Re: Medical Data

At 2:28 PM 9/25/96, Phil Fraering wrote:
>Of course, one area where the doctor will continue to hold a patient's
>records, instead of the patient, due to the nature of the current system:
>
>Prescription medication.
>

Digitally signed prescriptions from qualified doctors.

(Not that I support this system...I rather like the "anarchy" of Mexico,
where one walks into a pharmacy in Tijuana and can buy purt near anything).

>Of course, with the really big problems with this stuff, drug
>interactions, there's still no system for a doctor to find out what you're
>on thanks to another doctor. Which is why it's very important to always
>use the same pharmacist.


The lesson of the last decade has been that _interested patients_ often do
more research about their conditions and various drug effects than their
doctors can. (This happened with a friend of mine, who ultimately died, and
a similar case was recently detailed about Andy Grove, of Intel, who did
exhaustive research on the Net about his condition...making him (finally) a
real user of the Net. There was also a movie, "Lorenzo's Oil," about this
exact situation.)

In any case, the issue of which drugs one may be taking and maintenance of
"drug interaction databases" is not a core issue. One can selectively
release the list of drugs being considered to an "oracle" machine, and
check for dangerous interactions. Or tell the physician, which is certainly
no worse than the current situation.

--Tim May

We got computers, we're tapping phone lines, I know that that ain't allowed.
---------:---------:---------:---------:---------:---------:---------:----
Timothy C. May              | Crypto Anarchy: encryption, digital money,
tcmay@got.net  408-728-0152 | anonymous networks, digital pseudonyms, zero
W.A.S.T.E.: Corralitos, CA  | knowledge, reputations, information markets,
Higher Power: 2^1,257,787-1 | black markets, collapse of governments.
"National borders aren't even speed bumps on the information superhighway."

You're absolutely correct about the informed patient bit;  I have
developed the policy of checking the PDR entry for any medication I take. 
And found out about some interactions my doctor didn't tell me about.

There's a paradox about Andy Grove's situation: if he starts browsing
medical databases and someone can analyze his traffic, or scans his
traffic on a closed but not encrypted private email support group, they
can deduce much about his condition. Now since everyone else knows about
Grove's situation anyway (I suppose he talked about it) and it was brought
up regarding my comments about pharmaceutical interactions (and in those
comments I was acting reflexively towards a phobia about medical
interactions) it's a moot point concerning the medical side and his
privacy information; but the privacy angle still needs to be considered in
the general case:

In order for someone to do this in complete privacy, encryption would have
to be ubiquitous; the norm, rather than the exception it is now.

There aren't records of who looks up something in the PDR at your local
library, but an ISP could gather much info about its users from what sites
they frequent...

Phil Fraering          The above is the opinion of neither my internet
pgf@acadian.net        service provider nor my employer.
318/261-9649