Ever notice that after something is brought to your attention it tends to manifest itself prominently in your life when you had not noticed it before? That is exactly what happened to me last week at the doctors' office when I noticed that in less than 40 minutes, there were three breaches in personal confidentiality.

The reason that I picked up on this, when I would not have thought twice about it before, is due to a class that I am taking this semester about health and communication. Confidentiality in the setting of health care is a major subject area that we have focused on throughout the course. This privilege that should be enjoyed by everyone is sometimes broken without us knowing about it. Even health care practitioners don't realize that they are violating it. What happened in the course of events last week were quite simple and probably not even thought of as inappropriate. But if they had been pointed out, I believe they would have been realized as definite breaches of the confidentiality that could easily have been avoided.

When I walked into the office next to the waiting room to get my vitals taken, the door to the hall was left open. This door remained open the entire time I relayed my personal information and reasons I was there to the nurse. Anyone walking by in the hall might have been able to overhear what was being said and I remember at the time that I was uncomfortable with this. But I didn't shut the door, nor did I ask the nurse to.

During this time, a phone call arrived and was taken by the nurse as I waited. Though the call lasted only a few minutes, I was present while she discussed the callers' chart, condition, and course of treatment. This too, made me uncomfortable and I had the nagging feeling that I should leave the room while she discussed this sensitive information with the anonymous caller. Yet I didn't. Nor did she ask me to, or offer to call the person back.

The final instance occurred when I was about to be examined by my doctor. A phone call came in, but this time it was not a patient, but the surgeon of the doctor I was seeing. I was told that it was a very important and anticipated call. While waiting on the examining table, I tried to make my mind wander so as not to be invasive during my doctor's discussion of personal medical information with the surgeon. Though I wanted to step out of the room, it was not really feasible in this situation, nor could my doctor put off the phone call of a busy surgeon.

After discussing these events with my class, my professor asked me if I had said anything to my health care practitioners or had done anything about it. I told her that I had not but I had wanted to.

Recalling what was going on, I believe that I didn't say anything because I didn't want to be rude or embarrass the other party. But personal information should be kept confidential to the best of health practitioners' abilities and be done so consciously.

My speaking up about my concerns most likely would have been taken well by my caretakers and could have even increased their awareness of the ease in which confidentiality can be broken. They may even have been grateful for the reminder of the importance of each patient's personal information.

But since I did not bring things to their attention, they may continue to break confidentiality without thinking twice about it. By not letting them know that I was uncomfortable with what was going on, they might continue on with what they are doing, and nothing will ever change.

When you stop and think about past doctor visits, you may begin to remember that often you have overheard doctors or nurses discussing someone's personal matters. Many individuals would not appreciate that the general public is overhearing their charts, especially if they are discussing something embarrassing or serious.

Doctor-patient confidentiality is an integral part of an important relationship. Many of us believe that this is insured, but we must be wary of that mentality. Something as serious and personal as this cannot be taken for granted. Patients need to keep up their end of the relationship and realize that it is our responsibility to make sure that confidentiality is enforced.