Skype and HIPAA

@octoberfull: How should the therapist have responded? Because her style is to analyze me - what I say, what I feel, and what I do. She didn't say much about her violation, except that she did transition all her patients to a HIPAA-compliant video calling site except for me. Because we were already using Skype before she made the transition. I am doubtful, though, because like I said, she had scheduled a patient right after me yesterday, and the patient called her on Skype while we were finishing up our session. lol. I did ask her if what I did was wrong. That was when she said yes.

I didn't even get on her case about using Skype - a non-HIPAA compliant communication tool. I know that she knows. But most some professionals still use Skype, anyway, because it's more convenient and they don't think anything bad is going to happen from it. It's kind of like going out for a hike even though it's raining and the lightening could strike you. lol.

I don't think looking up family or friends is morally wrong. However, you have indicated that you thought that they could be clients, so the possibility that they are just family or friends seems moot to me. But I don't know what your therapist's reasons were for changing her stance. I think invading the privacy of another client is different because they did not choose to out themselves, but the negligence of the therapist disclosed their association with her. I don't know if I agree with your definition of harm. Technically, people who view pictures of naked children for sexual gratification are not putting hands on the children. Yet they are invading the privacy of those children. What they are doing is immoral.

She wrote me a note yesterday. Part of it reads like that, "Looking up people you believe are my patients, friends or family is understandable but wrong. I appreciate you bring up the issue with Skype because we certainly should switch to Zoom."

Zoom is a HIPAA-compliant video calling platform.

ETA: She does realize that I saved her @$$, right?? Another patient might not have been so kind...

I used Zoom with a previous psychiatrist. It's fine.

I feel like the therapist didn't understand why I looked the names up as a hypervigilant thing. And this in turn makes me feel like she sees me as bad. And it only makes me want to look up the names even more. Because, since she sees me as bad and doesn't seem to understand why I did it as a hypervigilant thing, it shouldn't be a problem if I continue doing it. She did express that she understands why I do it, but she still said it's wrong. That makes me feel bad. I don't think it's wrong.

I have this image of an obese person continuing to shove food down his throat because people see him as obese and nobody cares. Since nobody cares, why not continue shoving food down his already obese body?

I look people up. It's just what I do. Professors, acquaintances, peers, bosses, coworkers. I need to cover my back. I hadn't been on Skype in two weeks and when I got on it, I saw these names. If I can see these names, then these people can see my name, too. Of course I had to do something about it. It was already too late to delete my Skype account.

And there's this satisfaction about looking people up. Not only does it make me feel safer because I get an idea of who and what I would be up against, but it helps me accept my fate and reality - specifically my fate that I'll never have the kind of normal lives that people have - to be a part of a family or have a family. The more I see it, the more it hurts, but the more it helps me to accept my fate and reality and let go of empty hope and useless trying.

So it's not like I looked up the names purely out of curiosity or to snoop or be nosey. I did it because I'm a pathetic individual.

If this makes any sense at all...

Just because a person has some sort of issue that makes it difficult for them to control themselves - whether it is invading privacy due to hypervigilance or bingeing due to an eating disorder - does not mean that person is absolved of responsibility for his or her actions. I already explained why I feel looking up your therapist's clients is different than other people.

And to be clear, I am not sitting in judgement of you for googling the names. I don't think you are "bad" for having done so. I can't even say what I would have done myself. I think the action was not very moral, but I'm also not trying to cast stones from my glass house. I do all sorts of things that are wrong, and the therapist tells me so. I added a counterperspective to your opinion that it wasn't wrong simply to explain why someone might disagree, not to demonize you or argue that you are "bad."

If you gave her the names of the people you saw on Skype, she may have included the family and friends bit because to only have said clients would have been a tacit admission that they were clients - which would have been a further HIPAA violation.

I realize she uses the transference, but I think it's a technical mistake to interpret this situation. Easier to explain using another example-if you cancelled an appointment with her because a family member died, it would be inappropriate to interpret your feelings/behavior surrounding the cancellation. But it's a matter of judgment.

Sorry, when I wrote my other response, I didn't realize you were the only client using Skye. It sounds like thing are better between you now. I personally don't agree it's wrong to google her other clients-that's on her for breaching the privacy. Whether or not you agree, I hope you are not too hard on yourself.

As I thought about you looking up those folks, I took it from the perspective that those people could now also have your info. I don't think wanting to know who might have your info is unethical or "wrong." (In full disclosure, I didn't finish my doc program in ethics, so what do I know compared to some therapist attributing "wrongness" as she should be sitting firmly in her own "wrongness." Talk about a great example of a T throwing her crap on a client.) If she knew Skype wasn't compliant, the breach sits firmly on her shoulders. She may not have known the details, but she knew it was a no-no. Using a noncompliant system previously doesn't mean it should have continued. At the least, it seems professionally irresponsible to me.

On the phone, I said to the therapist that it makes me very, very uncomfortable because I feel naked and exposed. In response, she said that it made me feel very uncomfortable, too, that I can see those names.

Hmm. Are you victimizing yourself, woman? You don't get to victimize yourself in this situation.

Did it ever occur to you that the people you looked up, who may be connected in some manner to your T, might feel the same way? That, while what you did was certainly not... illegal or something, it would definitely be respectful to not dig around after people you know might be other clients of your T and want to keep that private.

No. Because I was protecting myself and being hypervigilant. When I feel that way, I am not thinking about the other person.

Wow, that sucks.

You did the right thing and are accused of something illegal. Well, maybe not but all but.

You speak of trust. I would, too. I'd try hard to trust myself, did I indeed did no wrong. The evidence is you did no wrong. It’s only when you talked to the therapist did your trust ebb. Fight to get back to there.

Then there is the question of therapist client relationship. I would understand some level of distrust with her. I would push to resolve it or cut ties. In this situation, I could imagine holding back because of the distrust, telling something short of the whole truth. As a matter of fact, I've been guilty of holding back because of trust issues. That did me me no good.

It looks like you are in a tough spot. Hold on to the truth that you did no wrong and trust yourself.

I'm thinking about this the other way around regarding you looking up those names. If you could see those, others could see yours. YOUR privacy was not protected. You have no idea if others have looked you up or what they now know about you.

Personally, even though you like this therapist, I feel like you need to make a formal complaint regarding these actions.

Yes. I think no one can judge me whether I did something wrong or not by looking up those names. I know my intent. My intent wasn't to snoop. If my intent was to snoop, it is wrong. The therapist thinks what I did was wrong. I disagree with her. I'm confident in my intention.

I think it would be too drastic to report this. She didn't know that Skype had this feature in its latest update.

I do wonder, though, if she was focused on herself. She said, "It makes me very very uncomfortable that you can see the names on my Skype." Don't victimize yourself. What about me? My privacy was invaded and exposed, too.

I am not on social media. I work very hard at not having any digital trace. The therapist knows this. I told her that when I discovered it, I wanted to go into hiding and not show up for our therapy session. But she didn't prompt any exploration of this feeling.