WHAT IS THE INTERNET LEARNING ABOUT YOU WHILE YOU ARE LEARNING ABOUT THE INTERNET

Privacy, confidentiality, and security are largely taken for granted i n physicians' offices. However, increasingly, physicians and insurance providers will be obtaining and exchanging information through the so phisticated resources available on the Internet and the World Wide Web (WWW, or the Web). Some of these resources will maintain the same pri vacy experienced in the office of a trusted clinician or in the readin g room of a great library, but more often than not, while people are l earning from the Web, the Web will be learning about them. The author describes a new type of file used by Web browsers (the ''cookies'' fil e) that may enable users to browse the Web more efficiently but that m ay also compromise the users' privacy. He then discusses exactly how a buses might occur if information obtained through cookies files is mis used, particularly by health insurance providers. Finally, he consider s privacy and confidentiality issues raised by computer-based medical records, and the role of the health care provider in maintaining confi dential and helpful doctor-patient relationships in the face of rapid technological change and the pressures of managed care.