Maintaining patient trust: why the little things matter

It's a typical Friday night in a busy emergency department. A patient is wheeled in on an ambulance stretcher, and during triage, the doctor discusses the patient's past medical history, including sensitive details, in a raised voice. Several neighbouring patients, along with paramedics attending other cases, overhear the exchange. It's a small moment, but one that could have serious consequences.

The trust deficit: when privacy breaches drive patients away

While privacy legislation provides necessary protection to manage patient health information, the real challenge lies in translating policy into consistent, everyday practice. In both public and private healthcare settings, breaches often arise not from malice, but from momentary lapses, systemic pressures or a lack of awareness.

When patients experience or witness privacy breaches, trust erodes in tangible ways that directly compromise healthcare delivery:

• Patients withhold critical information. Fear of disclosure leads patients to omit vital details from their medical histories. They may not mention substance use, sexual health concerns, domestic violence, or psychiatric symptoms – precisely the information clinicians need to provide safe, effective care.
• Patients avoid seeking care. A person who learns their HIV status was accidentally disclosed may delay future testing or treatment, putting their health at serious risk. Someone who discovers their mental health records were accessed without authorisation may refuse to engage with psychological services altogether, even when in crisis.
• Communities lose faith in the system. When word spreads through communities – particularly in rural areas or close-knit populations – that medical confidentiality has been compromised, entire groups may become reluctant to access services.

Common privacy breaches: the everyday moments that matter

While cyberattacks often make headlines, the most frequent privacy breaches are far more routine: discussing a patient's health information in a full waiting room, sending an email containing sensitive details to the wrong recipient, or using a laptop in public where patient data might be overseen. Along with unauthorised access to, or disclosure of, personal information, these all count as ‘data breaches'.

These breaches, though often unintended, can have serious consequences. The accidental disclosure of a patient's fertility treatment or pregnancy loss can cause profound distress, and may prevent them from seeking reproductive healthcare in the future. A conversation overheard in a corridor might mean a patient faces discrimination in their workplace or community.

Perhaps most troubling is the silent toll: the patients who simply disappear from care. They miss appointments, fail to collect prescriptions, or present late with advanced disease because they no longer trust that their information will be protected.

Practical tips to protect privacy and preserve trust 

Privacy is more than a legal obligation; it's a core clinical responsibility that directly influences patient outcomes. Best practice means:

• Familiarising yourself with policies to ensure you are not in breach. Hospitals and local health districts have their own policies and procedures about data management and access.
• Never accessing medical records without legitimate reason. You should only access patient records where there is a genuine clinical need or with specific authorisation. Accessing records out of personal interest, curiosity, or for self-education is likely to breach legal, employment, and professional obligations.
• Documenting every access to medical records of patients not in your direct care, noting the specific reason such as patient follow-up or approved research.
• Being mindful of your surroundings. Lower your voice when discussing patient information. Close doors during consultations. Angle computer screens away from public view.
• Securing all communications. Double-check recipient details before sending emails. Use encrypted platforms for sensitive discussions.

When patients trust that their privacy will be protected, they engage more fully in their care. They speak honestly and seek help when they need it. This trust is the invisible infrastructure on which effective healthcare depends. 

^{A version of this article originally appeared in the BLMA newsletter Synapse, Issue 17 (2025).
This version was published in Avant member magazine Connect, December 2025.}