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Do Your Patients Know Where You Live?

— Healthcare professionals have a right to privacy, too

MedpageToday
 A photo of a rainy street running through a suburban neighborhood.
Casey is a physician assistant.

I know where my former therapist lives. There's no non-creepy way to say that, and that's precisely the point.

The information was readily available via a quick search on the Oregon Secretary of State website. I wish I could say I was shocked at how easy it was to find, but the prevalence of healthcare professionals' personal information being widely available on the internet is a well-known problem.

For example, a survey by Doximity that approximately "85% of doctors worry about whether patients will access their personal information online." Although some efforts have been made to mitigate this, such as Doximity's own privacy service , the problem is far from being fully resolved.

Unfortunately, we live in a society in which even our most basic rights to privacy have been completely disregarded by the powers that be. Why do we tolerate this? Why haven't we found a better solution yet? I'm writing this in hopes that we will.

Sure, most paperwork comes with a warning, but it's hardly a black box warning. In about 10-point font, blending in with the rest of the text, applicants of all kinds are notified that the information they provide will become part of the public record.

Some people are applying for a national provider identifier (NPI) number. Other people, often therapists, have a private practice and are filling out the Articles of Organization for their limited liability company (LLC). Either way, the process is far from foolproof in terms of ensuring these individuals' privacy. The forms require a physical street address, and many applicants resort to providing their home address because they feel like it's their only option.

Consider the student or recent graduate who's ready to apply for an NPI number but doesn't yet have a "Business Practice Location." Consider the new parent who's taking a hiatus from clinical practice and isn't sure what address to provide when they update their information. Consider the rise of telehealth, and particularly how many therapists are continuing to work from home.

I suspect that those who end up putting their home address on these forms fall into three different categories.

First, there are those who might claim they missed the warning altogether. Despite how fervently our school teachers tried to instill in us the importance of always reading the instructions no matter what, everyone skims the fine print. We've all signed a document or checked a box indicating "I agree" without reading the provided information in its entirety.

Second, there are those who read the forms in detail but are confused about the wording. For example, the Privacy Act Statement on the last page of the NPI application , "certain information that you furnish will be publicly disclosed."

One might reasonably think, "OK, only certain information will be publicly disclosed. Surely that wouldn't include my home address!"

Fortunately, other forms are much more succinct and clear. For example, the paperwork for establishing an LLC in Oregon states, "the information on this application is public record [...] and it will be posted on our website." Given what's at stake, this degree of explicitness is imperative. There ought to be no doubt that applicants understand the implications of providing their home address on these applications.

Lastly, there are those who seem to have a different sensibility about privacy altogether. They list their home address knowing full well that it will become easily accessible to the public. Perhaps these people really don't mind. Maybe they grew up in a small town where it was normal for everyone to know where everyone else lived. I'm sure it will be fine, they reason.

Regardless of why people willingly share this information, the lack of available alternatives is troublesome. Given that more than 80% of nurses face workplace violence, shouldn't we have systems in place that proactively ensure we aren't publishing healthcare professionals' home addresses on the internet for anyone to find? Why must therapists choose between maintaining a fundamental degree of privacy or paying thousands of dollars every year for an office space they don't need? Privacy has become a privilege, and the cost is far too high.

Shannon Casey, PA-C, is a physician assistant and former assistant teaching professor in the Department of Family Medicine at the University of Washington in Seattle. She writes at .