They are testing for abusive behavior to identify drug abusers, re-sellers, or negligent providers (over prescribing).

I have read some people complaining that their provider will not prescribe the drug they need if THC comes up in the test. That is not universal, it probably depends on the individual provider or the health provider system.

The best part is that law enforcement can review the records at will (as long as they can articulate an official reason which is a very low bar.)

True, but a positive test wouldn't be enough to arrest someone for drug possession. I doubt it would even be enough to get a search warrant with.

It tests for dozens of drugs, including THC.

All patients prescribed a controlled substance have to take it.

Here is a link to a random lab describing it: https://etd.paml.com/etd/display.php?id=8412

I was told that I "may need to" take this test at some point. I never have and have been taking adderall for many years.

I assume the drug testing requirements may depend on the state or the provider. It benefits the provider/health system by providing evidence they are taking reasonable precautions to limit abuse.

Also, I don't know if psychiatrists in WA are held to a different reporting standard than general practitioners. When I used a solo psychiatrist, no testing or privacy waiver required. When my insurance changed, I lost that psychiatrist and went to a regular doc in a large health system (UW Physicians). They require the testing and waiver.

But the law was changing when I made the change, so it may apply to psychiatrists now, too.

The American Medical Association, et al., sold out their patients in exchange for not being held accountable for the US opioid crisis. (my opinion of course.)

My doc didn't think it was any big deal, she said I was her first patient to question it. She thought the waiver had some limitations, I showed her that it did not have any limitations except that access had to be for official use (which is not much of a limitation.) The records are stored in an electronic registry that various local or federal government agencies can access without warrants or notice.

As a lawyer I cannot imagine voluntarily entering into such an agreement against the interest of my clients. I still find it shocking.

The rationale was, prior to getting a surgery once, I was asked in pre-op to review my EMR information by the nurse. The info was completely wrong and very dated. I asked the nurse where the info was from since I had never been to that hospital chain before. Her comment was an affiliated urgent care I went to years ago was in their medical system. But the brand name was different because they were acquired. I was pissed. What if I had been rolled in unconscious and that EMR record was meaningfully inaccurate against my wellbeing?

So now it raises eyebrows but I refuse to provide any nonlegally required info. And to OPs point the response is one of almost mocking surprise. But the counter argument is, why would I trust you to not sell my data going forward? What if I'm wheeled into a hospital unconscious and your medical records from 20 years ago somehow cause me harm? Absolutely no way.