Confidentiality Limits when Working with Disruptive Professionals

April 14, 2011

Not long ago, the Chicago Tribune ran a controversial article about the how the Illinois Professional Health Program handles confidential information.  Their slant on the issue was that the Program was essentially harboring criminals by keeping secrets that could harm the public.  Interestingly, several years ago, the Maryland State Board of Physician Quality Assurance (BPQA) was disbanded after being criticized for being “too physician-friendly” and subsequently the Board of Physicians was established with a renewed perspective on their primary mission: to protect the public.

Clearly those working with impaired, distressed and disruptive physicians have struggled with “how confidential” information should be regarding their physician patients.  On the one hand we appreciate the need for the public to be warned of potentially dangerous docs.  But on the other hand, for our corrective and therapeutic work to have any chances of being effective, our patients (those, so-called, dangerous docs) have to have some assurance that what they discuss with us in remedial coaching, tutoring or therapy has some protection from others’ eyes and ears.  There needs to be a delicate balancing act whereby these often-competing needs are fully appreciated, discussed at the start of intervention and are repeatedly revisited by all parties involved.  When working in these types of situations, there are essentially two primary clients: the professional in my office and the referring agency (usually a licensing board, professional society, hospital, etc) who at some level represent the interests of the public.  When a treating clinician (or program) loses sight of this, problems arise.


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