Managed care and the paradox of patient confidentiality: A case study analysis from a communication boundary management perspective

Managed care organizations have become one of the dominant forms of health care delivery in the United States. Paradoxically, this system, designed to provide better, less expensive care for patients and increased efficiency for health care providers may be compromising patients’ privacy by making patients’ records available to a wider range of internal and external parties. By allowing many individuals access to patients’ health records, the confidentiality of patients’ private information in the managed care environment is at risk. Using an extension of the communication boundary management perspective (Petronio, 1991, 2000) within a case study approach, a breach of patient confidentiality in a managed care environment is examined. From this analysis, practical recommendations are offered to patients, health care providers, and managed care organizations for managing the paradox of patient confidentiality.