The conflict between accountability and confidentiality in Medicare's access to psychiatrists' notes.

Objective: The aims of this paper were to identify a conflict between psychiatrists' obligations regarding patient confidentiality and Medicare's auditing procedures, and to examine potential resolutions to the conflict. Conclusion: While it is reasonable for Medicare, as a taxpayer-funded instrumentality, to require documentary evidence to substantiate and justify claims, such a requirement constitutes a significant breach of patient confidentiality. Obtaining patient consent appears to be the only ethical resolution of the issue. [ABSTRACT FROM AUTHOR]