When pharmacists discuss confidentiality, they are usually referring to patient confidentiality. Ever since the 1996 Health Information Portability and Accountability Act, we have changed how we do business from prescription processing to protection of electronic health information. However, pharmacists deal with many other confidential processes. Are we as vigilant about maintaining confidentiality in these areas?
Professional confidentiality involves the expressed requirement that a person’s information not be divulged in the transaction of professional duties. This can involve an employment application, a resident or student interview, a manuscript in progress, or a nomination for a professional award. Professional confidentiality must be held to our highest standards because reputations are at stake.
Have you heard or been part of a breakdown in professional confidentiality? It starts innocently enough when a colleague says, “Do not tell anyone else, but did you know…” You are about to have a “red flag” conversation about something that may be confidential. What are your options?
Scenario One
You are a pharmacist in a company that is interviewing candidates for an open transitions-of-care pharmacist position. The search has been ongoing, and even though you are not on the search committee, you are concerned about getting a qualified individual hired. It is natural to inquire about progress with a Human Resources employee, but other than general progress statements, consider it off limits to speak about individual applicants until a hiring decision is official.
If we want to maintain a pool of worthy professional candidates, we need to honor professional confidentiality to allow them to explore potential positions without risking awkward situations with their current employer. Candidates may or may not work out because of salary, benefits, contract, reporting structure, or intangibles, but an undesired outcome does not need to prevent the person from continuing in his/her current position. If search process information is divulged unnecessarily, the selected individual may experience difficulty or resentment just as he/she is embarking on a new opportunity.
Scenario Two
We know how important recognition is for honoring achievement and motivating some individuals. Many state and national associations provide distinctive awards decided in large part by awards committee recommendations. Professional confidentiality is essential in this scenario.
Awards committees may have numerous nominations or just a select few. Nominees are often high achievers recognizable in the profession. If you serve on an awards committee, you will read candidates’ CVs, review multiple letters, and hold discussions, all of which will contain personal and professional facts that must be protected. Extra challenges come from learning the state or association of origin, alma mater, or other affiliations of nominees because we all have loyalties in our professional networks. The “Don’t tell anyone, but…” line of discussion is problematic in this scenario as well. All aspects of the selection process should be considered professionally confidential, not just during the selection, but always. No one is served when a nominee hears from a committee member what a specific individual said during deliberations. Comments made in helping to clarify qualifications against criteria can seem negative or hurtful if repeated out of context and may affect future opportunities.
Problems with professional confidentiality can arise in any situation in which criteria (eg, job qualifications, awards specifications) are weighed against subjective factors (eg, leadership, presentation skills, impact) by multiple people, either individually or together in a committee. We learn interesting things about candidates or nominees and may also encounter their shortcomings. Both should be protected by professional confidentiality.
Strategies for Maintaining Professional Confidentiality
What are solutions for maintaining professional confidentiality? Some use signed confidentiality conflict-of-interest statements, but ultimately we need to exercise self-vigilance. Is this information which I am about to share necessary? If not, stop. If you are not part of the official process, then perhaps you should consider a reference letter to share information about a person.
What are my true intentions for sharing this information? People can get caught up in spreading news before it is official, or in “being in the know.” If you are on the receiving end of such information, you have the option to ask, “Has this been officially announced yet?” Do not become part of the gossip or rumors.
Am I honoring my professional commitment to maintain confidentiality by divulging information? Could someone be hurt? Could I provide the same information if everyone (eg, committee members, applicants) heard me say it? Professional confidentiality cannot be regained once breached and therefore must be properly protected and honored. Those in charge of selections need to be explicitly clear about expectations, timelines, and processes. Those who serve need to ask questions if in doubt about individual responsibilities. Applicants and nominees also share responsibility to respect professional confidentiality. Your reputation and my reputation depend on it.