Fred Schulte's investigation of Veterans Affairs hospitals in 1987 led to reforms that helped transform the VA from a laughingstock to a model of efficient health care. His two other Pulitzer Prize-nominated projects for the South Florida Sun-Sentinel exposed dangers in cosmetic surgery and problems with Florida's Medicaid HMOs. Access to medical records made them all possible.

"Any time someone passes some kind of law like this, certain people are going to use it to block access whether they have to or not," Schulte told the Reporters Committee for Freedom of the Press. He saw an even bigger problem reporting daily stories.

If you haven't heard an update on whoever was in that awful crash on the midday news, it's because hospitals couldn't tell the reporters. If a reporter doesn't know the crash victim's name, the hospital can't even confirm his or her existence.

Emergency departments want enough information over the radio to begin taking care of an ambulance patient immediately, but not enough to who know he is or where he lives. For Dr. Roger Pacholka, the Xenia Fire Department's medical director, a call to a bedbug-infested house required some finesse.

"We had to be careful not to broadcast where the house was," he said, "but we clearly needed to know enough so we didn't have an ER crawling with bedbugs."

Pharmacists are specifically permitted to dispense filled prescriptions to family members or other individuals on behalf of the patient — who might be sick in bed. But they can't give anyone else a list of the patient's prescriptions. They don't know if the patient's spouse isn't supposed to find out about the drugs for a venereal disease or even high blood pressure.

"I can mail it to you, addressed to him," Centerville pharmacist Ron Rust told one patient's wife, "and you can open it when it gets there. But I can't give it to you."

Nor could he let the next customer see the woman's name after she signed for her husband's drugs. Doctors offices can use sign-up sheets and announce names in the waiting room, but pharmacists must collect signatures on individual stickers.

The 'Daily News' will be holding a roundtable discussion on Monday from 6 to 8 p.m. at Sinclair Community College. If you want to be a member of our audience, please contact Features Editor Connie Post at 225-2441 or cpost@daytondailynews.com by noon Monday.

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