January 1, 2004, just three short months from now, looms as the day that Canadian dentists will be forced into a new regime of heightened vigilance about the privacy of our patient records. And it is all because of a complicated piece of federal government legislation that most of us have never heard of — the Personal Information Protection and Electronic Documents Act (PIPEDA).
PIPEDA was originally written for the industry, trade and commerce sector of our economy, not for dentists and the health-care sector. But the federal government, in it’s infinite wisdom, decided to let the legislation also apply to dentists, physicians and other health-care professionals.
The legislation is complex, far-reaching, and will have an impact on how every dentist conducts his or her practice. The wording of the 55-page Act is so difficult to understand that lawyers and law firms across the country are rubbing their hands together with glee anticipating the financial windfall they will earn charging clients (i.e. dentists) to explain this complicated legislation. Some firms are actually charging more than $4,000 for a short, “How to Understand and Comply with PIPEDA” course.
PIPEDA sets out rigorous rules detailing how a dental office may collect, use or disclose information about patients. It includes everything from charts, photographs, radiographs and even tissue samples. The Act will also force every dental office to obtain a patient’s informed consent each and every time it collects, uses or discloses their personal information. This, of course, could pose a huge problem when a dentist attempts to sell his or her practice, because a host of lawyers, accountants, practice brokers and potential purchasers will naturally all want to inspect patient charts.
Another fundamental principle of this privacy act is that it gives any patient the right to request to see any personal information dentists hold about them. Dentists are required to help individuals who have made such a request (e.g., explain the filing system) and to assist them in understanding the information (e.g., explain abbreviations and technical terms). The new law also gives patients the right to correct, amend or delete personal information on their charts. Every dentist must also formulate an office “privacy policy” for publication to their patients, appoint an office “privacy officer” and develop record retention and destruction policies, including a policy to handle patient complaints.
Non-compliance with PIPEDA is a serious issue. Complaints to the Privacy Commissioner can be made by anybody who can lick a 48-cent stamp. It could be an unhappy patient, a disgruntled employee, or a jealous dentist down the street. The Privacy Commissioner’s office will investigate all complaints. He will have the power to enter a dentist’s office, summon witnesses, examine them under oath, and compel production of documents. If a violation is found, fines can range from $10,000 to $100,000 and may include an award of damages to the complaintant. The Commissioner can also make public his findings about the dentist.
Fortunately, for dentists in Ontario, there is good news! We are not going to be left to flounder on our own. The Royal College of Dental Surgeons of Ontario (RCDSO), the regulatory college, is demonstrating real leadership on this issue, and, in fact it is the only college or dental association in Canada developing a comprehensive ‘turnkey’ PIPEDA package for it’s members.
The College staff, under the direction of it’s very talented and dedicated registrar, Irwin Fefergrad, is preparing a complete information kit, including a CD-ROM, to send to all dentists in the province. It will be easy to understand, dentist-friendly, and it will walk dentists step-by-step through what is needed to be compliant-ready and to keep out of trouble with the Feds.
Unfortunately, with all the rules and regulations that dentists are faced with every day, simply staying out of trouble means you have to be part lawyer, part business manager and part political scientist — all occupations way beyond the bounds of our oral health care training. It is good to know that there is a dental organization out there, like the College, that understands the pressures we are constantly under, and is there to help us when we really need it.
