An anxious Mrs Jones calls the GP to obtain the results of her 16-year-old daughter's blood test. For reasons of confidentiality, the GP declines to offer any information about his patient. Disgusted by the GP's refusal, Mrs Jones asks her other teenage daughter to phone the surgery and impersonate her sister. She successfully extracts the information. Can anything be done to prevent such violations of confidentiality?
Patients commonly use the telephone to obtain test results and other medical information from their GPs.1–3 This allows patients and their families to be informed quickly and without leaving their home. However, the practical advantages of telephone calls are offset by risks to patient confidentiality.4 As the boxed case demonstrates, non-authorised persons can take advantage of the medium to access confidential information. Unlike face-to-face conversations, callers cannot identify each other visually and have difficulty identifying the true acoustic properties of their interlocutor's voice.5 Yet, a recent study on telephone consultations in general practice revealed that GPs regularly identify callers by simply asking for their name or recognising their voice.3 It is not known how often doctors unintentionally violate confidentiality by relying on these flawed methods. The recent NHS Confidentiality Code of Practice, which states that staff should ‘check that any callers, by telephone or in person, are who they say they are’ is laudable in principle but lacking in practical advice.6 So how can GPs and medical receptionists realistically check that callers are who they say they are?
In light of the importance of respecting patient confidentiality among doctors, patients, and bioethicists, it may be desirable to consider ways to eliminate or, at least, reduce such violations. The General Medical Council's (GMC's) guidelines specify that doctors ‘must make sure that it [patients' personal information] is effectively protected against improper disclosure at all times’.7 Without a promise of confidentiality, patients may be more reluctant to disclose information to their doctor, with adverse effects on their medical care and on public trust in the medical profession.8