“Dad, Jason said that you saw him in the office today.”

“Gee, Nick, it was very busy. I don’t remember anything about his visit.”

My response to my son was a lie, but I have always been willing to feign ignorance to protect my patients’ privacy. When our kids were home and within earshot I never mentioned that I had seen one of their friends or schoolmates in the office. In fact, I pretty much never talked about my professional life when they were around. They knew my work took a big chunk of my time and, in the remaining few hours, we had other things to talk about. Unfortunately, all three of my children may have mistaken my silence as an indicator that I didn’t like my job, which was far from the truth.

After hearing enough evasive answers, they realized that I had no intention of sharing anything about their peers’ medical history, regardless of how trivial the incident may have been. Even before HIPAA, I knew that my children shouldn’t be trusted to keep even the most innocent-sounding tidbit within the boundaries of our home. After all they were just children.

I suspect that most of you are equally cautious about sharing patient information with your children, even your adult children. But what about your spouse? Let’s be honest here: How HIPAA-compliant is your home? Does pillow talk sometimes drift over the line and compromise doctor-patient confidentiality? I suspect that we all share stories about interesting cases with our spouses hoping that we haven’t revealed enough information for them to figure out who were are talking about.

Of course, “interesting” is a relative term. If your spouse’s postgraduate degree is in computer science and not in medicine, he or she may not find your story about “the highest creatinine I have ever seen” very titillating. But, the story that begins, “You won’t believe what this mother was feeding her 6-month-old” might get his or her attention.

Although you may have known it wasn’t professional, I suspect that there may have been a few times when you have thrown caution to the wind and made no attempt to disguise the identity of the patient even though it was someone with whom your spouse was familiar. It may not have happened to you, but I can’t believe it never happens. Marriages are, or at least should be, very intimate and trusting relationships.

I think that many, maybe most, of the patients and parents in your practice assume that you have shared their stories with your spouse. My wife has often encountered a patient in the grocery store who launches into a story about their child’s illness and is surprised that Marilyn had no idea that the child had even been sick.

I also think that those people who believe the doctors share patient information with their spouses also believe that one of the marriage vows includes a clause in which spouses of physicians swear to keep those shared stories within the confines of the marriage.

Mind you, I’m not advocating that physicians should feel free to share any and all patient information with their spouses. In fact, I think as a rule, it shouldn’t happen, if for no other reason than it puts pressure on a spouse, who may fear that he or she might spread the tidbit inadvertently. But I think we have to be honest, human nature being what it is. Intramarital information sharing happens. Do you agree?


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