Dear Margo: Our Family’s Bad Seed

My ‘drama queen’ sister-in-law now has access to family medical records, what should we do? Margo Howard’s advice

Our Family’s Bad Seed

Dear Margo: For more than 20 years, my extended family has been putting up with my brother’s wife. She’s a negative, nasty, miserable person who blames everyone else for her problems. Lots of drama has been created time and time again because everything is about her. She’s managed to alienate everyone in the family — some, including myself, permanently. And I used to be one of her staunchest defenders in the interest of family harmony. Obviously, she has “issues,” but she won’t deal with them. Doing so would be admitting she wasn’t perfect.

Recently, this woman left a longtime job and went to work for a hospital — the hospital my mother, my other relatives and I have been going to for years. We are concerned about the access she will have to our medical records. Not to sound paranoid, but is there anything we can do to protect ourselves? Is there any way to ensure she doesn’t see our records? Do we call the hospital and fill them in? We honestly believe this woman is capable of justifying anything she does — with 20-plus years of experience to back us up. — On Edge

Dear On: I don’t know what this troublesome s-i-l would gain by viewing everyone’s medical recs, but I suppose anything is possible. The way you’ll know, however, is if she casually brings up, say, Uncle Albert’s vasectomy, in which case she will have breached HIPAA regulations and can be fired. Several hospital personnel recently were sacked for snooping in celebrities’ records in California hospitals. So I guess you all just wait for her to drop something into the conversation that you believe to be medically privileged. There really is no phoning the hospital to say you have a wretched relative who will probably snoop in the records. — Margo, vigilantly

Life Is Choices

Dear Margo: Almost everything about my four-year relationship is perfect. But the one thing that’s not is a big one: He is two decades older than I am and already has a kid who has a teenager of her own. I had always been on the fence about having a child, but I feel the pull more as I approach my late 30s. Now he has told me he’s 100-percent sure he doesn’t want to do the daddy number again. I don’t want to pressure him into anything, but I can’t help but wonder if I’ll regret not being a mom. I know I’d be a good one. He wants me to be happy, which, ironically, only makes it harder to imagine giving him up. What I want is to raise a child with him. I feel no real desire to be with someone new. How do you even do that when you’re already in love? I’m drawn to adoption and have considered single motherhood. He’s made it clear what he wants. How do I proceed? — Betwixt and Between

Dear Be: Carefully. And you are smart to think and talk about this now. That issue has wrecked more than one marriage. When you say you want to raise a child with him, you must deal with the fact that he’s said he doesn’t want to raise another child, period. He’s done that; now he wants another kind of life. He is already Gramps — which is what he would be taken for if the two of you had a child. Don’t bank on getting married and him changing his mind. (Though that has been known to happen.) Your choice now is motherhood or the guy.

I do think you’re one step ahead of the game by being inclined toward adoption. In the case of any unforeseen end to the relationship, you would not be burdened by a biological clock that had stopped ticking. Because this needs to be a personal decision, your decision, you might try my old standby: The List. Identify the pros and cons, and try to gauge the strength of your feelings in both directions. Life is choices, my dear, and some situations require us to choose. — Margo, introspectively

* * *

Dear Margo is written by Margo Howard, Ann Landers’ daughter. All letters must be sent via the online form at www.creators.com/dear-margo.html. Due to a high volume of e-mail, not all letters will be answered.

COPYRIGHT 2011 MARGO HOWARD
DISTRIBUTED BY CREATORS.COM

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65 comments so far.

  1. avatar Kate Olsen says:

    LW2 – OMG Margo – I can not believe your answer.  The family has every reason to be afraid.  And contrary to what you told her – she should call her hospital and advise them, discreetly, that she thinks a relative might search family records and release them.  It is done more often than you think and the hospital is held liable -not the person.  A heads up will give the hospital a clear path to see what this employee does.  If she does nothing – so be ti – but if she does the bad thing – they can nip it in the bud. 

    LW2 – Please get a real life – you knew when you started dating a man with a teenage granddaughter that it was not likely that he would want to do the daddy thing again and now he has told you explicity that he is not wanting to be a father – what part of that do you not understand.  If you want to be a mamma – you have to find a new man.  It appears that he has been honest with you so be honest with him and move on. 

    • avatar David Bolton says:

      LW1: Just because someone works at a hospital doesn’t mean they’re given an all-access card during training. Or access to a computer. Or a password. Or knowledge of how to navigate the hospital’s internal records. Or the knowledge of how to interpret them. Or the ability to cover their tracks if they do. What they ARE given (and I know this, because—ding! I work in a hospital) is paperwork that they have to sign regarding privacy and HIPAA laws that clearly states YOU WILL BE FIRED AND POSSIBLY SUBJECTED TO LEGAL ACTION if you access such records without authorization or reason. If LW1 is that paranoid, they can have records do an access search to see if anyone has been looking at family files.

      • avatar Annie H says:

        David;

        She’s not totally being paranoid.  I have a co-worker that was involved with a lawsuit with a neighbor.  This neighbor happened to work for the medical clinic they went to.  Once the co-worker won the lawsuit, strange things started popping up.  Complaints to the co-workers wife work using her married name when her name tag still had her maiden name on it, etc.  Two and two added up to four so they called this clinic and voiced their concerns.  Sure enough, this woman had accessed their medical files starting with the child, to the wife, etc.  She was fired and they have a lock on all of the records so two people have to access them one being a supervisor.  This woman didn’t bother to try to cover her tracks.  Pretty scary considering how crazy people can be.

      • avatar cbd says:

        They have every right to be concerned. When I was going through cancer treatment at a local hospital, I had a parent (who worked at the hospital) of a student in my class go through my medical records. She told EVERY parent in my class that I was dying from cancer. This person knew my entire medical history-everything. Such a violation. When I found out, I promptly let the hospital know and transferred my care to the local University hospital.

      • avatar David Bolton says:

        I didn’t say she was being concerned without reason—I said it’s not as easy as one might think to get unfettered access to records and to then be able to cover your tracks. Just because the relative has a job there doesn’t mean she’s got automatic access to records.

      • avatar Ghostwheel says:

        It would depend on where you work and what you do as to how much access you can get, and whether you even have to cover your tracks or not. I worked membership accounting for an HMO. I had access to everyone’s information within 3 months of working there. Since 90% of membership problems came in by phone, unless someone could prove they did not call me, I could have looked at any account I wanted and just claimed that they called me to confirm coverage. Just because I could also see their medical history while I was at it…Oh, well. So depending on how the health record system works at that hospital, it could be fairly easy to get information and not have to cover your tracks at all.

      • avatar bright eyes says:

        David – I also worked in a hospital, but I had no access to patient records at all. I worked in credentialing, making sure the doctors and their assistants had all of their paperwork. But I never had access to any other information than that.

        It depends on what she is doing at the hospital as to whether or not she will have access to the patient files. I’m not sure what I would do if this were me. I’m paranoid about specific people getting my personal information because they will put their nose in where it doesn’t belong and question me about why I saw this doctor or why I was on this medication. Medical information is something that should be kept private – if you choose to discuss it with others, then that is your option. I’d see what position she is in and then see if she handles medical records and possibly go as far as to contact a representative at the hospital and ask who has access to your records. This way you’re asking who can look at them without implicating the Sister in Law until you have further proof that she does, in fact, have access to your records.

    • avatar JCF4612 says:

      LW#1: Kate, I agree the family (knowing d- queen best) has reason to fear. I’d drop a short business-like anonymous note to the hospital HR administrator stating that their new hire is widely viewed as a loose cannon quite capable of breaching records confidentiality. No need to mention this woman is a family member, since that would compromise anonymity of the heads up. Once HR is alerted, it’s likely the woman will be better monitored than if nobody had ever said anything.

      LW#2: Again, Kate gets it. Wise up, girly. You are not dating a 40-something guy on the fence over parenthood. Your grandfather-beau has great potential of soon becoming a great-grandfather. Make your choice now, and be done with it.

    • avatar stateoflove_N_Trust says:

      There is nothing except previous poor behavior related to their interactions to justify the LWs concerns.  So, she is going to risk the job of her sister-in-law based upon idle speculation.  How is that appropriate.  Many people act like jerks, but some of them do perform their employment duties in a professional manner despite their personal failings outside of work.  I agree with Margo on this one. 

      • avatar snowwhite4577 says:

        Exactly stateofloventrust…..what can be done right now? Sis in law just got the job. If a letter is dropped to the hospital administrators, they cannot really do anything at this time because she probably has not done anything wrong (she just got hired).  If she is as “off” as you claim, than it will show soon and she might get herself in trouble.

        Also, who is to say that the  hospital administrators will take anything told to them before this person starts seriously. They may look at the letter and think “the person who wrote this is nuts,” and toss it in the circular file.

        I work for a social service agency, I have access to literally THOUSANDS of records, and if I inappropriately accessed it I would get in a HUGE amount of trouble, be fired and be fined thousands of dollars per violation. 

  2. avatar Katharine Gray says:

    LW#1:  We can only hope that your SIL’s job is not in the records department.  I think most responsible hospitals, especially in this day and age of HIPAA,  do not allow all employees to wander willy nilly through the stacks of records so unless her job is one which allows her to have access to those records, your worries are probably unfounded.   I would also not advise you to call the hospital about this.  Your SIL may be a drama queen bad seed person but you are only speculating that she may have access to the records and if she does that she will use that access.  To call her employer and suggest she might do something wrong simply because she is a pain in the ass is interfering with her employment relationship and in itself may be actionable by her against you.  The person you may talk to doesn’t know you from Adam, does not know the family dynamic and why would they even take you seriously?  For all they know, you are the one who is the family drama queen trying to make trouble for your SIL with  her new employer.   It is highly unlikely they would place a monitor on her to prevent her from looking at the records simply because you tell  them she is a bad person.  At most, you could call and find out what the hospital procedures are for keeping records confidential WITHOUT mentioning your SIL,  and learning what those procedures are may ease your mind.   And really, doesn’t your SIL pretty much know what you all have been treated for and hospitalized for anyway?  I pretty much know everything that has been medically wrong with anyone in my family.  I may not know their precise cholesterol levels or the amount of creatinen in their urine but I know so and so had gallstones removed.  And that so and so was admitted to the psych ward.  

    LW#2:  You are not going to change this man’s mind about being a father.  So decide whether you want to be a mother or be with the man.  You could always marry him, trick him, and see what happens but if you do, have a divorce attorney on call.   

  3. avatar lisakitty says:

    LW2: My advice to you is to find someone who shares your same goals and this is not the man who will do that with you willingly. 

    Let’s switch sexes here, so I can make a point that maybe you will understand.  I am in my 40s and my daughter just started college.  Last year, I met a man (my age) who has three small children (all of them under 7).  He’s divorced and has sole custody of his kids because the mother is abusive.  This man and I share many very strong interests and understand each other better than most people in our area can (shared backgrounds, careers, etc).  At one point he asked me out and I told him, no.

    Why not?  He’s very cute, we get alomg great, his kids are nice.  But we are in different stages of our lives.  I’ve raised my kid, she’s doing great.  I don’t want to deal with parent/teacher conferences anymore, I don’t want to worry about day care anymore, I’ve already done that.  And that’s what your boyfriend is telling you too.

    It’s not that he’s not a good guy. I’m a good person.  We are just at a different stage in our lives than you are.  That’s ok.  

    If you have a child with him (using the time honored trick of getting pregnant without his buy in), you will at the very best have a man who is reluctant towards parenthood, and at the worst, a man who resents both you and the baby for forcing him to take a step back in his life when he thought he made it past that phase.

    Ultimtely, ask youself, is that fair to the child?  There’s your answer.  Move on.         

    • avatar Briana Baran says:

      Excellent, empathetic reply, lisakitty, told from a woman’s perspective.

    • avatar P S says:

      Very nicely said.

    • avatar John Lee says:

      Ditto, well said all around.

    • avatar bright eyes says:

      Completely agree with you. And that is how I feel too. I have a 13 year old and love him – BUT I do not want to start over again. I am not ready to push him off to college just yet, but I feel that having a baby at this point, would be starting all over again – diapers, bottles, etc. And I have no desire to do it all over again.
      I do realize that being a single parent has a lot into that, but so does the freedom of having an older child. I’m only 33 at this point, so while my friends are thinking babies, preschools and that I’m nuts. I’m thinking colleges, scholarships and paying off my house.

      • avatar Miss Lee says:

        I remember being in my early 40′s, raising a teenager and having folks remind me that it was still time to have a child with my new husband.  One of the great pleasures being past menopause is that these discussions are forever off the table along with the pressure to appear in public in a bikini.

  4. avatar Briana Baran says:

    Re: L#1: Not knowing what exact position the LW’s obnoxious SIL has at the hospital, it is impossible to predict what sort of access she might have to medical records. Different jobs have different levels of access, and rightly so. I find it interesting that the family creator of havoc has chosen to take a job at a hospital at which many family members are long time patients…especially in view of her justly earned position as pariah.

    It isn’t paranoid to be proactive in a case like this. However, calling the director of whatever department she’s employed by and spinning “outrageous” tales of iniquities will probably not get you very far. I would try to get whatever documentation you have (emails, letters, bounced checks, police reports…I suppose I’m relying on my own scandalous family’s behavior, but one never knows) from whoever is willing to provide them (the more the better, and the more affective and less *personal* a presentation you’ll make), and make an organized, formal overture to her superior to present your concerns about her ability to access family records, then use them for harmful purposes. Go higher if necessary. HIPAA will help if she manages somehow…as she would be subject to serious consequences…and having her superior(s) forewarned is an excellent idea. There is often an enormous amount of information in medical records…much more than just illnesses, surgeries and accidents.

    Re: L#2: If you are “approaching” your late thirties (say, 37), that makes your fellow 57, which is not old by any means. It would appear that he did his child rearing fairly young, and so did his daughter in order to have an official teenager of her own. Some people actually plan it that way…they want the business of parenting well out of the way while they’re still relatively young. He’s content to be Grandpa, have fun with ‘em, then give ‘em back to mom. This is not an unreasonable stance, and he’s made his ideas about a “second family” clear in a direct and honest manner.

    I don’t know you, and I can’t tell if you’ve had a long term wish to be a mother, if you’re feeling pressure from peers and family, if this is baby hunger, if it’s that biological clock thing (I never experienced any of the aforementioned, so I am unclear on them all), if you’ve fallen truly madly deeply and have some half-formed expectation that when one does so, one ought to have a baby with the object of one’s love and raise a family, or if you think this will prove your love to him. Or prove HIS love to you. Or any combination of the above.

    What I do know is that, from your letter, you’re swimming in uncertainty. You love him, and don’t want anyone else…but you’re drawn to single motherhood. You’ve been on the fence about motherhood…but recently, you’re craving it. Could it be that his adamant lack of desire for children has caused to feel a need to bend him to your will by forcing a decision on his part? One that will surely tear the two of you apart? Or is it more that you, in considering single motherhood, are actually considering single woman-hood? There doesn’t have to be “someone else”. As for knowing that you’d be a “good mother”…nobody can predict that, dear. We have them, and hopefully do our best…and eventually they’ll let us know, one way or another, how we did in the end.

    I will tell you this…nix the baby thing for right now, whether having one or adopting…as you are far too conflicted and uncertain. Get some stability, make some serious decisions. My intuition says that you are ready to move on…if so, do it now, and as painlessly as possible, without trying to force issues that will just cause heartache and recriminations.

  5. avatar srtwo says:

    lw2: Time to face reality  You are just at two different stages of your life.  He wants someone to play with besides his family and you want a “regular family”.  Even if you decide you would rather stay in this relationship, the odds of you strongly resenting him a few years from now are rather high.  And if you get pregnant by him, there is no way to tell how that will play out.  I actually see quite a few of those around me. (in that group, every one was working at a stable job and made enough money to support a child. And my grilfriends all became mothers in their mid to late 30s, early forties) In most cases the guy stayed and after a while completely embraced the daddy part and everything that was previously said is long forgotten.  But in a couple of cases, the guy just ran for the door never to be heard from again.  So you need to be sure you feel up to be a single mother if needed.  True, it is not necessarely fair to the child but then again, how often are children born in absolutely prefect circumstances.  And even then, there is not telling how it will be when they grow up.  The most unusual story in my circle of friends, is one who has had her heart set on adoption , forever.  So she proceded to adopt a child as a single mother, while beeing in a relationship.  Her boyfriend who has no legal ties to the kid , although he never beleived she would go through with it, has heventually embraced the father part (and it has been almost 10 years).  You have to go on with your life without fear. 

  6. avatar Janice Haines says:

    LW 1-I see the problem, since a place I lived in only had a huge, regional medical center, and I knew of several cases where my co-workers wife (she was a medical aide or whatever the call the floor patient clerks) and she routinely looked in records of patients.     I actually heard on one occasion, that a friend of my co-worker was terminal and with what, and was shocked to find out it was from his wife’s snooping, and the patient and her spouse didn’t know yet.      Whenever anyone from work went in the hospital they told their doctor about the snoop and the doctor would arrange for the patient (whenever possible) to be on a different floor, and for the patient chart to be separated and only access by the appropriate staff.     I understand that nothing was ever done about this woman, and when she finally retired everyone breathed a sigh of relief (she was the type that would file grievences endlessly, and always has work injuries that I suspected happened elsewhere).

  7. avatar butterfly55 says:

    LW2, I am married to a man 20 years older than I am, I was about your age when we said our vows.  I would tell you not to marry him even without the problem of disagreeing on children, with that I would say a big NO.  We have been together for 23 years but the past 10 have been like a friendship and the last 5 like a caregiver.  You don’t need to be doing that work for a child and a husband.  The age difference becomes bigger with each passing year.

    • avatar Paula says:

      I thought about that angle, too. Whenever there is a large age gap between two spouses, as they both get older, the chances get higher and higher that the younger of the two will at some point become the caregiver. As well as the child issue, think ahead to the possibility of having a teenager still at home while also having to deal with his/her father’s medical problems. True, when you marry someone “for better or for worse, for richer or for poorer, in sickness and and health,” caring for your spouse if he or she becomes ill is part of the package. And there’s no assurance that the younger of the two won’t develop a health problem and need his or her spouse’s care. But the chances are much higher for the younger to take on the care of the older when there is such a large age gap.

  8. avatar Barbara says:

    LW#1 (and all the responders who say to call the hospital): Seriously? You know what I would do with someone who called to tell me some gossip about a newly hired employee? I’d hang up the phone and laugh. Unless you have documented proof that she has done something wrong what do you really expect the hospital to do? Fire her on your word? (I know that would delight you.) There are legal safeguards against accessing or sharing any information in a medical record. If you find clear evidence that she has, then you can ask the hospital to take action. But you had better have some proof, not just gossip.

    It sounds like you have just as much of a problem as your SIL if you would even think of this.

    • avatar Briana Baran says:

      Golly gee, Barbara, if you do indeed work in a hospital (and I can believe it, based on few, mmm, interesting experiences), I just bet it’s in lower level administration. Why would I say this? O, to quote you: “There are legal safeguards against accessing or sharing any information in a medical record.”. Right. There certainly are. And people with ethics generally have this in mind. Those without…not so much. O, and then there was this little gem, which followed your tirade about “gossip”, “…I’d hang up the phone and laugh.”.

      LW1 was asking questions, and I can fully understand her worries. I’ve been a manager, and a supervisor, and I wish, in one particular instance, that I, and one of my store managers had listened more carefully to a part-time employee’s words, and the “gossip” about said employee that we were both hearing from our customers. We didn’t, and the young man murdered his ex-girlfriend and a male friend (truly just a friend) one evening.

      I am the person who recommended documenting as much as possible and formally approaching the woman’s supervisor. It is no laughing matter when a toxic person gets into a position that can seriously threaten family members., nor are these petty concerns. The woman had a steady job for 20 years, and switched to work at a place at which it may be possible for her to access many family members’ medical records. Family members whom she has systemically alienated over the course of more than two decades.

      If you find all of this amusing, perhaps it is you with the problem. Either that or you’ve lived an exceptionally charmed life filled with shiny, happy harmless people, rainbows and unicorns.

      • avatar John Lee says:

        Well said Briana. 

        Even if she is not, Barbara sure does sound like the example you described.

        My wife works at a hospital as well and yeah, despite the cloud of HIPAA firing, hospital workers at all levels have been known to abuse their knowledge of confidential information.  Someone at her hospital not too long ago just got fired for getting the phone number of an attractive patient to call her for a date.  And of course, no, that guy wasn’t some IT guru or database administrator.

        Not saying it would necessarily be effective by warning the hospital because you might get a person like Barbara on the other end, but it doesn’t hurt.

    • avatar A R says:

      Sorry, but I have to stand with Barbara on most of what she said. Assuming that the family member has access to all sorts of records just because she works there is just……well, silly. There are different levels of access and security for most jobs with sensitive records.
      I agree that calling the hospital to report a “maybe, might gonna, could possibly” scenario is over-reactive. If businesses reacted to stuff like that without proof or more substantial info, many of us would not have jobs thanks to loony clientele who wig out easily.
      I’m with Barbara. If someone called to tell me that they were scared that a relative who works at the hospital might, maybe possibly find out about their business simply due to being on the payroll…..geez….
      After I finished rolling my eyes, I’d reassure them as best I could and thank them for calling.
      At the end of the day, the only thing this letter writer can control is whether she and other family members continue to patronize a place where a person they don’t like works. They can always go elsewhere.

      • avatar Keeta says:

        I worked at a hospital as a volunteer when I was 14. I had access to medical records via computer. I would use it to look up info on people that I knew. Of course being young and stupid, I had no idea that this could be traced. However it was traced and I was not allowed to work there anymore. This was 21 years ago and things very well could have changed since then, but for me to be 14 years old and have that kind of access is ridiculous. It makes me wonder that maybe the only reason it was noticed that I was snooping on people was because my ID was that of a “Volunteen”. “Real” employees may be able to rifle through that info without it catching the attention of anyone.

  9. avatar Cindy Marek says:

    L #1: Margo, actually I think she should notify the hospital that this in-law might try to access family medical records for her own purposes. HOWEVER: It depends where (office/department) in the hospital she’s been employed. If she’s in the cafeteria or a front-desk secretary, she cannot simply traipse into the medical records department or onto a medical ward and “begin browsing” (either paper charts or electronic files). There are safeguards and security checks in place. I am a medical transcriber of 22 years, btw. If this in-law is a ward clerk or in medical records, she certainly does have access to records to some degree or other.

    L #2: I’m reluctant to say much; obviously you two love each other. If he would change his mind and you have a child together, would that be fair to the child to have an aging father? If you decide to stay with him and are willing to forego having a child, you’d better very much know you will be okay with that decision 20 years from now. And that’s so difficult to know. You don’t have the luxury of time on your side in this; search your heart with your head.

    • avatar Briana Baran says:

      # Cindy Marek: Re: L#1: You made the the precise point that I was trying for…everything depends on her position at the hospital. If she is employed in a way that allows her regular access to files, then yes, there could be a problem.

      It’s very strange to me that so many think that medical records contain only one’s illnesses, injuries and surgeries…they can contain a lot of things about an individual’s history and life that one might prefer remain private. And not all families share everything with everyone. Some things are truly no one’s business that might appear in medical records, and might cause emotional devastation if they were ever found out.

      • avatar Cindy Marek says:

        Briana, in 1990, when I was 5 years into my career (and 25 years old), a younger woman was hired in my department. She’d been my coworker for about a year when she discovered that a personal enemy had been treated there. She came over to me (for whatever reason), said she’d seen her enemy’s medical record, got some “interesting information” from it, and was tempted to go around blabbing about it. I warned her off. She let the matter go.

        So yes, there can be situations.

  10. avatar mabel says:

    Re LW1 – I can’t believe some folks here are taking the fact that she’s even working at that hospital as evidence that she plans some malfeasance. You must live in big cities. In many rural areas there’s only one hospital in the entire county… and it’s almost the only place in the county that offers decent-paying jobs. The idea that this woman left a longtime job to take a job at the local hospital JUST so that she would have access to the medical records of her in-laws is a little bit extreme.

    In fact, the part of the letter that jumped out at me is the fact that the SIL had a “longtime” job. People who have bona fide problems getting along with others tend to change jobs A LOT unless they work for themselves. The fact that this isn’t the case for SIL makes me wonder if she’s really the psycho here or if she just doesn’t like her in-laws (perhaps with good reason). People who’ve been the same job and same marriage for decades usually – not always, but usually – tend to be the emotionally stable ones. Just sayin’.

    • avatar Briana Baran says:

      @mabel: In what world of naivete do you abide? In almost every job I’ve held, some of the most enduring employees, with the longest tenure in their respective positions, have been the most obnoxious, vicious, back-stabbing, miserable (in the sense of making life horrible for those around them), dishonest people present. This has been especially true of long-term female employees (I am not making any social commentary or judgment…this is based on my own, my friends’ and my family’s, including my husband’s, experiences).

      However, back-stabbing, dishonest, vicious and obnoxious do not necessarily mean stupid, mentally or emotionally unstable…or unable to be sweet as sugar -candy to the right people. There are a lot of decades-long marriages in which *both* partners are horrible people and get along famously…with each other…and no one else. And work relationships are emphatically not the same as the inter-familial sort.

      How it just irks me when people equate nastiness and ugly behavior with “mental or emotional instability”. Mental illness doesn’t mean you’re automatically an impossible, “crazy” person who hurts everyone around them…and being “normal” is absolutely NO guarantee of kindness, compassion, and an angelic disposition…much less ethical behavior. Another person who lives in over-the-rainbow land…and who needs to take off those green tinted glasses and see the reality of Oz.

  11. avatar staili says:

    LW #1 – she should call the hospital, not to discuss the SIL, but to ask about the methods of safeguarding of medical records. For example, in some hospital systems, upon request, the pt’s electronic medical record can be set up so that it can not be accessed without someone typing their password in right before (ensuring an electronic trail that would scare a lot of people away from snooping). Also, there is some electronic tracking in some hospital systems, and the pt can request an audit to see whether an unauthorized person has gone in. I was a little surprised Margo didn’t bring this possibility up — she should have talked to a hospital privacy expert before answering the letter.

  12. avatar R Scott says:

    LW1 – Not knowing what her job is it’s hard to say but she may not have access to medical records. Lots and lots of important positions in a hospital have nothing to do with patient medical records. If she does have access she is bound by very strict regulations and would be putting hersefl in jeopardy. Also, as a manger if you were to call and tell me about this I would give you a lot, “yeah”, “uh huh” and “thanks for calling”. Family issues are family issues and not a part of a person’s job performance. I have had parents call me to whine about kids, I had a wife call me to tell me I needed to fire her husband to teach him a lesson. …”Yeah. Uh-huh and thanks for calling”.

    LW2 – If you want a kid you need to exit this relationship. I like Margo’s idea about a list and her mom always said to ask yourself if you’re better off with him or without him. Good luck. Not an easy choice.

    • avatar carol grzonka says:

      people talk about regulations as though they’re sacred.   and consequences as though they’re graven in stone.  both of these,cause and effect, are simply words on paper.  it’s guidance (or simply protection for the institution)  for the ethical and something to be ignored by the unethical.  ask anyone who’s been beaten by the person they’ve had a restraining order against.

      • avatar Briana Baran says:

        @ carol grzonka: You have made a most excellent point, one that certain people seem oblivious to, which either means that they dwell in cloud-cuckoo land and are hopelessly naive…or that they are somehow unwilling to admit, for some curious reason, that humans endlessly break the rules regardless of consequences.

        Of course there are systems, rules, firewalls, checkpoints, flags…all sorts of methods from cameras, security cards, sign-in sheets to computer log-ins, access codes, alerts and passwords that should prevent *honest*, *ethical*, even *fearful* people from illicitly examining the medical records of others. It’s a bit like guns…decent, ethical, honest, thinking people who have them don’t blow their neighbor out of his shoes for not edging his grass, or shoot toddlers to gain gang status. But certain people, lacking in ethics, humanity and conscience do…as do those who believe that they can “beat the system”, and therefore, “get away with it”. The same would apply to a person who might circumvent a hospital’s computer system by simply not using it…most large medical centers still have all of their current patients’ hard copy medical records on site…and not as carefully guarded as one might think. Or a person could use another individual’s personal access information. I am always bemused at how many people…and I know this because my husband is an IT administrator, and it drives him insane because of security issues…write down every access code, password, log in and user-name they have…and identify them…and “hide” them underneath desk blotters, in unlocked drawers and under keyboards. Where they can be readily found…because everybody does it…and it would be extremely hard to identify who had borrowed whose codes…especially in a place in which there are numerous terminals that could be used.

        As for all of these serious consequences…people still murder people in front of witnesses…well knowing what the Death Penalty is…and how the law can be completely ineffective. Please…all of the security and threats of dire punishment is meant to discourage the those who have even a modicum of ethics, common sense, or self-preservation. Just like locks are for the honest, and the tentative. Deterrents…but not guarantees.

      • avatar R Scott says:

        Briana – “…cloud-cuckoo land and are hopelessly naive…or that they are somehow unwilling to admit, for some curious reason, that humans endlessly break the rules regardless of consequences.”  WTF?? Some of us hopelessly naive waifs on could-cukoo land aren’t paranoid and lookng for the boogy man behind every tree either. The chances of this woman getting their medical records are pretty darn slim. There are too many check steps.

      • avatar Briana Baran says:

        R Scott: Have you not read the comments from people who have actually worked in hospitals and medical establishments explaining actual instances of such occurrences…or do you simply think that they’re lying for their own amusement? And then there are the stories regularly appearing in the news that concern breach of confidentiality of medical records…not to mention the thousands of other suggestions, contracts, rules, confidences and laws people ignore with impunity every day. And the prisons full of people who have been convicted of such actions. And the thousands of people who have had their lives, supposedly thoroughly protected by all of those “check steps” turned absolutely yo hell by identity thieves.

        It is naivety to be so certain that it can’t possibly happen. All it takes is a bit of intelligence, curiosity, an ability to observe and learn…and a lack of ethics or fear of consequences. No, I am emphatically not paranoid or looking for the boogey man behind every bush (I’ve even been letting my son walk to school…by himself (gasp!) since the elementary school). Pedophiles aren’t lurking behind every tree, kidnappers in every white van, I doubt that the black helicopters are hovering or that my husband is cheating with every woman at work. Or that the school is accessing my records by copying my driver’s license into their system for security reasons, or that the credit/debit card machine at Target is automatically opening my FBI dossier to the check-out person.

        But I am a very clever person with a nimble, curious, ever-questing mind, I learn quickly through observation and experimentation…and at my last job I learned to bypass all of the security systems in our computer programs…not in order to do harm…but so that I could *fix* our constantly crashing computers (we only had one on site IT professional). I do not have any computer degrees, nor am I a programmer. I am smart, and I am honest. If I were not, I could have done an enormous amount of damage, or helped myself to some interesting benefits. I didn’t.

        If I can do it, others can as well, including those with more nefarious motives. And they do. My husband works in IT…and he knows just how useless so much alleged excellent, fool proof, multi-checkpoint security actually is. He’s been doing this for two decades and is entirely up-to-date…and says that a person such as myself, but one with a *devious* mind, whom appears to be essentially harmless, is the most difficult to guard against. Go back and re-read my comment…it’s rather frightening just how simple crime can be. As I said, I don’t personally fret…but I am aware.

      • avatar R Scott says:

        I too have worked in hospitals and now manage an IT team that designs records software and online security systems. But, hey believe what you want. Carry on.

      • avatar Sadie BB says:

        R Scott – I too have worked in IT as a contract worker for 20+ years on both functional/design side and technical side. In every single technical role I had access to the complete database with the exception of VIP (famous) clients. These are not small shoestring companies either.
        Yes, I passed a reasonably stringent background check but nobody checked my head for ‘crazy’.
        Then of course there is always ‘social engineering’. ‘Oh, I see you’re logged in. Can I just quick check on this one thing while you go for coffee?’

      • avatar R Scott says:

        And the world could end tomorrow but it probably won’t.

        Like I said, carry on.

      • avatar Sadie BB says:

        R Scott – and even knowing what I know I don’t worry about my personal info being accessible.
        UNLESS I know that someone hostile to me works in the IT dept. Never happened to me, but it appears to have happened to LW1.

      • avatar Sadie BB says:

        Has the world already forgotten the subcontractor in India who didn’t get paid so she posted all the patients medical records online?

      • avatar stateoflove_N_Trust says:

        It does not matter whether humans break rules or not.  What matters if this person is going to break the rules and what can be done about it.  Further, it matters what action the LW takes to stop her if she believes that SIL is doing something she shouldn’t.  In this case the LW has offered nothing to indicate that her records are in jeopardy.  Her fears do not justify bad conduct on her part, which calling the hospital to heap upon them all the years of an employee’s bad behavior would be.  Jerks have jobs too and many times those jerks can perform their job duties in a professional manner.  She might even open herself up to a lawsuit by doing that and ruining her relationship with her brother if his wife gets fired after leaving long-term employment for a new job.

  13. avatar Lila says:

    For LW2, yes, very smart to hash that out now. It seems that your choice will come down to either a husband who is likely to pass on 20 years before you (assuming a ripe old age for both), or the possibility of a child. And only the possibility!

    She is already in her late 30s. Yes, women that age have kids, but fertility drops swiftly past the mid-30s. For childbearing planning purposes, she can’t afford to give the marriage a whirl only to divorce a few years later… well into her 40s or beyond.

    And Margo – adoption is neither fast nor easy these days, and an older, single woman is NOT a prime candidate. They are competing with young infertile couples for a limited supply of infants. International adoptions are difficult as well, each country for different reasons. And all adoption (or fertility treatments) are really expensive.

    This woman needs to decide which is more important to her – this man or possible motherhood – and she needs to decide quickly.

  14. avatar Lila says:

    For LW1, maybe the middle ground, for now, is to get a meeting with the relevant hospital administrator and just ask the question: “How do you PHYSICALLY safeguard patients’ records and keep them from being viewed by anyone with no direct involvement in their cases?” I would explain, without naming names, that you have a personal concern due to a hostile relationship with someone who now works here. Does one password get you into any electronic record? Is there then an electronic record of every user who has accessed the record? Are paper records centrally stored, and how does one get to see them? Do they have to be signed for? Etc. You want concrete reassurance that your records are safe from casual browsing by ANYONE, much less a person hostile to you, and the administrator should be made to understand that your concern is very real. And like Briana says, all the rules in the world will not keep bad people from doing bad things. You want PHYSICAL safeguards.

    Write down the name of the person you spoke with, the date/time/location, and the content of the conversation, and keep that. It might come in handy later.

    Assuming that an accountability trail is created by anyone accessing the records, it would seem that you will have recourse under HIPAA, IF the Bad Seed snoops and then lets on that she knows something.

    • avatar stateoflove_N_Trust says:

      This is a nice middle ground position.  I would add that the LW should not give the name of the person even if asked and probably should try to avoid identifying herself. 

  15. avatar flyonthewall says:

    LW#1 A few people to whom I am very close work for a large regional hospital. This information I am posting comes from them. ALL employees of this hospital are well versed in how the privacy laws work, btw not just those directly in patient care. The way that the privacy laws work, anyone who tries to compromise medical records can not only be fired, but face large fines. The hospital also faces large fines as well and is thus encouraged to be proactive in the prevention of any unauthorized information being leaked. Any employee who is remotely thought of as someone prone to gossip or divulge any medical information without authorization faces restriction from such information. The names of all patients are considered private information as well as the medical records themselves so employees cannot say that “so and so is a patient here” unless he or she has specific authorization to do so.

    With all of that said, I don’t know what the hospital is like that your sil works for, but if she opens her mouth and talks about any patients or their medical history in an inappropriate setting that violates privacy laws, she and the hospital WILL get into major trouble. As you are a patient with medical records in said hospital, you can talk to them as a concerned patient and let them know that you are worried about a potential breech in privacy laws concerning your relative who is their employee. That will put the hospital on notice. Let the hospital know that if your records or the records of other patients are compromised that you will gladly report the hospital to the proper authorities. and legal action will be taken.

    • avatar stateoflove_N_Trust says:

      Putting the hospital on notice only jeopardizes the job of the sister-in-law who while she may be a jerk, she also may be completely professional in the discharge of her duties. She does have a long history of employment with the same company.  The LW has very little basis for speculating as she does.  Her speculation is based on the fact that this woman is a PITA.  I am sure the brother will be very happy if his wife loses her job after leaving a long-time employer because of such idle speculation. She may be in an at-will state which means they can terminate her for almost any reason.   If she really believes that SIL might do something, then she should contact an attorney to find out what her legal exposure may be on this.  Defamation or other similar torts could be committed by LW without seeking advice.

      • avatar flyonthewall says:

        @stateoflove_N_Trust: I did not say anything about identifying the relative by name to the hospital. I just said that lw should let the hospital know that she will be watching and ready to report if any slip ups occur concerning private information. If the sil does her job as she should and obeys privacy laws, there shouldn’t be a problem.

  16. avatar Bea says:

    LW1 – Most hospitals have electronic records which should have an audit trail.
    That means whenever a record is accessed an electronic signature of the person reviewing the data is recorded.
    It’s also possible medical record access is limited on a need to know basis for example a radiology tech may not have access to any records beyond what is needed in his/her scope of practice.

  17. avatar BeanCounter says:

    LW#1:  Every time you go to your doctor’s office, ask him/her to do a quick check to make sure this crazy lunatic has not looked at your records.  it’s that easy.   Tell your DOCTOR your concerns, telling him/her about past emotional trauma with this person, and make sure they are kept in line.  I see my doctor every 6 months.   I don’t think that’s an unreasonable request.  All you’re telling your doctor or his/her assistant is to check and make sure you’re okay.

    discussing the confidentiality of your records with your own doctor is not going beyond what is reasonable.

  18. avatar francophile1962 says:

    Re: LW#1: A prior poster (sorry, I don’t recall which one) postulated that she already knows pretty much everything about her relatives’ medical conditions, except exact cholesterol, etc. Um, NO, s/he knows what s/he has been *allowed* to know! What if someone has gone in discretely because they had a cancer scare and didn’t want to worry family members, or an abortion and didn’t want it to be public knowledge (or STD treatment, anyone)? After all, you “don’t know what you don’t know”…

  19. avatar Abby Normal says:

    LW2: Just because someone works at a hospital does not mean that they will have access to patients’ medical records.  I work in the Finance dept. at a hospital for 20+ years, and I have not (nor will I need it) given access to a patients’ medical records (electronic or paper).  The security is very, very tight on this sort of thing.  In my college days, I did work in a medical records department of a hospital… and yes, I did see some things, but generally I didn’t have the time to be viewing charts.. and if I was reading charts, my coworkers would be wondering what I was doing.

    I do have access to financial records and patient financial accounts, and there is some minimal medical data in the files (diagnosis, I think, and charges/tests done during the hospital stay/visit).  However, the hospital I work at (and others as well) has additional security in place that flags a computer users account for going into family or personal records.  The administration and my bosses then will be questioning me why I was in the record with proof to show that I actually needed to be in the questioned records…. 

  20. avatar Annie H says:

    LW #1, Even with HIPPA people will snoop, this I know for a fact (posted a comment regarding my co-worker and his wife in reply to david).  I would talk to the hospital about how they protect your records and see how you feel after talking to them.  If you are still concerned, you could ask about extra security for your records and see what is available.  OR you could document what she does and if she starts having too much knowledge then go to the person in your family it affects and then go to the hospital with documentation. Not knowing what your family member’s job is makes it hard to say what she could access.  I totally understand this persons concern. 

  21. avatar Paula says:

    Has anyone thought about the possibility that, if this sister-in-law gets wind of anyone in the family contacting the hospital, she might try to SUE them for attempting to sabotage her job??? Tread carefully!!!

    I’d say contact the hospital and state generally that you have a nosy family member who works there and want to be sure that all records are kept strictly PRIVATE!!!! Don’t mention “family member” by name or accuse her of anything (especially when nothing has happened – yet); just check on the hospital’s privacy policies and stress that all records for your family should be kept strictly confidential!

    • avatar Katharine Gray says:

      Yes, I raised that point in my comment.  Its called Wrongful Interference with Employment Relations and is actionable under certain circumstances.  That is one reason why employers are very careful not to take action on unsolicited information from people who call and give damaging  information about employees.     I also  suggested she contact the hospital to find out what kind of procedures they have in place to protect confidentiality and that knowing those may ease her fears.  Seeing some of the comments from those who actually work in the medical profession who talk about the safeguards may ease LW#1′s mind as well.  I am not very high tech minded but it appears that with HIPAA most medical facilities have state of the art security procedures in place…thanks to the computer age and the ability to trace those who try to breach computer security.

      I am also curious…is it possible for someone to contact a medical facility and say  *send me all my medical records and don’t keep any copies of it in your paper or electronic files?*.  If LW#1 and her family can do this…and then use another hospital in the future…that would solve the whole problem.  I don’t know but I’m smelling a skunk here and it is not the SIL..looks like the LW and her family are looking for reasons to sabotage SIL.  Of course we never know the whole truth from these letters.   

  22. avatar susan says:

    LW#1, Margo is absolutely correct, HIPAA is in place.  I have worked at 3 famous hospitals, including one in Los Angeles that is frequented by celebrities. I’m still in the medical field.  First of all not everyone is granted permission to access medical records, second, the hospital computer system tracks everything we do, especially the access of private health information.  If you access a medical record you have no business being in you can and will be fired on the spot.  I was working in the celebrity hospital when it happend, the employee was fired and escorted out of the hospital by security.

  23. avatar impska says:

    LW1: What’s so hard about calling up the hospital and saying “It’s come to my attention that someone I know works at the hospital and I’m concerned about my privacy. What measures can I take to protect my medical records from being accessed frivolously?”

    • avatar B.eadle says:

      Obviously that is the simplest best answer and one that was put forth earlier, but was virtually ignored because nothing rains on this advice parade faster than a logical, reasonable and simple resolution.

  24. avatar Caramia says:

    I worked in medical records in a 58 bed hospital here in the remote reaches in the middle of nowhere and even they had a way of determining when any employee was checking on things they had no reason. This to the point our boss came over to a co-worker and told her if she continued checking her own file for test results, her privilege for doing so would be taken away. I question if that was possible being that she worked in Medical Records and it was vital for completion of her job to access records, but more a warning that they had the capability to check up on who looks where. Knowing the PTB had that capacity made me paranoid enough not to snoop anywhere I didn’t have reason to.