Academic journal article Journal of Singing

Medical Privacy and the Professional Singer: Injury Stigma, Disclosure, and Professional Ramifications on Broadway

Academic journal article Journal of Singing

Medical Privacy and the Professional Singer: Injury Stigma, Disclosure, and Professional Ramifications on Broadway

Article excerpt

MEDICAL PRIVACY PRACTICES

In the United States of America, medical privacy policy often reads like a bureaucratic quagmire. Impenetrable policies littered with legalese have left consumers embittered and skeptical, questioning the benefits of promised protections. However, protected health information saves lives. For those in the performing arts, it may save careers as well.

Medical privacy is the fulfillment of the expectation that personal health information (PHI) shared with healthcare providers, employers, and teachers stay private. Many regard this expectation as a basic human right.1 When trust is breached, there are consequences. People become less likely to share sensitive information and show a decreased willingness to seek care, particularly in cases of stigmatic illness and injury.2 In such cases, disclosure to family or employers without an individual's express consent can be devastating, resulting in social isolation, job loss, and higher rates of serious mental illness, including depression.3

In 1996, the federal government took action on the issue of medical privacy by passing the Health Insurance Portability and Accountability Act (HIPAA). This act created privacy protections for personal health information (PHI) disclosure by establishing ironclad protocols for medical conduct.4 All employees working in healthcare settings receive mandatory training and must successfully pass a HIPAA certification exam before commencing their duties.5 This system, while largely regarded as cumbersome,6 has effectively reduced privacy breaches within the healthcare system.7 However, healthcare professions are not unique in their collection of PHI. Many corporate employers, human resource departments, and teachers also handle and manage PHI on a regular basis.8 In the performing arts, a singer's ability to perform is intrinsically tied to his/her personal health. Unfortunately, HIPAA does not apply to health information in these settings and employers are not required to obtain any privacy certification or training.9 This gap in protections exposes those working in the performing arts, making them uniquely susceptible to breaches regarding their medical privacy.

MEDICAL PRIVACY PRACTICES ON BROADWAY

Official policy and documentation largely ignore the issue of Broadway performers' PHI. Medical privacy is not mentioned within the current production contract (Broadway) handbook published by Actors' Equity Association.10 Additionally, medical privacy is not addressed in either the standardized principal or standardized ensemble performer's individual contracts,11 and is also missing from standardized union agreements with talent agents and managers.12 Currently, a performer's PHI is handled by stage managers and company managers on a case-by-case basis. Anecdotal evidence suggests that stage managers and company managers all use their own system when handling this information, resulting in different procedures and expectations for companies and even individuals.

Documentation is further complicated by the wide disbursement of employment records within the industry, often containing performers' PHI. Show reports, which may include lists of illnesses and injuries,13 are disbursed eight times a week to all department heads, including directors, music directors/conductors, choreographers, producers, and even casting directors. In addition, theatrical management companies, which employ company managers, typically handle multiple Broadway shows simultaneously.14 Therefore, Broadway production companies have far greater access to interviewees' PHI during the "job interview" process than traditional corporations.

IMPACT OF PERFORMERS' PHI DISCLOSURE

The specific impacts of performers' PHI disclosure have never been formally explored, yet consequences resulting from performance-related injuries are often mentioned in the research literature. For example, a study by Gehling et al. stated that injuries might be "deleterious to a performer's career," but did not go into any detail about how or why. …

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