The doctor-patient relationship is expected to be one of trust and privacy, and the 2003 Health Insurance Portability and Accountability Act (HIPAA) was supposed to cement that bond for good.

However, a recent study from a West Virginia University communications professor finds that health care providers dont always see HIPAA as a hard and fast ruleespecially where patientsfamilies are concerned.

Dr. Maria Brann, assistant professor of communication studies in the Eberly College of Arts and Sciences, has studied the circumstances surrounding the disclosure of private information.

Her study,The influence of illness factors on physicianslikelihood of disclosing confidential health information to relatives of patients,was published in the September edition ofCommunication Studies,a leading trade journal for communications professionals.

Confidentiality of patientsinformation is vital to beneficial interactions between patients and health care providers,Brann said.Patients expect that their information will be kept confidential, and based on this expectation, patients disclose personal and sometimes sensitive information to their health care providers.

The study found that health care providers are sharing confidential health information on a daily basis, frequently with relatives of patients. More importantly, physicians consistently claimed that while HIPAA regulations are theoretically good ideasthey also admitted they would follow their own ideas for the patient, even if it meant violating such regulations.

And while HIPAA does allow for the disclosure of information to specific third parties in emergency situations, Brann found that confidentiality was breached in many non-emergency circumstances, such as the diagnosis of mild dementia or a lower IQ.

In interviewing physicians, Brann found that several illness factors, such as a patients prognosis or diagnosis, played an important role in information disclosure.

And she found that physicians sometimes disclose information because they express empathy toward the relatives; they want to encourage relatives to be advocates for the patient; they hold cultural expectations, or more commonly, theyre delivering a diagnosis thats severe.

As a health care consumer, I have always been interested in confidentiality maintenance, or lack thereof,she said.I have witnessed firsthand how easily patientsconfidential information is disclosed. Many times physicians freely give information to relatives of patients simply because they are relatives, but we know that this may actually be harmful to a patient.

Brann earned her Ph.D. from the University of Kentucky in 2003. Her research interests include ethical issues in health communication contexts, healthy lifestyles through physical activity, womens health issues, ethical gynecological care, differing aspects of body image, the aging population, gender constructions, and drug and alcohol abuse.

For more information, contact Brann at maria.brann@mail.wvu.edu or 304-293-3905.