We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editorial |

Threats to the Confidentiality of Medical Records—No Place to Hide

Paul S. Appelbaum, MD
JAMA. 2000;283(6):795-797. doi:10.1001/jama.283.6.795.
Text Size: A A A
Published online


If privacy is not an extinct phenomenon, it certainly is an endangered one. Entrepreneurs—often using questionable tactics—offer access to private data about persons famous and obscure.1 More insidiously, "electronic busybodies" gather endless information about us all, as we check out at supermarkets, make purchases with credit cards, and browse Web sites where every click of a mouse reveals something about our peculiarities and preferences.2,3 There is, increasingly, no place to hide. Although the contraction of privacy in other spheres may be cause for concern, in medicine the problem is particularly difficult. Demands for access to medical information are put forward in the name of cost savings, quality improvement, public health, advances in research, and other laudable goals.4 Managed care companies insist on reviewing medical charts to determine if care should be authorized; accrediting bodies want to ascertain that clinicians' notes are detailed and complete; government agencies seek identifiable information for planning purposes and to prevent fraud5; and law enforcement agencies see in medical records a means to identify and convict wrongdoers. Most of the time, access to these records is sought without patients' knowledge or (in more than a formalistic way) consent.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

12 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles