Is it ethical for a psychiatrist to monitor a patient’s blog without the patient’s permission? If so, what information from the blog is suitable for entry in the patient’s medical record?
The U. S. health care system encourages patients to take more responsibility for their own treatment decisions and expects their doctors to cooperate in that effort. But the guidelines for exercising that responsibility remain very murky indeed.
The American Psychiatric Association proscribes its members from commenting on the mental health of public figures under its nonbinding “Goldwater Rule,” which followed a published survey of more than 1,000 psychiatrists commenting on Barry Goldwater’s emotional fitness for the presidency.
Fibromyalgia, with no positive tests, is a “foreigner” in the medical landscape. Medicine looks for signs of pathology, changes in the structure or function of organs. The mantra of physicians facing patients with fibromyalgia: “Your tests are normal.”
You are not just the rural patient’s doctor, you are the doctor for the football team, a friend, and perhaps a relative; you speak on health at local schools and are expected to attend fundraisers.