Your Right to Privacy: A Basic Guide to Legal Rights in an Information Society

By Evan Hendricks; Trudy Hayden et al. | Go to book overview

XII
Medical and Insurance Records

Is there a basis for doctor-patient confidentiality?

Yes. It has its roots in the oath for physicians put forth by Hippocrates more than two thousand years ago. The Hippocratic oath states "All that may come to my knowledge in the exercise of my profession or outside of my profession or in daily commerce with man which ought not to be spread abroad, I will keep secret and never reveal." Traditionally, people who had access to health care were treated by their own physicians, many of whom adhered to the Hippocratic oath and, as sole custodians of their patients' medical information, protected its confidentiality. But the health care system has undergone a dramatic transformation. Doctors still treat patients, but an entire bureaucracy has arisen to facilitate financing and payment of health care. Many people have health insurance through their employers. Others are covered directly by insurers. Still others receive health benefits from federal, state, or local governments. All of these third party payers (employers, insurers, and governments) and providers (doctors, hospitals, HMOs, clinics, etc.) need access to medical information in order to administer health coverage and verify payments.

More than forty states have statutes that protect the confidentiality of communications between physician (or psychiatrist) and patient-the doctor-patient privilege. But these statutes merely prevent the doctor from being forced to testify about the patient's communications or reveal the patient's records in a court of law without the patient's consent. They have no application to the enormous number of situations in which a physician is permitted or compelled, by law, regulation, or long-established practice, to reveal information about the patient to outside parties. Even under doctor-patient privilege laws, doctors may be required to testify about a patient or reveal a patient's records. In a criminal case, medical testimony may be introduced by the prosecution or the defense. In a civil case -- such as a negligence or malpractice suit, a divorce or custody suit, or a commitment proceeding -- the

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