COMMENTARY
Bloom & Buell's

DiMaggio to Doctor:  Shut Up

It must be pretty exhilarating when your patient wakes up from a six-day coma and talks to you.  It must be embarrassing when he accuses you of breaching his confidentiality.  We don't know if this is what happened, of course, but news reports have indicated that when Joe DiMaggio, a famously private man, came out of his coma, he was quite upset that his doctors had been issuing daily press-briefings about his health.

This made us think that now was a good time to review the rules about confidentiality for health-care providers.

The general rule is that a health-care provider may not give out any information about a patient without that patient's consent.  (When a patient gives consent to release records or an opinion, a provider is protected as long as he stays within the scope of the consent.)  There are several exceptions, of course.  One is the information given to a public agency which has a right to it, another is information given in the form of testimony in court or at a deposition, where the patient has had advance notice.  Another is the information about a patient given to the health care provider's professional liability carrier so the carrier may investigate a claim of alleged medical negligence.  And a provider may give information to another health care provider who is also treating that patient and to the patient's health insurer.

Naturally, a provider may--and generally must--provide a copy of a patient's records or a fair summary by way of report to that patient when requested.  The exceptions to this rule are limited:  when the patient is under guardianship or a minor, the request must come from the guardian or the parent.  Another exception is when the delivery of the records would not be in the best interest of the patient for psychological reasons.  In that case the records may be delivered to a patient's subsequent provider.

Without his consent, information about a patient may not be revealed under any other circumstances, no matter how helpful or benign that revelation may be.  If you have a question about a real or potential breach of confidentiality, consult legal counsel.