Health and genetic information is regarded as the most private of information. People desire to keep their medical and health care records private for many reasons, including personal privacy, avoiding stigmas associated with certain diseases or conditions, and preventing job and economic discrimination.

In the medical field, the confidentiality of medical information is protected, at the most basic level, by the ethical and professional rules of the American Medical Association (AMA). Specifically, the American Medical Association (AMA) issued the following professional rule in the “Current Opinions of the Judicial Council of the American Medical Association Canon 5.05”

“The information disclosed to a physician during the course of the relationship between physician and patient is confidential to the greatest possible degree…The physician should not reveal confidential communications or information without the express consent of the patient, unless required to do so by law.”

The modern health care system is complex and personal medical data is disclosed as a matter of operating procedure. Medical data is disclosed to doctors, nurses, and other professional staff. In addition, patient-level medical and care data is widely circulated among insurers, hospitals, employers, government agencies, health care information brokers, pharmacy benefit managers, and the American Medical Association.

Considering the American Medical Association Canon rule 5.05, should the American Medical Association (AMA) disclose that it is selling doctor and patient data via the AMA Physician Masterfile Database? Importantly, most doctors aren’t even aware their medical care data, along with patient-level information, is being sold by the American Medical Association (AMA):

The results of a Kaiser Family Foundation research study showed that only 60% of physicians were aware that the American Medical Association is selling their information through the AMA Physician Masterfile Database, but 74% of physicians were opposed to the practice once they were so informed.

Even worse, doctors were less informed about their ability to opt-out of having their practice-level data sold, according to an American Medical Association survey in January 2007, only about 10% to 15% of physicians were aware of the AMA’s Physician Data Restriction Program (PDRP); a second survey in late May showed that physician awareness had increased to 33%.

According to Dr. Robert Musacchio, PhD, the AMA’s Senior Vice President of Publishing and Business Services, “Our goal is to have 60% of the physicians aware of the program at the end of 2007 and shoot for 100% by the end of 2008, which is probably an unrealistic goal…We’re doing everything possible to make physicians aware of this, and so far there has been a higher level of awareness than I thought there would be, but a much lower response in terms of people actually opting out.” In 2002, sales of licenses to the American Medical Association’s (AMA) Physician Masterfile generated $20 million in revenue for the organization. By 2007, sales of the AMA Physician Masterfile had reached $40 million per year.

At the very least, does the American Medical Association (AMA) have an obligation to inform DOCTORS that information about the medical care they provide and the medical care received by their patients is being sold to corporations, health information brokers, insurance companies, and other entities? Must the American Medical Association (AMA) disclose the end users of their AMA Physician Masterfile Database (e.g., not the licensees, but the ultimate data purchasers)? The American Medical Student Association, as well as most Americans, think the American Medical Association does need to disclose, disclose, disclose! Immediately and completely. Doctors practice-level data, as well as patient-care information and personally identifiable medical information should not be a “revenue stream” for the American Medical Association.

MORE ABOUT THE AMA PHYSICIAN MASTERFILE DATABASE

For the past 60 years, the American Medical Association has made the AMA Physician Masterfile available for sale to corporations and other medical entities. Currently, purchasers of the AMA Physician Masterfile database include pharmaceutical companies, consultants, market research firms, insurance companies, hospitals, medical schools, medical equipment and supply companies, health data brokers, and commercial organizations.

AS A PATIENT, information about your medical care is included in the American Medical Association’s collection of physicians’ practice-level data. All doctors are automatically enrolled to have their practice-level information recorded, UNLESS the doctor affirmatively acts to opt-out. It is NOT the choice of the patient, but the choice of the doctor as to whether the patient’s information will be sold.

MORE ABOUT THE AMA’S PHYSICIAN DATA RESTRICTION PROGRAM (PDRP):

The American Medical Association does not grant any doctor or patient the opportunity to prevent information about their medical care from being collected in the Physician Masterfile Database. However, the AMA has been willing to give doctors the choice to opt-out of mailing solicitations and sales calls from pharmaceutical representatives. Specifically, the American Medical Association has two options for doctors wishing to “opt-out” of the sale of their patients’ medical information: (1) the Do Not Contact (DNC) restriction and (2) the Do Not Release (DNR) restriction.

(1) DO NOT CONTACT—To add a “Do Not Contact” (DNC) restriction to a Physician Masterfile record, a physician must complete the No Contact Form and submit it to the AMA. Due to the advance purchase of AMA Physician Masterfile information for mailing purposes, it may take 90 days or more for all end-users to implement a No Contact request. As a result, you may continue to receive AMA mailings for 6-8 weeks. (Forms may be completed online, by mail or fax, or by calling 1-800-621-8335.)

  • A Do Not Contact restriction means the physician will no longer receive medically related information from medical publishers, continuing medical education providers and pharmaceutical manufacturers using the AMA Physician Masterfile as a list source.

(2) DO NOT RELEASE—To add a “Do Not Release” (DNR) restriction to a Physician Masterfile record, a physician must complete and sign the DNR Authorization Letter and submit it to the AMA via mail or fax. Due to the advance purchase of AMA Physician Masterfile information for mailing purposes, it may take 90 days or more for all end-users to implement a Do Not Release request. As a result, you may continue to receive AMA mailings for 6-8 weeks.

  • A Do Not Release restriction means the physician’s profile will no longer be available to credentialing verification organizations, hospitals or managed care organizations requesting credentials unless the physician provides written permission. In addition, the physician will no longer receive medically related information from medical publishers, continuing medical education providers and pharmaceutical manufacturers using the AMA Physician Masterfile.

All consumers should be aware that the AMA does NOT offer a “Do Not Collect” option. Importantly, the “Do Not Contact” and “Do Not Release” restrictions only limit the DISSEMINATION of patients’ medical care information by the AMA, and not the actual COLLECTION of this information. Even if your doctor elects both opt-out options, the AMA Physican Masterfile database will still be recording the practice-level activities of your doctor and the care you’ve revieved.

Read more about the American Medical Association and the AMA Physician Masterfile database it sells to corporations.

Under Federal law, all consumers are entitled to an annual copy of their medical report files from the nationwide specialty consumer reporting agencies.

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