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When patients unburden themselves to me in my consulting room, they do so in the knowledge that what they say is confidential. They tell me many things they wouldn’t want others to know: issues that may be psychological or social—past traumas, current relationship struggles, alcohol use—or physical problems such as erectile dysfunction, incontinence, or recurrent infections. I add this information to their notes (enough to jog my memory, at least) because I need to pick up on it when we consult again. But that doesn’t mean that the patient wants everyone they consult with, in all medical settings, to have access to what they just told me.