"A practicing. . . counselor, physician,. . .[or] mental health profaessional, . . . who obtains information by reason of the person's employment. . .shall not be allowed, in giving testimony, to disclose any confidential communication properly entrusted to the person in the person's professional capacity."
Iowa Code § 622.10
Under most circumstances your doctor or counselor cannot give your records to anyone but you. The goal is to encourage complete and honest communication between doctor and patient. This privilege is based on the constitutional right to privacy. This protection is also found in Iowa statutes. Therefore, unless you have given the doctor or counselor permission to do so, it is wrong to reveal this privileged and confidential information. Giving permission is sometimes called "waiving" the privilege or signing a release so a third party can get your records.
This protection does not go away just because you are involved in a court case. In cases such as custody, divorce, or domestic abuse, for example, the other side may ask you to hand over all your medical and mental health records. This is done through a "discovery request" or "request for production of documents." In most circumstances, you do not have to give the other side your records.
The only exception to this general rule is if the patient's medical or mental health condition is an important part of the patient's own case (called an "element" or "factor" or "issue"). This exception is called the "patientlitigant" exception. What happens if the other side claims you are sick or mentally ill? Making such a claim does not automatically get rid of the doctor-patient privilege. The patient can deny the claim without giving up or waiving the confidentiality of his or her records.
The Iowa Supreme Court made this protection very clear in a case decided in December of 2010. The case is called Ashenfelter v. Mulligan. In that case, grandparents wanted visitation rights with their grandchildren. The mother of the children had decided that visiting the grandparents was not best for the children and denied their request. The grandparents claimed the mother of the children was unfit and they requested her medical and mental health records so they could prove this. The Iowa Supreme Court ruled these records were protected by the doctor-patient privilege and the mother did not have to provide them to the grandparents.
The grandparents also claimed the patient-litigant exception applied because the mother's medical condition was a factor in the case. The court disagreed. They said it was a part of the grandparent's case but it was not an element or factor in the mother's case. She had no reason to make it a factor in her case and had not done so by denying she was sick. The patient-litigant exception therefore did not apply.
The doctor-patient privilege is an important right of privacy. It helps make sure doctors have all the information they need to properly diagnose and treat people. The law protects this confidential information unless the patient makes their health a part of their own case.