title: Patient confidentiality within the context of group medical visits: is there cause for concern?
abstract: BACKGROUND
  Group medical visits (GMVs), clinical encounters with a medical component delivered to groups of patients, have emerged as an innovative approach to potentially increasing efficiency while enhancing the quality of primary health care (PHC). GMVs have created the need to pay explicit attention to patient confidentiality.
  
  
  OBJECTIVE
  What strategies are used by providers and patients to address issues of confidentiality within GMVs?
  
  
  METHODS
  In-depth interviews were conducted with 34 PHC providers and 29 patients living in nine rural communities in British Columbia, Canada. Data were analysed using interpretive thematic analysis and a relational autonomy approach.
  
  
  RESULTS
  We found three main themes: (i) choosing to disclose: balancing benefits and drawbacks of GMVs, (ii) maintaining confidentiality in GMVs and (iii) gaining strength from interdependent relationships: patients learning from each other. Confidentiality can be addressed and was not a major concern for patients attending or providers facilitating GMVs in these rural communities.
  
  
  CONCLUSIONS
  Patients adopted strategies to address their own and others' concerns related to confidential health information. Providers used multiple strategies to maintain confidentiality within the group, including renegotiating what information is shared and providing examples of what information ought to be kept confidential.
  
  
  CONCLUSIONS
  Although GMVs are not for all patients, a relational autonomy approach is useful in drawing attention to the context and structures which may influence their patients' ability to act autonomously. Successful delivery of GMVs requires both patients and providers to negotiate between maintaining confidentiality and an appropriate level of disclosure.
authors: University of British Columbia School of Nursing and Centre for Health Services and Policy Research, Prince George, BC, Canada.
authors: Sabrina T
authors: ST
authors: Wong
authors: Health Science Programs, University of Northern British Columbia, Prince George, BC, Canada.
authors: Josee G
authors: JG
authors: Lavoie
authors: University of British Columbia School of Nursing, Prince George, BC, Canada.
authors: Annette J
authors: AJ
authors: Browne
authors: University of Northern British Columbia School of Nursing, Prince George, BC, Canada.
authors: Martha L P
authors: ML
authors: MacLeod
authors: Health Science Programs, University of Northern British Columbia, Prince George, BC, Canada.
authors: Meck
authors: M
authors: Chongo
mesh_terms: D000368:Aged; D001955:British Columbia; D003219:Confidentiality / Q000592:standards*; D003695:Delivery of Health Care / Q000458:organization & administration*; D005260:Female; D006126:Group Processes; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000458:organization & administration; D011320:Primary Health Care / Q000379:methods; D011364:Professional Practice; D036301:Qualitative Research; D012424:Rural Population
keywords: health-care provider; primary care; qualitative; relational autonomy; rural