Between Fact and Fiction - Invisible Profiling in Medicine

Kafico Ltd
3 days ago
2 min read

Updated: 4 hours ago

In our work supporting healthcare providers with their privacy responsibilities, we often see how well-intentioned record keeping can accidentally drift into risky territory. One example is the way behaviour is sometimes documented in medical records, especially when staff are trying to protect themselves or others. These notes usually come from a good place, but if we’re not careful with language, they can create long-term issues for patients and for organisations alike.

It is, of course, sometimes necessary to flag behaviours that could affect safety. That might be to protect staff, other patients or, in some cases, the individual themselves. But we have to be really careful about the language we use when we do that.

Invisible Profiling

Not just because of fairness, but also because the law is very clear when it comes to things like "invisible profiling". That’s when people are effectively put into a category without being aware of it or having the chance to respond. It’s a serious issue in data protection and it’s easy to fall into without meaning to.

One area where this can show up is in behaviour notes or alerts, especially when we start using shorthand that shifts from describing what happened to making assumptions about character.

Take the difference between "aggressive patient" and "staff have reported incidents of shouting and physical intimidation". The first is a label. It tells future clinicians, rightly or wrongly, what kind of person they’re dealing with. The second is a record of something that happened. It’s much closer to fact.

And the truth is, most of us wouldn’t like being labelled based on one incident. Especially if that moment was out of character, a mental health crisis, a grief response, or even just a bad day.

That’s where we have to pause and ask ourselves: is what I’m writing a statement of fact, or is it an opinion dressed up as one?

Here’s a quick comparison:

Opinion-based entry	More factual version
Aggressive patient	Multiple staff have reported shouting and physical intimidation
Difficult and rude	Patient refused treatment and used raised voice
Non-compliant	Patient has missed three appointments since June

If we do need to add a flag, something like "chaperone required" can be a good starting point. It gives other staff a heads-up without making broad assumptions. A short note to support that flag can give helpful context, ideally based on what has actually been reported.

Ultimately, this isn’t about being soft. It’s about being accurate, fair, and lawful. And about remembering that every one of us is more than the worst thing we’ve done on a hard day.

If someone reading your note in five years will make a decision based on it, let’s give them the clearest and fairest information to work from.