Notice of Privacy Practices
This notice describes how medical information (Protected Health Information or “PHI”) about you may be used and disclosed and how you can get access to this information. Please review it carefully.
Our Uses and Disclosures
We typically use or share your health information in the following ways:
Treat You. We can use your health information and share it with other professionals who are treating you. Example: During the course of your treatment, the physician determines that he/she will need to consult with your primary care physician. The physician will share information with that physician and obtain the physician’s input.
Health Information Exchange. We, along with other Oregon health care providers, participate in CareAccord, Oregon’s Health Information Exchange (HIE), administered by the Oregon Health Authority, that allows patient information to be shared electronically through a secured network that is accessible to the providers treating you. We may disclose your PHI to CareAccord unless you opt-out of participating in the HIE.
Run Our Organization (our health care operations). We can use and share your health information to run our practice, improve your care, and contact you when necessary. Example: We use health information about you to manage your treatment and services.
Bill for Your Services. We can use and share your health information to bill and get payment from health plans or other entities. Example: We give information about you to your health insurer so it will pay for your services.
How else can we use or share your health information?
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html
Help With Public Health and Safety Issues
We can share health information about you for certain situations such as
- Preventing disease
- Helping with product recalls
- Reporting adverse reactions to medications
- Reporting suspected abuse, neglect, or domestic violence
- Preventing or reducing a serious threat to anyone’s health or safety
We can use or share your information for health research.
Comply With The Law
We will share information about you if state or federal laws require it, for example, with the U.S. Dept of Health and Human Services if it wants to see that we’re complying with federal privacy law.
Respond to Organ and Tissue Donation Requests
We can share health information about you with organ procurement organizations.
Work With a Medical Examiner or Funeral Director
We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
Address Workers’ Compensation, Law Enforcement, and Other Government Requests
We can use or share health information about you, in accordance with applicable law:
- For workers’ compensation claims
- For law enforcement purposes or with a law enforcement official
- With health oversight agencies for activities authorized by law
- For special government functions such as military, national security, and presidential protective services
We may disclose your Protected Health Information to your employer in accordance with applicable law if We are retained to conduct an evaluation relating to medical surveillance of your workplace or to evaluate whether you have a work-related illness or injury. You will be notified of these disclosures by your employer or as required by applicable law.
Respond to Lawsuits and Legal Actions
We can share health information about you in response to a court or administrative order, or in response to a subpoena.
We are required by law to maintain the privacy and security of your protected health information.
- We will notify you promptly if a breach occurs that may have compromised the privacy or security of your information.
- We must follow the duties and privacy practices described in this notice and give you a copy.
- We will not use or share your information other than as described here unless you authorize us in writing. You can revoke your authorization at any time, for future uses and disclosures of your information. Let us know in writing if you want to revoke an authorization.
When it comes to your health information, you have certain rights. The health and billing records we maintain are the physical property of our office but the information in those records belongs to you unless limited by applicable law. This section explains your rights and some of our responsibilities to help you.
Get An Electronic or Paper Copy of Your Medical Record
- You can ask to inspect or get an electronic or paper copy of your medical record. Ask us how to do this (including through our patient portal).
- We will provide a copy of your medical record within 30 days of your request. We will charge a reasonable, cost-based fee as allowed by law, which you will be advised of in advance.
Ask Us to Amend Your Medical Record
- You can ask us to amend health information about you that you think is incorrect or incomplete.
- We may say “no” to your request, but we’ll tell you why in writing within 60 days.
Request Confidential Communications
- You can ask us to contact you in a specific way (for example, home rather than office phone) or to send mail to a different address.
- We will say “yes” to all reasonable requests.
Ask Us to Limit What We Use or Share
- You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
- If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information (for the purpose of payment or our operations) with your health insurer. We will say “yes” unless a law requires us to share that information.
Get a List of Those With Whom We’ve Shared Information
You can ask for a list (accounting) of the times we’ve shared your health information for 6 years prior to the date you ask, who we shared it with, and why, except for certain disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
Get a Copy of This Privacy Notice
You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
Choose Someone to Act for You
If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to
- Share information with your family, close friends, or others involved in your care
- Share information in a disaster relief situation
If you are not able to tell us your preference, for example, if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases we never share your information unless you give us written permission:
- Marketing purposes
- Sale of your information
- Alcohol or substance abuse treatment information
- Confidential HIV-related information
- Genetic information
- Mental Health/Psychotherapy notes
We may contact you for fundraising efforts, but you can tell us not to contact you again.
File a Complaint if You Feel Your Rights are Violated
- You can complain if you feel we have violated your rights by contacting our Privacy Officer at 4103 Mercantile Drive, Lake Oswego, Oregon 97035, or at (503) 850-9950. You can file a complaint with the U.S. Dept of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
- We will not retaliate against you for filing a complaint.
For more information see www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
Changes to the Terms of this Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website.
Notice Revised and Effective: July 1, 2020
Anyone who has had shoulder joint trauma, a broken bone, dislocation (when the humeral head pops out of its socket), or other serious injury or surgery is at risk for developing shoulder osteoarthritis many years after the initial trauma. Trauma to the shoulder joint eventually leads to shoulder osteoarthritis.
Other persons who are risk are those whose jobs or recreational activities have required a lot of time lifting objects overhead, throwing, or doing high-impact activities such as chopping wood or using an air hammer. These repetitive motions over time cause wear and tear of the shoulder joint, causing the cartilage to thin and become less flexible.
Other risk factors include:
- Congenital defect or illness
- Family history
- Gender (glenohumeral arthritis is more common in women)
- Advanced age
Common symptoms of shoulder arthritis include:
- Mild to moderate stiffness
- Pain with movement
- Limited range of motion
- Episodes of inflammation (swelling)
- Grinding sound with movement
Your orthopedic surgeon will perform a comprehensive clinical examination to determine whether or not you have shoulder arthritis. This may include other tests such as X-rays or an MRI.
Medical History. Your doctor will ask you questions about your medical and family history and about any medications you may be taking. This information will help guide further treatment options.
Patient Interview. Your doctor will ask you about your work and lifestyle activities, and whether or not you have had any previous shoulder injuries. You will also be asked to describe your pain–the pattern, any limitations to range of motion–all vital information to rule out other potential sources of pain such as shoulder bursitis, shoulder impingement, rotator cuff tears or other common shoulder problems.
X-Rays. Digital imaging is ordered to arrive at clinical diagnosis–verifying whether or not there are significant signs of shoulder osteoarthritis.
MRI. Your doctor may order an MRI (magnetic resonance imaging) for you if x-rays of the shoulder are inconclusive or if it is suspected that your pain is due to damage to the shoulder’s labrum or rotator cuff. An MRI provides more detailed images of the soft tissue (ligaments, tendons, and muscles) and bone.
Lab Tests. Lab tests may be ordered to rule out other causes of shoulder pain, such as infection or gout.
Physical Exam. Your doctor will examine your shoulder for signs of a previous injury, tenderness, pain points, range of motion, and muscle weakness. Other joints may be examined as well to determine if you have any other joint problems that may indicate an inflammatory condition such as rheumatoid arthritis or gout.
There are both nonsurgical and surgical treatment options available for the treatment of shoulder arthritis. Conservative treatment may provide pain relief and reduce episodes of inflammation. In combination with beneficial lifestyle changes, your doctor can provide you with a treatment plan that can significantly improve the range of movement in the shoulder. Effective treatment and physical therapy can help manage your inflammation and slow down the progression of the disease.
Nonsurgical Treatment Options
Nonsurgical treatment options may provide pain relief and reduce episodes of inflammation. Such options may include:
Activity Modification. Modifying your daily activities and exercise will help to avoid pain, especially activities that involve intense shoulder activity like weight lifting or chopping wood.
Periodic Rest. When patients experience extreme bone-on-bone pain, they need to rest the joint and should not ignore it. Your body is telling you to take it easy, so listen.
Warm or Cold Compress. Warm or cold compresses applied to the joint can decrease swelling and provide some immediate pain relief.
Physical Therapy. Stretching and muscle strengthening exercises help to maintain the shoulder’s range of motion; however, they should not be too aggressive and patients should proceed slowly for the most benefit.
Injections. Steroid injections can help to alleviate severe pain from shoulder arthritis.
Surgical Treatment Options
Surgical treatment options to relieve symptoms of osteoarthritis, such as the following, may be necessary if patients don’t respond to conservative treatment:
Shoulder Arthroscopy. This is a minimally invasive procedure that is done to remove loose pieces of damaged cartilage.
Shoulder Osteotomy. This procedure is done to shave off osteophytes (bone spurs) and reduce friction between bones.
Shoulder Arthroplasty. This is a total joint replacement done to replace the ball and socket glenohumeral joint with an artificial one made of metal and plastic.
Hemiarthroplasty. This is a partial joint replacement where one half of the shoulder joint, the humeral head, is replaced with a prosthesis and the glenoid (socket) is left intact.