Privacy in occupational health practice: promoting and impeding factors

AIM: This article describes the views of occupational health professionals, employees, and employers on factors that are thought to promote and impede privacy in occupational health practice. METHODS: The data were collected through theme interviews with 44 subjects and were analysed by content analysis. RESULTS: Both promoting and impeding factors organized around two content areas: "caregiving" (patient-caregiver relationship) and "tripartite cooperation" (cooperation between occupational health professionals, employees, and employer). The content areas illustrated the two different roles Finnish occupational health professionals have toward their two groups of clients: employees and employers. "Adequate behaviour" (respect, good communication, presence) and "Adequate knowledge base" (instinct, work experience, ethical thinking, knowledge of legislation) promoted privacy in caring relationship, whereas "Inadequate behaviour" (untrustworthy, busy, distant, "friend") impeded its realization. In tripartite cooperation, the promoting factors had to do with "Common good" (impartiality, regular contacts, community spirit, fair play) and "Individual good" (informed consent, advocacy). The main category, "Confusions in loyalties", emerged from three subcategories (confusions in confidentiality, confusions in duties, and confusions in roles) illustrating the impeding factors in tripartite cooperation. CONCLUSIONS: Questions of privacy are crystallized in occupational health professionals' diverse duties and roles towards employees and employers. In occupational health practice, privacy cannot be seen only as a privilege of employees, but must also be viewed as an instrumental value serving the interests of employers and whole work community. Confusions in loyalties need more discussion and research before privacy can be optimally realized. Lapses in confidentiality should never happen.