At the beginning of the Martin Luther King Jr. holiday weekend, rumors were swirling that golf pro Tiger Woods had checked into Pine Grove Behavioral Health and Addiction Services in Hattiesburg, Miss., for the treatment of sex addiction, and that a photo substantiating the story was worth several hundred thousand dollars. In response to the media alert, black tarps were placed over walkways and annexes at the South Mississippi health facility. 

 

The speculation—was Tiger in Arizona or Mississippi or elsewhere?—kept the media guessing, and hospital marketing directors talking among themselves. Mum was the word to reporters—and with good reason. If a marketing director receives a call asking about a particular patient and answers with something like, “I cannot confirm or deny,” then all a reporter has to do is attribute the quote as: “I cannot … deny.” Sometimes, the dots are removed.

 

“One must be very careful how to respond,” said Ruth Ann Hale, APR, public relations director for Methodist Le Bonheur Healthcare in Memphis. “The primary concern is for the patient, and respecting the patient’s wishes—celebrity or not. Anyone can be a no-information patient and opt out of the directory.”

 

A secondary cause for concern among hospital administrators for misspeaking about a patient (high-profile or not): being popped with a HIPAA fine for a security violation. Fines can range from tens to hundreds of thousands of dollars. 

 

“With margins so thin, one fine can cripple a hospital,” said a hospital marketing director in North Carolina.

 

Marketing directors often come under fire when information leaks from outside hospital walls. For example, the local police may tip off media to the location of a high-profile patient.

 

“We had a patient whose family member told the media where he was,” recalled Hale. “We went to the patient and asked, ‘what are your desires? Do you want us to share information with the media?’ The patient didn’t approve, and asked to remain a no-information patient. Our loyalty is to the patient.”

 

Some high-profile patients want the media to know their health status.

 

“In that case, we help them issue statements, always while respecting their privacy,” she said.

 

Admission clerks play a key role in educating new patients about the no-information option.
“Many times, patients are so wrapped up in the health concern that brought them to the hospital, they aren’t thinking about anything else,” said Hale. “The admission staff advises them on the right to be a no-information patient.”

 

Even before HIPAA mandates were in place, healthcare providers had to be especially careful with VIP patients. For example, in the 1960s when Ben Carmichael, a cardiologist from Hattiesburg, Miss., was a member of the medical teams that attended President Dwight Eisenhower at Walter Reed Hospital in Washington, D.C., and President Lyndon B. Johnson at Brooke Army Medical Center at Fort Sam Houston in San Antonio, Texas, even he had difficulty knowing their status. “To get close to Presidents Eisenhower and Johnson was tough in itself,” he said. “We were rubbing elbows with the Secret Service every day.”

 

The authors of “Celebrity Patients, VIPS, and Potentates,” published in The Primary Care Companion to the Journal of Clinical Psychiatry, brought up another point: “The celebrity patient’s newsworthiness inflicts on caregivers a cluster of problems so predictable that it’s almost syndromic. Since caregivers are used to protecting the privacy of patients, maintaining confidentiality isn’t usually the main problem faced when taking care of a celebrity. The difficulty lies in the caregivers’ protection of their own privacy when they suddenly find themselves in the glare of the spotlight.”

 

The American Medical Association doesn’t have a policy that explicitly addresses the special challenges high-profile patients pose. Nor does the American Academy of Family Physicians. The American College of Physicians notes almost parenthetically "physicians of patients who are well-known to the public should remember that they are not free to discuss or disclose information about any patient's health without the explicit consent of the patient."