Virtual Mentor. August 2000, Volume 2, Number 8.

Cases in Law and Ethics

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Being the "Company Doctor"

An ethical case explores whether a workplace physician breached patient confidentiality by divulging an employee's medical information to the employer.

To guide students through the process of ethical reasoning and to acquaint them with case law, a new case study will appear every 2 to 4 weeks. Students will be given legal and/or ethical opinions to assist their decision-making.

August Case Scenario

For the past 2 years, Mr. Bradford has been working for XYZ Inc. Over the past few months, he feels that he has been denied several promotions and that his superiors do not appreciate his contributions. Consequently, he has been experiencing some work-related stress that has resulted in severe headaches. He sees Dr. X, a family physician retained by his employer. Dr. X believes that Mr. Bradford is suffering from anxiety and depression, and refers him to a psychiatrist. Dr. X divulges this information to Mr. Bradford's employer who places it in his employment file. Mr. Bradford eventually learns about this and complains to his supervisor. His supervisor maintains that the company has a valid interest in knowing this information. Moreover, the supervisor claims that no patient-physician relationship was ever formed, so the doctor had no obligation to maintain confidentiality. Mr. Bradford is incensed about this situation: "Don't doctors swear to some oath that requires them to keep the confidences of their patients?"

1. Did Dr. X violate the Hippocratic Oath and breach the confidences of Mr. Bradford?

2. In the context of a workplace exam, does Dr. X have any obligations to the employer?

For more information relevant to this case, see AMA Code of Medical Ethics, Opinion 5.09; "Confidentiality: Industry-Employed Physicians and Independent Medical Examiners."