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Employees at federal agencies who work remotely are being called back into the office under the Trump administration. At the Department of Veterans Affairs, some doctors and therapists are concerned that this change will compromise their patients' privacy. NPR's Katia Riddle reports.
KATIA RIDDLE, BYLINE: Conversations between doctors and patients can get quite personal. That's true at the VA as much as any medical facility.
PAIGE: There's a lot of talk about sexual health and what are people doing in their sex lives.
RIDDLE: This woman is a physician at the VA. She asked that we only use her middle name, Paige. She's afraid of losing her job for speaking out. She says there are a lot of different kinds of clinicians throughout the agency that need to regularly have these delicate conversations with patients.
PAIGE: Those are not things that any of us want to talk about with another person nearby.
RIDDLE: Many VA clinicians all over the country were hired on a telehealth basis. It's a way to expand VA health care and especially helpful for reaching rural areas. Therapists say there simply is not enough private space in VA buildings to have confidential sessions. This woman is a mental health clinician at the VA. She asked to be identified by an initial, H, for fear of being fired for speaking out.
H: What we've heard is there's not even enough room for each person to come in one day a week, let alone five days a week.
RIDDLE: H says she and her team have all been instructed to prepare to return to work in person instead of doing telehealth from home. However, in many instances, they will still be doing telehealth, just from a shared office space.
H: We've been told that they're cleaning out closets. They're looking into trying to purchase headsets.
RIDDLE: Even with the best headsets in the world, she says, there is no way to conduct productive therapy sessions from an open space. This is not just an ethical question. It's also a legal one. That's because of a federal law known as HIPAA that protects patient privacy.
H: People need to know that they have privacy and confidentiality, both from a HIPAA standpoint, but in order to do high-quality psychotherapy work, both parties need to be fully concentrated and not worried about censoring themselves.
RIDDLE: Some say this policy change is not in line with the ethos of the agency. Kayla Williams is a senior policy adviser for an organization called VoteVets.
KAYLA WILLIAMS: Unfortunately, the emphasis in this current moment does not seem to be on providing that highest quality care but figuring out ways to cut the size of the department.
RIDDLE: The VA has cut hundreds of positions and are looking to cut tens of thousands more. Williams says between the back to work order and these cuts, people there are dispirited.
WILLIAMS: I hear from someone almost every day who tells me that they and their colleagues are crying.
RIDDLE: In an email response to this story, VA spokesperson Peter Kasperowicz called the concern around HIPAA compliance, quote, "nonsensical," and said, quote "VA is no longer a place where the status quo for employees is to simply phone it in from home." He went on to say VA would make space accommodations in order to ensure veterans' access to care would remain uninterrupted and HIPAA compliant. These clinicians say they are not reassured and are concerned they will lose a lot of colleagues. Here's H again.
H: That they simply will leave the VA because that's not a workable solution.
RIDDLE: Some people are even worried they could lose their medical license for providing care in these conditions. They're drawing their own ethical red lines in their minds, balancing concern for themselves and their patients. Katia Riddle, NPR 瓜神app.
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