“Patients have a right to expect that you will not disclose any personal information which you learn during the course of your professional duties, unless they give you permission. Without assurances about confidentiality, patients may be reluctant to give doctors the information they need in order to provide good care.”—General Medical Council, Duties of a Doctor.1

I believe that when doctors reveal information to insurance companies they destroy the trust that is essential for good medical care. When I receive a request from an insurance company for information about a patient, I feel uncomfortable. I know that the patient has given written consent, but does the patient have any choice? In order to buy a home, most of us need a mortgage and life insurance is usually a requirement for this. Is the patient really in a position to refuse to apply for life insurance?

When an insurance company requests information from a doctor, these are the kinds of questions that are asked

• Do the patient's records indicate any clinically important family history?

• Has your patient ever been advised that any aspect of their …