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Understanding Doctor/Patient Confidentiality Law

Instructor: Zona Taylor

Zona has taught Nursing and has a master's degree in Nursing Education and Maternal-Infant Nursing from University of Maryland Baltimore.

Keeping private information between a doctor and patient is not a simple issue. This lesson provides definitions and introduces current laws. It also gives examples of when private medical information may be revealed.

What Would You Do?

Think about the last time you went to the doctor. Whether you were there for a sore throat, a sprained ankle, or your annual checkup, odds are you had to answer a bunch of questions. There are questions about your background, about your habits, and about why you are there in the first place. Some of these questions seem like they could be embarrassing. For example, if you're there with a sprained ankle and the doctor asks you how you hurt it, you might hesitate. Do you really want to tell the doctor that you fell into a chair while having a silly dance-off with your friends? Or do you just opt for the more generic (and less embarrassing) answer: that you just tripped over something and twisted it. The doctor doesn't need to know the embarrassing details, right? You might want to think again.

What Is Doctor-Patient Confidentiality?

First some definitions:

  • Privacy is keeping private info to yourself.
  • Confidentiality is not revealing what another person has told you in private.
  • Doctor-patient confidentiality is the belief that what you (a patient) tell your doctor will stay private.

Why Does It Matter?

Well, quite simply, because doctors can only help if they know what's going on. And if patients believe that the doctor will keep information private, they are more likely to reveal all the details surrounding their illness or injury. So if you trust your doctor not to share your embarrassing dance party accident with his golf buddies, you will probably tell him the whole story, including how you hit your head on the coffee table. When the doctor receives all the information, the doctor is more likely to make an accurate diagnosis and prescribe the appropriate treatment--and this is true in simple cases (like the sprained ankle) and more complex cases. If you think there's a chance you will become the office joke, you are more likely to you're your doctor the generic version of what happened, and your choice to withhold information may impact the doctor's ability to make an accurate diagnosis and a successful treatment plan.

Federal Law

Legislators at the state and federal level felt that confidentiality was such a big deal that they helped to pass a federal law called the Health Information Portability and Accountability Act of 1996, or HIPAA. One part of the HIPAA law talks about patient privacy as it relates to access to medical records. Another part addresses with whom the doctor is allowed to discuss a patient's medical information.

HIPAA allows access to a patient's medical record for a few very specific reasons, including payment by insurance companies. In all other situations, the patient must agree to any release of medical information before it is released -- except as required by law.

Is Confidentiality Guaranteed?

Confidentiality isn't always black and white; sometimes doctors find themselves in tricky situations involving patient confidentiality. Is it better to keep the patient's information private? Or is it better to notify key people who need to know for public health reasons? Or to protect a human life? There are certain times when doctors may need to violate patient privacy...for the sake of the patient.

Children

Most young children are not able to make their own medical decisions, and even when they are old enough to talk, they may not be able to articulate their own concerns or issues. But if they do share something that seems private, most doctors/nurses will share that information with parents. For example, a 12-year-old boy may tell the school nurse that he is being picked on in the locker room, but he hasn't shared that information with his parents. After discussing the details with the boy, the nurse could call the boy's parents and request a meeting to discuss what happened and the information that was shared. The parents decide to meet with the principal and they work together to address the child's concerns.

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