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February 12, 1997

Psychiatric Care and Patient Confidentiality

Author Affiliations

New York Psychoanalytic Institute New York, NY

JAMA. 1997;277(6):460. doi:10.1001/jama.1997.03540300028025

To the Editor.  —In Resident Forum,1 Dr Szigethy writes cogently about the problems with the professional identity of psychiatry in the era of managed care. I would like to briefly elaborate on one of her points, the compromise of patient confidentiality when third-party reviewers are involved. The leaders in psychiatry should take the lead in reexamining the casual manner in which patients are asked to waive their rights to privacy and confidentiality. When psychiatric treatment is involved, managed care companies are either uninterested in or unaware of the impact on patients when they are obliged to waive their or their family member's privacy and confidentiality in order to receive psychiatric services, however limited these services may be.More important, the large problem of the loss of privacy and confidentiality in mental health treatment is just the tip of the iceberg. Physicians routinely send medical information, such as operative reports