elected to the presidency”  (Full letter)

Yeah, that Harold Bornstein. Dr. Jen Gunter did a full, line-by-line, deconstruction of the letter at the Huffington PostI’m A Doctor. Here’s What I Find Most Concerning About Trump’s Medical Letter.

Well, it turns out the letter was even worse than Dr. Gunter thought. And that is because of the signature block, where Dr. Bornstein signs his name with “F.A.C.G.”

Bornstein Signature block

That stands for Fellow of the American College of Gastroenterologists. In order to be a Fellow, one must be board certified and pay your dues to the organization. And being board certified is a very big thing for doctors, since it entails taking a grueling test to show that you have the knowledge to be an expert in your field.

The gastroenterology boards are a subspecialty of internal medicine.

But as Rachel Madow learned, after being tipped by one of her viewers, that membership in ACG actually lapsed in 1995 — 21 years ago. And according to the American College of Gastroenterologists, he shouldn’t be claiming he is a member of the organization if he is no longer a dues paying member of the organization.

Yet Dr. Bornstein continues to use those initials after his name.

Dr. Bornstein, incredibly, responded to Madow’s request for comment and said that:

F.A.C.G. is a title that they sell for a fee; in reality it has no value.

He then went on to explain to Madow that he would continue to use this title that “has no value.”

Now that I have given you the past, let me stand on the shoulders of Gunter and Madow to go further with some facts and opinion: What he is doing is fraud.

The website for the New York State Department of Health, gives examples of medical fraud:

Examples of Medical Fraud

  • False and intentionally misleading statements to patients.
  • Submitting false bills or claims for service.
  • Falsifying medical records or reports.
  • Lying about credentials or qualifications.
  • Unnecessary medical treatment or drug prescription.

You can see the one that I highlighted. I posted all of the ones listed so that you can see the significance of the infraction. Not significant to me as someone tossing around opinions, but to the Department of Health.

Is this something that the Department’s Office of Professional Medical Conduct (OPMC) should be investigating? Maybe.

I called Douglas M. Nadjari for an opinion, he being an attorney who represents physicians primarily involving matters of professional misconduct before the Office of Professional Medical Conduct and the Office of Professional Discipline.

While not discussing Bornstein/Trump in particular, since he doesn’t have knowledge of the facts, he said that investigation and charges of professional misconduct could theoretically be pursued regarding a physician with a false credential for:

  • False advertising; and
  • Practicing the profession fraudulently
  • Lack of moral fitness

If the doctor were indeed board certified, OPMC would not pursue discipline unless it received a complaint or if a patient was injured.  If one of those two things happened, he would likely be asked to consent to an interview and be asked to change his ways.

The kicker for me, though is that he apparently already knows what he is doing is wrong. And has refused to change it.