This is a guest post by Megan Stoddard, an active BACE member:
It’s another day on Timebank, and the sidebar is humming with activity (note – it’s down now, but hopefully will be up soon). Tina earned one hour from Rob for “changing the oil in my car.” Mary, whose profile shows that she is a CPA, earned one hour from Jane for tax advice. And Joe, whose profile indicates that he is a psychotherapist, and who offers psychotherapy and no other service on Timebank, earned one hour from Andrea for psychotherapy. A look at Joe’s profile, or at Andrea’s, shows that she has credited him an hour for psychotherapy every week for the last two months.
Because Andrea has paid her therapist in Timebank credit rather than dollars, the fact that she has been receiving therapy is now public information. It will appear in the sidebar until other transactions push it off, and it will appear in her profile, and in Joe’s, as long as the site exists. On Timebank, there is no way to hide a transaction. There is no way to make a transaction confidential. Users cannot remove past transactions from their profiles. That information is available to all Timebank users, now and forever.
Yet under almost all circumstances, confidentiality laws prevent Joe from telling anyone at all that he’s seen Andrea as a client unless she gives consent, explicitly and in writing. Even the circumstances in which Joe could divulge that information to someone else would not allow him to make that information public. And under normal circumstances, Andrea would not have to make that information public in order to pay Joe.
If she wrote him a check, the bank(s) that processed the check would have to keep all transactions confidential. If her therapy were paid for by health insurance, the health insurance company would also be bound by strict confidentiality laws. No one could publicly reveal that Andrea is a therapy client except Andrea herself, and no person or institution could legally force her to make that information public.
The confidentiality laws exist for good reason: making it publicly known that you are or have been a therapy client could hurt you. In Andrea’s case, a current or potential employer or business client of hers could find out through Timebank that she’s received therapy and assume that she’s mentally unstable. Or suppose she’s involved in a child custody dispute, and her ex learns through Timebank that she’s in therapy and decides to use that against her. Or it could even be that an acquaintance finds out, and while they don’t necessarily think any less of Andrea for it, she’s uncomfortable with having them know.
When it comes to preserving Andrea’s privacy, the law is on her side; traditional institutions are on her side; and the monetary economy would be on her side. But Timebank is not–at least, not as it’s currently set up.
Arguably, Timebank isn’t on Joe’s side either. At first glance, the system would seem to benefit him: he gets to promote his therapy practice and acquire new clients. If people see in the sidebar or on Joe’s profile that Joe has been receiving credits for therapy, and they themselves are seeking therapy, and perhaps unable to pay for it in dollars, they are likely to turn to Joe. However, potential clients may also be frightened away by the impossibility of keeping the transaction confidential.
The fact that Joe is providing psychotherapy does not need to be a secret. Neither does the fact that he’s seeing clients through Timebank. If those two facts are known to the Timebank community, the community benefits. But who the clients are does need to be a secret.
If Timebank provided the option of making individual transactions confidential, sensitive services such as psychotherapy–and other services that normally require the identities of clients to be kept confidential–could be given and received without compromising confidentiality. Timebank is, in fact, in the process of doing just that. The programming team is currently working on changes to the site’s coding, which will include an option to anonymize individual transactions. These changes are expected to be implemented before the end of 2013.
In the meantime, there are a few ways to work around the current setup when giving credit for a confidential service. In the following examples, we use therapy as the confidential service, but it could also be legal services or any other service that requires client confidentiality
– The therapy client could set up a separate Timebank account, with a pseudonym, to use only for crediting therapy services.
Pro: The client’s privacy would be preserved, and the therapist would still have his/her therapy practice made known to the Timebank community.
Con: If the pseudonymous account were used only for therapy transactions, the client could not earn any credits under that account. If the therapy client did any work to accrue credits under the pseudonym, his/her identity would become known to anyone he/she interacted with in the course of performing services.
– Instead of saying the credit is for therapy, the client could type something like, “Thanks for the help” when posting the credit. As a variation, the client could credit the provider for a different service entirely–gardening or computer help, for instance.
Pros: The transaction remains visible without telling the public that this person is receiving therapy, and it allows the client to keep participating in Timebank under the same account.
Cons: If the therapist is offering therapy services, as Joe is, others could put two and two together and determine that the “help” given was psychotherapy, so the client’s privacy is not really being preserved. And this solution does not give the community the benefit of knowing that psychotherapy services are being given and received.
– Instead of crediting the therapist directly, the client could credit Timebank, and Timebank could credit the therapist.
Pros: The therapist’s profile, and the sidebar, will show that he/she was credited for psychotherapy without revealing who the client was, and the client’s profile will not show that he/she credited someone for psychotherapy. Meanwhile, the client can participate fully in Timebank under the same account.
Cons: It would be impossible for the client to credit Timebank without giving a reason for the transaction, which would appear in his/her profile and the sidebar. While the client would have the option of giving a nonspecific reason–and then emailing the Timebank team to tell them to credit so-and-so for such-and-such service–the very fact that this person is crediting Timebank and not specifying the reason could make others wonder what this person has to hide. Also, doing it this way would require the client to tell the Timebank team that they’re a therapy client. While the team will keep this information confidential, it would mean about half a dozen extra people would know.
None of these solutions are perfect. The Timebank team asks the community to bear with us as we work on solving this problem. And to help keep confidential services confidential, we offer the following suggestions:
– If you have already credited someone openly for a service that you would rather keep confidential, Timebank administrators can remove the credit at your request. This will send the credit back to you. You can then re-credit the service provider in a way that conceals the nature of the service you received, or ask the Timebank team to credit him/her for you, as described above. If you would like any of your past transactions removed, please email@example.com.
– If you have provided a confidential service through Timebank, we ask that you make a reasonable effort to contact all of your Timebank clients and make sure that they know about this issue, the possible solutions, and that it is being discussed on the site. The Timebank team has attempted to contact providers of confidential services in advance of this article being published, but we were not able to reach everyone.
– In the same vein, if you have received a confidential service through Timebank and have not heard about this from your provider, please make the effort to contact your provider, to ensure that he/she knows and can inform other clients.
– Finally, we suggest that if you are providing a confidential service, you also include other services in your profile that would not raise confidentiality issues–i.e. gardening, childcare, web design, etc. You do not necessarily have to provide those services, but having them in your profile would give your clients an out when crediting you, until anonymous transactions become possible.
Timebank users deserve no less from the alternative economy than from the monetary economy. If traditional institutions, the law, and the monetary economy all serve to preserve privacy when services of a sensitive nature are given and received, Timebank cannot afford not to do the same.
Disclaimer: The characters in this article are fictional. While they may have something in common with actual Timebank users, any resemblance to real persons, living or dead, is purely coincidental.