Rumpole of the Bailey<\/a><\/em> (in case you don’t know, hilarious stories of legal absurdities).<\/p>\nOur latest saga concerns her developing cataract. She sat on her glasses and so needed a new pair. The optician suggested she see an ophthalmologist, and some how an appointment was made. I wasn’t sure of the exact mechanics of how the appointment was made, but my brother told me that it was for a time when I will be away. I thus set about changing the date, and my brother gave me the number to ring.<\/p>\n
I rang and was told that the office had moved and I had to ring another number. I did. I told the woman who answered that I was ringing on behalf of my mother and wanted to change the date.<\/p>\n
\u201cI can’t talk to you.\u201d she said. \u201cI need to talk to your mother.\u201d
\n\u201cShe’s demented,\u201d\u00a0 I answered.
\n\u201cOh, I’ll have to talk to my supervisor.\u201d
\nI’m put on hold, listening to a very loud version of a Mozart tune played by an unmusical computer. It hurts, but I don’t like to put the phone down.
\n\u201cWhat can I do for you?\u201d asks a woman, presumably the supervisor, after a few minutes. I tell my story again.
\n\u201cWho made the appointment?\u201d
\n\u201cI’m not sure. It happened after my mother saw an optician. Perhaps it was the optician.\u201d
\n\u201cIt can’t have been.\u201d
\n\u201cMight it have been the GP?\u201d
\n\u201cIt must have been a member of the public. We only take bookings from members of the public.\u201d
\nShe says this to me as if I’m an idiot. Perhaps I am, and perhaps I should have known that they take bookings only from members of the public. I can’t believe, however, that I’m the only person in Britain who doesn’t know this, and I’m moderately confident that I’m not the biggest idiot in Britain. Even if I am the biggest idiot in Britain she shouldn’t talk to me as if I am.
\nSo, rather to my surprise and without premeditation, I say \u201cPlease don’t talk to me as if I’m an idiot.\u201d I’m embarrassed. She’s stunned. But after a pause we resume.
\n\u201cYour mother must have made the booking.\u201d
\n\u201c It can’t have been. Perhaps it was my brother.\u201d
\n\u201cI’ll look on the system.\u201d
\nMore electronic Mozart.
\nAfter a few minutes. \u201cThere’s nothing on the system. It must have been your mother.\u201d
\n\u201cIt can’t have been.\u201d
\n\u201cAnyway I can’t talk to you without your mother’s permission.\u201d
\n\u201cBut she’s demented.\u201d
\n\u201cIn that case, I’ll ring the GP. They should have on their system that that’s the case and that I can talk to you. I’ll call you back.\u201d
\nAs I wait, wondering if she’ll call back, I reflect that she doesn’t know who I am anyway. Just because I say that I’m Richard Smith, doesn’t mean that I am. I also wonder how likely it is that a fraudster would ring up and try and change the appointment of an elderly woman. Where is the gain?<\/p>\n
She rings back. \u201cThe GP’s system has no record that what you say is the case is the case.\u201d Do I detect a note of triumph in her voice?<\/p>\n
\u201cYou mean that the system doesn’t record that she’s demented, that she’s booked for an appointment with an ophthalmologist, or that you can speak to me?\u201d<\/p>\n
I’m not surprised that the GP’s system doesn’t record much. They often don’t. My mother does have an \u201cofficial\u201d diagnosis of dementia. I know that because we used it to get an attendance allowance, but we don’t go much to the GP. What’s the point?<\/p>\n
\u201cI can’t speak to you about the woman you say is your mother.\u201d
\n\u201cSo we can’t even cancel the appointment? That means that nobody will turn up and the appointment will be wasted.\u201d
\nShe perhaps sees that this is getting very silly. \u201cLet me ring your mother.\u201d
\nI’m not keen on this. It’s the afternoon, and my mother may well be in bed. Plus she gets a lot of strange calls. \u201cWhat do you need to ask her? I can probably tell you whether she ‘ll be able to answer.\u201d
\n\u201cI need to know her date of birth, and whether she will let me speak to you.\u201d
\n\u201cI’m not sure that she’ll know her date of birth. She’ll let you talk to me.\u201d But how do you know I’m me, I think but don’t say.<\/p>\n
Ten minutes later she rings back. \u201cThe number on the phone was the number of your sister in law. She says I can speak to you?\u201d How, I think, do you know that was my sister in law? How do you know my mother said that you could talk to my sister in law? How do you know that my mother is happy for my sister in law to say that you can speak to me? How do you know I’m me?<\/p>\n
This was not a good experience, but the system is satisfied.<\/p>\n
Richard Smith<\/strong> was the editor of the BMJ until 2004 and is director of the United Health Group’s chronic disease initiative.<\/strong><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"I am the chief medical officer of our family. I am the bridge between my family members, some of them eccentric and one of them demented, and an unforgiving health […]<\/p>\n
More…<\/a><\/p>\n","protected":false},"author":1,"featured_media":38364,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[955],"tags":[5637,14755],"class_list":["post-16833","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-richard-smith","tag-confidentiality","tag-nhs"],"yoast_head":"\nRichard Smith: Are we too concerned with confidentiality? A fable - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2012\/05\/04\/richard-smith-are-we-too-concerned-with-confidentiality-a-fable\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Richard Smith: Are we too concerned with confidentiality? 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![\"Richard](\"http:\/\/www.bmj.com\/site\/blog\/icons\/bmjh7648e.jpg\")
I am the chief medical officer of our family. I am the bridge between my family members, some of them eccentric and one of them demented, and an unforgiving health system. Many doctors\u2014indeed, anybody familiar with the strange language and rigidities of health systems\u2014fulfil the same role, and it gives us some useful bottom up views of our health service.<\/p>\n