1601 N. Tucson Blvd. Suite 9
Tucson, AZ 85716-3450
Phone: (800) 635-1196

Association of American Physicians and Surgeons, Inc.
A Voice for Private Physicians Since 1943
Omnia pro aegroto

November 9, 2005
VIA FACSIMILE

Dear Representative,

The Patriot Act has resulted in harmful, unintended consequences for doctors and patients. But now you have an opportunity to correct some of the damage that has been done and avert future harm that could result in unnecessary pain and suffering for patients.

On behalf of the hundreds of thousands of patients we treat, the Association of American Physicians and Surgeons, a non-partisan professional association of physicians in all practices and specialties since 1943, strongly urges you to accept the Senate’s version of Section 215 of the Patriot Act re-authorization. While we have some concerns about the Senate version as well, the stronger law enforcement oversight is a crucial first step to protecting the sanctity of the patient-physician relationship, which in turn, is critical to quality patient care.

Simply, these provisions have already had a disturbing effect on communication between patient and physician, creating chasms in information which are creating impediments to effective treatment.

We understand the need for aggressive measures in the fight against terrorism. But the expanded law enforcement powers of the Patriot Act combined with the pre-existing law that prevents a doctor from telling a patient when his medical records are seized or examined by law enforcement, have combined into an explosive situation.

Patients are lying and withholding information, and physicians are being asked to lie for them. A gagged doctor and a fearful patient are the prescription for medical disaster. In fact, a poll of doctors conducted by AAPS shows that 87% had been asked by a patient to keep information out of a record. Further, 51% report government requests they believe to violate patient-physician confidentiality.

Our members report that patients specifically mention the Patriot Act when expressing reluctance to discuss certain conditions. This can lead to potentially dangerous and debilitating interruption in effective treatment.

For example, a patient reports he is afraid to tell his doctor that the medication he is receiving is not controlling his pain. He’s afraid that if he asks for higher doses of opioids, the Patriot Act will be invoked to target him (and his doctor) for investigation. This is not an absurd suspicion, given the high-profile investigations and prosecutions of doctors as well as patients by the DEA and Department of Justice.

We specifically support several provisions included in the Senate version of Section 215:

  1. Require a factual showing of reasonable grounds that records sought are relevant to a terrorism investigation;

  2. Prevent “fishing expeditions” feared by patients by identifying that the records requested pertain to a suspected terrorist or person in contact with a terrorist;

  3. Allow the recipient of a request to consult with an attorney;

  4. Require advance written approval in by the FBI Director or Deputy Director for access to medical records;

  5. Imposed a 4-year sunset on the Act.

We also strongly oppose any additional attempts to insert an administrative subpoena provision into the final bill. As we testified at DHHS hearings, there has already been demonstrated abuse of these “requests” in fraud investigations, resulting in less protection for medical records than those documents in a patient’s home.

The Senate version is a step in the right direction to begin to heal the damage that has been done. If you need any assistance or information, please contact Michael Ostrolenk, Director of Government Affairs at (301) 717-0599.

Sincerely,

JANE M. ORIENT, M.D.
Executive Director