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Two hundred and fifty patients at a university hospital teaching clinic and 200 patients in a small private medical office were questioned about their expectations for confidentiality. It was found that in general, subjects in both groups had similar expectations of how physicians handle confidential information. This included physician behavior in situations such as discussing cases with other physicians for second opinions, submitting cases to medical journals, and discussing cases at parties or with spouses and friends. The similarity existed despite demographic differences between the two groups and despite marked differences in the two practice settings. A few differences between the groups were noted, however. University clinic patients were more likely than private office patients (54.5% vs 38.5%) to expect that cases are discussed at large physicians' meetings. Private office patients were more likely (77.8% vs 67%) to expect physicians to discuss cases with nurses. Men in both practice settings were more likely than women to believe that physicians commonly submit cases to medical journals (75.8% vs 59.9%), or discuss cases with nurses (81% vs 67%), non-medical friends (10.9% vs 4.4%), spouses (53% vs 36.4%), and at parties with physicians (56.4% vs 39.6%).