Industry-Employed Physicians & Independent Medical Examiners

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Physicians may obtain personal information about patients outside an ongoing patient-physician relationship. For example, physicians may assess an individual’s health or disability on behalf of an employer, insurer, or other third party. Or they may obtain information in providing care specifically for a work-related illness or injury. In all these situations, physicians have a responsibility to protect the confidentiality of patient information.

When conducting third-party assessments or treating work-related medical conditions, physicians may disclose information to a third party:

With written or documented consent of the individual (or authorized surrogate).
As required by law, including workmen’s compensation law where applicable.
When disclosing information to third parties, physicians should:
Restrict disclosure to the minimum necessary information for the intended purpose.
Ensure that individually identifying information is removed before releasing aggregate data or statistical health information about the pertinent population.

AMA Principles of Medical Ethics: IV

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Related Opinions

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Opinion 1.2.5

Sports Medicine

Physicians who serve in a medical capacity at athletic, sporting, or other physically demanding events should protect the health and safety of participants.

Opinion 1.2.6

Work-Related & Independent Medical Examinations

Industry-employed physicians or independent medical examiners establish limited patient-physician relationships. Their relationships with patients are confined to the isolated examination; they do not monitor patients’ health over time, treat them, or carry out many other duties fulfilled by physicians in the traditional fiduciary role.

Opinion 3.1.1

Privacy in Health Care

Respecting patient privacy is a fundamental expression of respect for patient autonomy and a prerequisite for trust. Patient privacy includes personal space (physical privacy), personal data (informational privacy), personal choices, including cultural and religious affiliations (decisional privacy), and personal relationships with family members and other intimates (associational privacy). Physicians must seek to protect patient privacy in all settings to the greatest extent possible.

Opinion 3.2.1

Confidentiality

Physicians have an ethical obligation to preserve the confidentiality of information gathered in association with the care of the patient. With rare exceptions, patients are entitled to decide whether and to whom their personal health information is disclosed.

Opinion 3.2.4

Access to Medical Records by Data Collection Companies

Information gathered and recorded in association with the care of a patient is confidential. Disclosing information to third parties for commercial purposes without consent undermines trust, violates principles of informed consent and confidentiality, and may harm the integrity of the patient-physician relationship.

Opinion 3.3.2

Confidentiality & Electronic Medical Records

Information gathered and recorded in association with the care of a patient is confidential, regardless of the form in which it is collected or stored.

Opinion 11.2.2

Conflicts of Interest in Patient Care

Under no circumstances may physicians place their own financial interests above the welfare of their patients. Treatment or hospitalization that is willfully excessive or inadequate constitutes unethical practice.

Opinion 11.2.4

Transparency in Health Care

Physicians have an obligation to inform patients about all appropriate treatment options, the risks and benefits of alternatives, and other information that may be pertinent, including the existence of payment models, financial incentives, formularies, guidelines, or other tools that influence treatment recommendations and care.