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Dr. Monica’s Corner: Doctor-Patient Confidentiality & the Medic’s Responsibility



Monica AlabiWe all have aspects of our lives that we prefer to keep hidden. Events that have happened to us in childhood, activities (incongruent with our character) that we have participated in or things we simply do not want to share with our friends or family.
Being a doctor is almost like being a catholic priest where people find it comforting to be able to share these stories without fear of judgement and are offered forgiveness.

Some of our secrets can make us unwell and sharing them is helpful; who can you trust? Discussing the full gist can certainly aid diagnosis.

In my many years of working as a medic, I have heard too many of these secrets to mention. Some of my colleagues say I get more than my fair share of these sometimes very shocking life stories. I like to think that people feel comfortable to disclose to me and know that it will stay CONFIDENTIAL.

The most frequently occurring are stories of childhood abuse, domestic violence and sexuality/sexual exploits.
These tend to have long term effects on the physical, mental and spiritual health of most patients and we need to start talking seriously about them.

One story that strikes me is of Mr Bamijoko (Not Real Name). He walked in to the consultation room looking like the world had collapsed on his shoulders. “How can I help you today” I asked. ”I am so low Dr” He started to cry. Nothing embarrassing about seeing a 55yr old man cry particularly when you’re caught in the web he has found himself in.

The story was, Mr Bamijoko (NRN), a well-respected University lecturer has been caught by his wife for being unfaithful and he is distraught. Not just because he has been caught but also because he is still very much “in love” with the other woman and will be a repeat offender. He has told his longsuffering wife that he is no longer seeing her, however according to Dr Maury, that was a …!

You may be tempted to say, serves him right. However, his story is; he studied all his life, married quite late, Christian values, hardly sowed any wild oats.
He married a fellow lecturer, had a baby and things changed, as you would expect. He then has a series of minor emotional affairs, which he worked through with his wife.

Then comes a new female lecturer in his department, attractive, single, maternal and listens to him drone on and on about his subject.
He “falls in love” with her. After a few months, the affair is blown open and his wife is very upset. She decides to move out of their home to her parents’ and gives him an ultimatum to choose between his new flame or her.

He ruminates on this for a while, managing to spend time with the other woman on the side. After a while, he decides he misses his wife and child and went to plead with his Mrs to come back home amidst promises of never seeing his girlfriend again.

Wife is now back home and he is still completely drawn to the other woman hence his attendance on the day. He is tearful and low and exhibiting all the symptoms of depression.

Mrs Bamijoko (NRN) wants a full STI check (sexually transmitted infections) and is waiting to know her fate while Oga is still lovesick. I offer him a listening ear, counselling support and the check madam wants.

While he can be supported to face his reality and be as honest as he can, I will not be judging his final decision.
He will not be judged, that is not a health professional’s role. My role is to keep all his secrets safe. I may run into him in church, the supermarket or elsewhere, it doesn’t matter. No one will ever hear it from me.

There are occasions when a doctor cannot keep a secret. If the patient is deemed to be a risk to the public, then the appropriate authorities will be notified immediately. There are many examples of those (story for another day)

In the West, patient confidentiality is key and patients can freely come forward to get early diagnosis and treatment. Everyone who has access to clinical records is signed up to confidentiality. In Nigeria however, fear, lack of information and low patient confidence is ruining lives.

Whatever your secrets are, if they are making you ill or you simply want to talk about them, go to your doctor, clarify the confidentiality clause and get spilling!

Twitter: @vinehealthorg Instagram: @vinehealth @star.doc Doctor, Philanthropist, Wellness Expert, Policy and Leadership


  1. Saratu

    August 17, 2016 at 7:29 pm

    I’m so proud of you. Well done. I totally agree with you and I hope a lot of Nigerian health professionals take note. We need to be more responsible with people’s lives and the information they entrust us with. I look forward to many more articles Doctor Alabi!

  2. Tosin

    August 17, 2016 at 9:34 pm

    this life…emotional abuse too much

  3. Ajara

    August 18, 2016 at 3:28 am

    This is a timely topic. Something crazy happened to my cousin recently. She confided in their family Doc about a rash she had which was proving stubborn to regular treatments. Suddenly , her husband went and bought all these treatments. Only to find out the doc hinted her husband and advised him on how to take care of himself!

    • you are sick

      August 18, 2016 at 9:32 am

      Ajara you are sick. If your husband is infected and doesnt tell you, will you be happy? He will just kill you with the infection

      Assuming it is a rash gotten via sexual act or sexual infections, outside the marriage (or even within), shouldnt the husband know about it?

      He needs to know so he can treat himself too
      If one partner is treated, and the other is not, the infection will never go cos they will still sleep together.

      If she got it outside, the man needs to know so he can protect himself

      If it is within (from the husband), the husband needs to know so he can treat himself and not infect the wife again, upon being treated.

      Do you understand now?

    • Na you sick joor

      August 18, 2016 at 11:01 am

      That’s the problem right there. We don’t know whose role it is to do what. It is not the Doctor’s role or job to tell her husband! That’s an infringement of her right to confidentiality with her Doctor! He’s job is to advice her on speaking to her husband and treating her! He took advantage of knowing her husband and acted as a gossip not a Doctor. In developed countries, he’s arse will be sued for all his kids will be worth in future! Rubbish

    • Dolapo

      August 18, 2016 at 1:32 pm

      The approach was wrong, the doctor should have monitored the progress, informed her about contacting her sexual partners and basically inform her on keeping herself and people around her Safe till they get a conclusive result. As per HIV or other serious cases, Dr. Monica mentioned it earlier that there are cases that are reported directly but even at that it’s not the doctor’s responsibility to squeal to family without permission. Unfortunately, our moral state have a huge role in how we treat n relate to people (some people infect others with HIV because they claim someone else did it to them). Let’s make the change by starting with ourselves and children by teaching them good values especially the one that said ‘treat people the way you want to be treated’ and professionals should heed to their ethics.

    • Marian

      August 19, 2016 at 3:26 am

      Nope! Not our place to tell the spouse. Infact that’s a lawsuit in my part of the world.. If a pt comes in and is diagnosed with STD, they are supposed to alert the people they have been with but we are not obligated to seek their partners out. The only time as stated in the article we can legally tell on a patient is if they are suicidal or pose a physical threat to others. E.g pt states he is going to kill/harm himself or gf/ friend/wife/stranger.

    • you are sick

      August 19, 2016 at 9:30 am

      @Dolapo, na you sick jor and others, you are blabbing cos it is the woman abi?

      Just trade places. Let it be your husband who is infected and continues sleeping with you without treating himself, without letting you know and the doctor hiding it from you

    • Dolapo

      August 18, 2016 at 1:16 pm

      Wow! He would have at risk of practicing her in the US

  4. Meena

    August 18, 2016 at 7:14 am

    Interesting topic,very timely,thanks Doc!

  5. Joanne

    August 18, 2016 at 8:36 am

    Dr. Alabi I do appreciate your thoughts and your understanding of the importance of medical history confidentiality. I’m hoping those in the medical field would appreciate their roles and treat patient health record/ history as scared. I’m also hoping healthcare outfits would take advantage of IT tools to enhance confidentiality and keep audit trail of who and when patients charts are accessed.

  6. Ugo

    August 18, 2016 at 8:41 am

    Hello Dr Alabi, this is a fantastic write up! It has profund content and makes for an interesting reading! I pray that some of your colleagues would borrow a feather from your cap. Am so looking forward to your next write up!

  7. Olusola Akinola

    August 18, 2016 at 9:18 am

    Lovely and timely piece and we need to be more aware of traumatic issues affecting mental health in our nation. If we can address these and start the healing process, a lot of the problems we face as a nation that prevents us from being great will be removed. Thank you Monica

  8. Chris

    August 18, 2016 at 9:37 am

    Nice piece! Definitely agree that discussing with your doctor helps. Women tend to be better at talk about their problem while we men try to put up “macho” front and suffer in silence. Men especially, African men need to open up and discuss their problems so that the doctors can give them the appropriate treatment. Maybe it is the fear of being vilified or being classed as a failure when we make mistakes. Men, let’s get spilling to get better mental and physically. Thank you Dr Monica!

  9. Joyce Olusegun

    August 18, 2016 at 11:54 am

    Interesting and Insightful reading Dr Alabi. I hope we get the chance to subscribe to more of your medical write up so that we can enjoy a constant dose. Only you can make a medical write up interesting with your down to earth approach. Keep it up. I am already hooked!!!

  10. Funmi

    August 18, 2016 at 1:08 pm

    Very relevant topic especially in Nigeria. Hope this gets around and have a positive influence on the confidentiality clauses in the medical profession in Nigeria. Welldone @ dr Monica. Looking forward to other relevant topics from this corner. Trust you to make it happen

  11. Josephyne Olusanya

    August 18, 2016 at 1:11 pm

    Great write up Dr. Monica. I enjoyed every bit of it. Please keep the good work.

  12. Francis

    August 18, 2016 at 1:32 pm

    This is an awesome piece, Dr Monica. The actual truth is that most people pass away more because of bottled up emotions and self guilt than other forms of illnesses. The truth is not far fetched; because they barely could find who can help ameliorate their plight while keeping their secrets. On this path, you will really make an immense impact on mankind, particularly if this kind of service is encouraged amongst other practitioners. Great job, Dr Monica, you’re doing us proud.

  13. Dolapo

    August 18, 2016 at 1:45 pm

    Thank you D. Doc Monica for raising more awareness and as read in some of the comments, we still have a way to go in terms of confidentiality in some developing countries. It’s easy to see your relatability through your write up, I hope more doctors are opening their ears more while using their brains too, after all, medicine is about wholeness of the mind, body and soul. Thank you once again and I look forward to the next article or better yet, can we subscribe.

  14. Sam Onigbanjo

    August 18, 2016 at 1:45 pm

    Great Piece Monica, It’s nice to remember the role of a good Doctor and the story it’s self is quite sad for the family in question. I hope you keep on supporting in your capacity as a great Doctor.

  15. Diwe

    August 18, 2016 at 1:50 pm

    Beautiful piece, Dr Alabi. The priviledge and responsibility we have as doctors is amazing! This special priviledge means we can certainly do more than prescribing and dispensing.. Keep it up!

  16. Bolly

    August 18, 2016 at 4:14 pm

    Well done, I love the piece and a worthy read indeed. However no tears here for Mr Bamijoko and his likes though.

    Now you say to clarify the confidentiality clause before spilling one’s woes. Is that within just 10mins of a GP consultation and to then be quickly fobbed out the door (with regards to GP surgeries here in the UK) with a piece of prescription or form? Seriously, how much help can this be to a patient’s psychological well being except to increase his/her anxiety after letting go of one’s innermost fears or worries. Surprised you got that much out of Mr Bamijoko actually. I probably should change my GP surgery. My opinion here is that time slots should be flexible enough to accommodate satisfactory patient centred consultations which I gather (again, my opinion) many people still find lacking in their GPs or medics.

    Nigeria is even worse, with long waiting times for consultation in public hospitals, patients hardly get enough time to get their worries out, lest of all time to clarify confidentiality clause. In the private ones, doctors spend so much time in the consultation rooms you wonder if both patient and doctor were on a conference call together. And by the time it’s your turn, you’re probably so upset with the wait you’d have forgotten your original worries. My opinion here is that as Nigerian patients have more of physical medical problems than psychological ones (not saying there aren’t many), the consultation times and style should be hastened to accommodate alot more patients’ problems rather than quizzing them and their family members for gossip material to be used later amongst their colleagues thereby adding to consultation queues.

    Plus how do you doctors draw the line between confidentiality and loyalty? Must be hard. (talk for another time I guess).

  17. John

    August 18, 2016 at 8:47 pm

    Interesting article. I’m interested in finding out if the problem is that Nigerian Drs do not have a confidentiality oath or this is not encouraged by the the Nigerian medical and dental council, or if it is that the people do not know of or trust it’s existence.
    Whatever is not revealed cannot be healed. Great job Monica. More grease to your elbows.
    I hope people can write to you and expect their information anonymised but still get great advice.

  18. Abiola Oguja

    August 19, 2016 at 2:39 pm

    I must say firstly how proud I am of you Dr Alabi. It is impressive that one of our own have held and still holds such important positions in a Western Country. The best is yet to come. With regard to the topic of , I am very much for it. I am a very private person and would not like it all if a doctor should betray my trust by telling others about my medical history that should be my choice only. Though I haven’t any experience of my own to share about the Nigerian system, I have heard and read stories enough to make me support a change for the better. So if there is anything you can do to help change the system, that would be wonderful and welcomed by people who have been let down by the lack of regulations and/or prosecutions. All the best, May God make the changes easy.

  19. Acogny

    August 19, 2016 at 8:22 pm

    Excellent and very timely article! Thanks to the author Semisola!

  20. Bukola

    August 20, 2016 at 9:48 pm

    We are truly proud of you Dr Alabi .

  21. Polish girl

    August 23, 2016 at 6:36 pm

    Its amazing that the doctors do listen to all these stories….why would one take doc’s time to tell stories of their infidelity?? As a tax payer do I have to pay for it??

  22. Hospital Plexus

    September 6, 2016 at 2:35 pm

    Nice piece, Dr Alabi. Sadly, many doctors do not observe this confidentiality oath. This betrays patients’ trust in the healthcare profession.

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