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‘Three can keep a secret, if two of them are dead.’ (Benjamin Franklin) ‘Whoever wishes to keep a secret must hide the fact that he possesses one.’ (Johann Wolfgang von Goethe) ‘If you reveal your secrets to the wind you should not blame the wind for revealing them to the trees.’ (Kahlil Gibran) Our village postman used to start a rumour at the first house of his delivery and see if he could beat the rumour to the end of his round. Medical gossip had a special cachet that proved unbeatable. One day it all went wrong when a rumour created by his imagination coincided with fact: not only was this unfortunate for the victim, but the only apparent and plausible source was the GP surgery. For us, the matter was quickly cleared up by a disclosure of the real explanation, an unfortunate coincidence, but the damage was done; a patient was badly harmed and it could not be undone. Witnessing damage like that reinforces the importance of medical confidentiality. While in the past such an event could only happen in a rural community, the advent of electronic storage and transfer of huge amounts of information, and the ability to target specific recipients has resulted in a global village, with village problems and issues; this is a concept barely grasped by either the public or our profession. Since the NHS began until recently my home served as the village surgery. Consultations were conducted by my grandfather, my father, and latterly by me in the utmost confidence. Any information would only be disclosed in the interest of the patient. Information could be documented fully, partially, or exceptionally never recorded. Information remained where it belonged, physically confined in a little room. It never went anywhere else, unless there was a clear reason …
A G Baird (Sat,) studied this question.