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Objective To understand the authority medical services have to maintain medical confidentiality regarding the results of workers’ health assessments.Material and Methods A study was conducted with a sample of 65 company medical services in Ecuador, using a Google Forms questionnaire. These services are organized and funded by companies; therefore, the doctors working there are dependent on the company. This places the health professional in an intermediate position between the interests of the employer and those of the worker. Furthermore, an interview was conducted with representatives of trade union organizations from 23 companies using another survey.Results In 43% of companies, other individuals linked to management request information from the doctor about the results of workers’ health assessments. Also, 24.6% of the services did not provide the results of the medical assessments to the workers. Meanwhile, only 45.8% of worker representatives believed that the company respected medical confidentiality, while 54.2% did not. On the other hand, only 25% of union representatives believed that the medical service ‘defends the workers.’Conclusions Surveillance of workers’ health requires a trusting doctor-worker relationship that respects medical confidentiality, provides information on evaluation results, and complies with the current legal framework. It is necessary to work to ensure that companies respect medical confidentiality and strengthen the authority of physicians. We propose conducting further studies with a more representative sample and exploring new aspects not yet addressed in this preliminary study.