Psychiatrist Among Powerful Voices in Health Care

What does Texas psychiatrist Deborah Peel, M.D., have in common with Gov. Arnold Schwarzenegger and Sen. Hillary Clinton? For one thing, all three were voted among the most influential voices in the nation's health care system.

The readers of Modern Healthcare magazine voted the practicing psychiatrist of 30 years and founder of the foundation Patient Privacy Rights fourth among the 100 “Most Powerful People in Health Care” in August. The sixth annual list was based on 12,600 reader-submitted nominations and final balloting for the 300 most-nominated people. Nearly 265,000 votes were cast.

Peel was listed behind Sister Carol Keehan, president of the Catholic Health Association; former Massachusetts Gov. Mitt Romney; and California Gov. Arnold Schwarzenegger. The magazine's readers said they thought she was more powerful than health heavyweights such as Sen. Edward Kennedy, House Speaker Nancy Pelosi, and Bill Gates.

Peel became known through her work with the nonprofit foundation she launched in 2003 in Austin, Texas, after realizing the implications of the privacy rule issued as part of the Health Insurance Portability and Accountability Act (HIPAA).

The rule “legally authorized more than 4 million entities to use and disclose our personal health information without our consent and over our objections,” she said in an interview with Psychiatric News.

Those users of health record information can include financial institutions or employers, who could use what they read in the records to reject loan applicants or job seekers, for example.

“Information technology companies' business models are based on selling the patient data entered with their software, because [those data are] so valuable,” Peel said.

In a world where more patient health records were becoming easily transferrable to many patients, Peel saw dire consequences for parties. And as a psychiatrist, the immediate and significant harm to her patients from even the fear of disclosure was obvious.

“Even the threat of exposure has a really negative impact on our ability to treat mental illness,” Peel said.

Her efforts to ensure the privacy of patient records has included educating the media about the daily sale of millions of individual health records, testifying before Congress on the need for federal protections, and working with health information technology businesses to change their practices.

“This is a tremendous honor for one of our colleagues,” said Carolyn Robinowitz, M.D., APA president. “Dr. Peel's tireless work as a patient advocate is something to be admired.”

Part of that work included her leadership in forming the bipartisan Coalition for Patient Privacy in 2006, which includes more than 40 organizations from across the political spectrum, including the Family Research Council, California Medical Association, and American Civil Liberties Union. The coalition was organized to present a united front to lawmakers to convince them of the need for individuals to control all access to their health records and the consequences of having those records easily accessible to third parties.

The coalition has urged Congress to pass legislation that would ensure that the right to health privacy is guaranteed and protected in federal statute beyond the HIPAA law, which allows businesses to sell such data. Peel has also spoken out against legislation, such as the Wired for Health Care Quality Act (S 1814), because she and other privacy advocates maintain that it would undermine patient control of the health records it purports to protect because, in part, it would not recognize a patient's right to health information privacy in routine situations.

She has urged health information technology companies to support the use of technology such as consent management systems and health record banking or trusts that allows consumers to have control of their personal health information.

Peel also has held a range of leadership positions within APA, including membership in the APA Assembly Allied Organization Liaison Committee and the APA Assembly Committee on Planning. She was president of the Texas Society of Psychiatric Physicians, the state's APA district branch, from 2000 to 2001.

More information on the Patient Privacy Rights foundation is posted at<www.patientprivacyrights.org/site/PageServer>.▪