BOB GARFIELD: This is On the Media. I'm Bob Garfield.

BROOKE GLADSTONE: And I'm Brooke Gladstone. Earlier this year, at a convention in Las Vegas, an attorney for the Radio and Television News Directors Association gave a speech entitled: Doctor, I Have an Awful Pain in my HIPAA. HIPAA, as any medical reporter will grouse, stands for Health Insurance Portability and Accountability Act. A small part of that law known as the Privacy Rule went into effect in the spring of last year and quickly became a thorn in the side of reporters like Andrew Holtz; he's a freelance medical reporter based in Portland, Oregon and past president of the Association of Health Care Journalists. Andrew, welcome to On the Media.

ANDREW HOLTZ: Nice to talk to you, Brooke.

BROOKE GLADSTONE: So, the Department of Health and Human Services drafted the privacy rule at the request of Congress, and the stated intention was to, quote, "provide patients with access to their medical records and more control over how their personal health information is used and disclosed." Well, that sounds good to me. What went wrong?

ANDREW HOLTZ: I think that what I get a smell of is institutions working more to protect their own interests than really to look out just for the interests of their patients. For instance, a reporter in the Midwest reported that it was her usual practice when talking to patients on medical stories to sit down with the patient or the family, say in the hospital cafeteria. Suddenly, with HIPAA being used as an excuse or a rationale, she was told that a minder from the hospital would have to be there. So the hospital was restricting access specifically to journalists, even to areas open to the general public.

BROOKE GLADSTONE: So you don't object to the principles implied in the Privacy Rule. You just think that it's being applied in a way that's, frankly, directed at journalists.

ANDREW HOLTZ: There are key areas where even the obvious language of the regulation does shift the balance between the public interest and the interest of private individuals, and I think it's perhaps been shifted a little too far. For instance, in emergency medicine I've covered stories for television on how heart attacks are treated. Well, you can't schedule a heart attack. In order to do the story, you have to be there at the moment when the patient comes in. So the general practice over the years has been you go ahead and shoot the footage, but don't use it until the patient comes around or the family agrees, at their leisure, that yes, it's okay. And if they say no, the tape is destroyed. These days, that kind of thing has basically shut down.

BROOKE GLADSTONE: Just for the record, and at the risk of stating what may seem obvious, why do you think it's so important that reporters have access to this kind of information?

ANDREW HOLTZ: The more you clamp down on and make it harder for journalists to talk to patients, then the less likely it is that alarm bells will go off. Often, these days, you can't even find out the names of individuals or the kinds of cases that are happening in a community. So reporters need to press as hard as they can and document these cases where the restriction of information has ended up harming the community or harming patients because they didn't realize, perhaps, that a bad outcome they had was part of a larger pattern of bad outcomes in that institution.

BROOKE GLADSTONE: Well, there has been a longstanding tug of war between privacy and the public's right to know, and usually this gets played out in the courts. Is that where you see this issue heading?

ANDREW HOLTZ: Yes, and actually I'm a little bit surprised it hasn't gotten there faster. Eventually, the courts will have to decide what exactly the regulations do say, because there are quite a few areas that are left open to interpretation.

BROOKE GLADSTONE: Thanks very much.

ANDREW HOLTZ: Thank you, Brooke.

BROOKE GLADSTONE: Andrew Holtz is a member of the board of the Association of Health Care Journalists and current medical reporter based in Portland, Oregon.