"Fantastic therapist versus confidentiality and technology"

In healthcare, I believe there is a reasonable expectation that anything you say to one healthcare provider can be shared with any healthcare professional involved in your care. But they still get you to sign a form consenting to the sharing of information, anyway. Now I don't subscribe to that convention, I repudiate it completely. I've had some pretty unkind things said about me behind my back so all my healthcare professionals' communication with each other requires my express permission. So if my GP wants to write a referral to another healthcare professional, she discusses what she will say with me, gets me to look over what she's written, I might say "I don't like x" and she will change x, then she sends the referral through. My psychiatrist always tells me if he is going to write a letter to my GP, and sends me a copy, and restricts himself to medication management only, does not include any other personal information whatsoever.

Now I told the psychologist I was seeing that I wanted to see what she was going to write to my GP before she sent it. She showed me what looked like a blank generic form letter that had absolutely no personal information on it whatsoever - it literally could have been written about any client. I gave her permission to send that to my GP. I thought - Great! That's exactly what I want.

Then a year later she writes another letter to my GP - this time behind my back, she didn't show it to me first - and that letter has a whole heap of personal information in it. So to my face she effectively says  - I'm not going to share any personal information with your GP - but behind my back she blabs about a heap of personal information to my GP. And when I called her on it, she seemed completely oblivious to the fact that she had done something wrong. She didn't seem to be able to get it into her head that I had only consented to her sharing the information which was in the letter I sighted (which was literally zero personal information) - and that in sending a letter full of personal information, she had breached my privacy. That she'd effectively lied to me by showing me one thing to my face then going behind my back and doing another thing. 

Because nowadays when you send a letter to a patient's GP it is not confidential to that GP, it's on an electronic file, and anyone in the practice can access it; specifically any random GP that sees me, for whatever random reason, will look up my file, and might be click-happy and just click on a few things - and they could easily click on a letter from a psychologist. Bang goes my privacy. I do not consent to random GP's having access to that kind of personal information, but because she sent it to my GP, it is there for anybody to access.

I feel she also has a blind spot around technology - in my opinion she spent two sessions pressuring me to record our sessions, and I felt very embattled, very heavily pressured. She was the epitome of what I hate about technology - it is great when it's an optional extra, and patients can choose to use it, but the problem is that practically speaking what actually happens is that patients get compelled to use it, that the choice not to use technology is taken away from them. I certainly felt like there could have been a sub-text of, she wouldn't continue to see me if I didn't co-operate and record sessions - and that's exactly why I loathe technology, because the choice of people not to use technology is taken away from them.

That aside, she's fantastic. If you're happy for your healthcare providers to communicate whatever they like to each other, and you like using technology, and are happy to record sessions, she's wonderful. Really empathic, caring, supportive. Just with some rather glaring blind spots around confidentiality and technology.