To be fair, much patient care happens without knowing what the patient actually does or did for a living. Sometimes it comes up organically, sometimes doctors, nurses, caregivers ask, and sometimes it never comes up.

If the patient is what we would call a “poor historian” which is a typical thing that is found with dementia care patients (do you know where you are right now? And they really don’t, so deep dives don’t occur past the how oriented to present reality is this patient, beyond those generic determination questions, when they fail.)

So let’s say she has no family. Shows up in hospital, doctors determine dementia, she’s stable and it’s time to go, physical and occupational therapy in conjunction with the MD determine a lack of safety to going home alone so it’s now decided for this patient to go to a care home, and she goes to a care home. Who then, inside the care home, says: oh, maybe I should call the Texas legislature about this random patient of whom I know nothing personal, never mind HIPAA.

How would they know? How could they talk if they did, given HIPAA?

Or there is a relative making decisions by phone who never thinks, oh, maybe I should call her boss and tell them. They just miss that part in the midst of everything else.