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Views & Reviews No Holds Barred

Margaret McCartney: Do patients know that their records aren’t private?

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g6763 (Published 17 November 2014) Cite this as: BMJ 2014;349:g6763
  1. Margaret McCartney, general practitioner, Glasgow
  1. margaret{at}margaretmccartney.com

Confidentiality is core. We teach students not to gossip. Notes are password protected. Doctors are struck off if they reveal private facts about patients in public. And patients need this safety so that they can talk without fear: without an expectation of confidentiality doctors would know even less about patients’ problems.

But privacy is eroding. Doctors have long been expected to breach confidences in specific circumstances—for example, in the United Kingdom, if patients disclose conditions that mean they should not drive. In such cases the doctor must tell the government, but only after making “every reasonable effort to persuade them to stop [driving],” and, the General Medical Council says, after the patient has been told in person and in writing.1

On its website the Care Quality …

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