Writing a case study of a psychiatric patient may change the patient-physician dynamic even if the patient consents to be written about. And when the patient is a minor and consent must involve her parents, the process becomes even more complicated.
Instead of trying to reduce the number of people who have access to a patient's medical record by quarantining information, hospitals should explain the current meaning of confidentiality to patients as part of the informed consent process.
As courts continue to define the balance between a First Amendment right of free speech, the public's right to know, and protection of the private, physicians must take care to protect patient privacy in any publishing endeavor.