Francis Farmer, a famous movie star, was hospitalized for insanity at Western State Hospital in Washington in May 1945. It was not her first hospitalization for mental disorder. During her time there male orderlies regularly violated her while she was restrained in bed and sold passes to non-staff members to do the same. This was clearly a violation of hospital policy and such behavior was, in part, what the orderlies were there to protect against.

I make note of this not to horrify you, though it is horrifying, but to point to the fact that the very idea of privacy in medical record keeping is a relatively new one and is an ideal which has never been neared, let alone achieved. The idea has reached critical mass at a time when it is now unlikely to ever be realized. We live in a digital world where brilliant people spend their time trying to break the codes and systems that protect your privacy down for personal gain. People steal things that have value. It has been so since the dawn of time and it will be so as long as there are men and women living on the planet. If there is gain to be had in accessing your records someone will find a way to access them.

Ms. Suleman is a famous person, by choice, and her medical records are therefore a commodity. The people who accessed them didn't need more "training". They were likely paid by outside sources to do it. That is why they were fired and we all know it. No amount of training will stop that. In fact, the more the employees know about the system the easier it is to break into should they choose.

A friend of mine, a surgical nurse who worked for several high end plastic surgeons in Southern California told me that a co-worker of hers had disclosed (in a drunken episode during a conference they attended together) that her retirement plan was to spend her last year snapping secret photos with a spy cam during the surgeries of some of the famous people she was exposed to in the operating room. She would save them and after she quit, privately and discreetly "shop" them to several star mags. She would make more for the sale of those photos than she earned in her entire nursing career she said. Of course, in the morning she assured my friend that she would never do such a thing. We'll see. As long as humans provide medical care our privacy will NEVER be assured. The only thing we can do to protect ourselves from invasion of privacy is to punish those who would use the information they retrieve against us. Even then, I am not clear how it will ever be truly secure.

The benefits of technology must be weighed against the dangers, no differently than anything else. If the benefits are more efficient, safer, cheaper and more accessible health care and the dangers are that our privacy is not assured (which it currently is not) then clearly the benefits outweigh the risks.

We must continue to try to secure medical privacy for patients, but we must not allow that assurance to keep us from using the tools that will allow us to best serve patients in caring for their health.