It's got front-line medical professionals afraid to actually do their jobs, it's got companies and organizations afraid their employees are going to get them murdered with lawsuits (including the company I work for (an engineering contracting co) and organizations (like the one I work for, NASA) so that even employees like me that have no access to health data have to take HIPAA training, wasting millions of dollars every year. But lawyers still find ways of purposefully creating workarounds like this so the organizations who can profit by it can still find ways of disregarding the law.

But it's not just wasteful training of thousands who should be uninvolved that's a problem. I volunteer for a search & rescue organization, so I took a class "Emergency Medical Responder". Essentially this purports to be a 'first aid' course, and it's sort of the minimal prerequisite for most courses that emergency volunteers would want to take - search & rescue personnel, volunteer firefighters, professional firefighters, police, etc. The course is currently 58 hours long, when I took it several years ago it was 48, I think. I took it over several weekends.

The course notes that I took were probably 1/3 legal material. Primarily HIPAA, Good Samaritan Law, and Scope of Practice. The material taught was almost as much about these subjects as it was about actually helping people. That seems like too much, right?

And some of it was just CYA nonsense. After taking the class, my scope of practice does not permit me to give anyone a pill of any sort in a first aid situation. No ibuprofen to an injured hiker, no heart meds out of the patient's pocket. I can't pierce the skin. No insulin out of their personal meds, even if the dude's hysterical wife says that's what he needs and a blood sugar test (I'm also not allowed to administer most of those) shows they need one. No epi pen. No epi pen! Literally anyone can administer that! The 'workaround' we were instructed to perform if we come upon a patient who is unable to give but who needed their epi pen is to:

1) Take out and prepare their epi pen for injection
2) Put it in their hand and wrap their fingers around it
3) Wrap our hand around their hand
4) Jab it into their leg to administer the meds
5) Claim they had done it themselves

That stuff is beyond my scope of practice and therefore I can't do it without risking my license (which matters a lot more to the professionals than it does to me as a volunteer) I can't administer oxygen! I got into it a bit with the instructor regarding that one.

So I can do things like secure the scene, check alertness levels, maintain c spine, stop bleeding, set bones, and check blood pressure.

I mean, I could technically check blood pressure. The instructor showed us the procedure. All 45 or so people in the class were offered the chance to test it out to show that we could do it. But we weren't given 6-10 blood pressure cuffs and split into groups to try it on each other. The instructor was worried that might violate HIPAA (because he would be effectively pressuring us into revealing our BP to each other) so the only option to try out the procedure was to take his blood pressure, one at a time. Most of us (me included) declined to waste the couple hours or so it would have taken for us all to do that.

Whenever I hear someone say HIPAA, I immediately recall that I don't really know how to take someone's blood pressure because my first aid instructor thought teaching us how to do it would be a HIPAA violation. More importantly, I think about the volunteer/pro firefighters and police who maybe needed that training more than me and didn't really get it for the same reason. The stakes seem higher for them than for me, because I don't carry a blood pressure cuff in my gear so I couldn't test a patient in any case.

That said the American Heart Association's CPR course and Homeland Security's Stop the Bleed course are both great and I highly recommend then to everyone.