Maryland board can't punish doctor for defending privacy of patients

Judges said the state does not have unfettered access to medical records. The medical board is considering an appeal.

By Amy Lynn Sorrel, AMNews staff. Nov. 5, 2007.

A Maryland appeals court handed a victory to a physician who stood up to the state medical board in defense of his patients' privacy rights.

Judges unanimously found that Bethesda, Md., psychiatrist Harold I. Eist, MD, did nothing wrong when he refused to immediately turn over medical records for three of his patients to the Maryland Board of Physicians because the patients objected.

The agency charged Dr. Eist with failing to cooperate with an investigation into his conduct and levied a $5,000 fine against the doctor.

Dr. Eist said he was just honoring his patients' wishes. If they knew their confidentiality could be compromised, "it would devastate the trust people have built up over the centuries in the doctor-patient relationship going back to the Hippocratic oath," said Dr. Eist, a former American Psychiatric Assn. president.

The Maryland Court of Special Appeals agreed and said the board cannot ignore patients' constitutional rights to medical privacy when investigating a third-party complaint.

Although Maryland law gives the board authority to obtain medical records without patient consent, the court said that right is not absolute. Instead, judges said it's up to the board -- not patients or their doctors -- to show good reason for overriding patient privacy to access information that, if disclosed, could harm patient care.

"When the governmental interest is not a compelling one that outweighs the individual's privacy right, the records may not be disclosed," the Sept. 13 opinion stated. If those competing interests aren't balanced, "the psychiatrist-patient relationship ... can be damaged merely by the threat that the records containing the patient's most personal thoughts will be turned over to others to examine," the court said.