It seems clear: We should not disclose who our clients are, when they come in, or why they see us. Boom! Black and white. Except . . . it’s not clear.

Client confidentiality is complex at its core and made more confusing if you get the bulk of your clients from word of mouth (which most of us do).

I’m not speaking from a pedestal when it comes to confidentiality. I’ve struggled with the gray areas and messed up many times. I’ve learned from experience. Over the years, I’ve identified the most common situations that pop up, and I’ve created scripts to handle them properly.

Don’t Discuss Clients with Other Clients

Well, duh. But it’s trickier than that. It can come up in an innocent way, especially when your clients are your biggest referral sources. Here’s an example:

Blanche (my regular client) buys her friend Rose a gift certificate. Blanche comes in a few weeks later for her appointment and asks if Rose has scheduled yet. You tell her Rose hasn’t.

No biggie, right? It’s probably fine to acknowledge that someone isn’t a client. But then Blanche nags Rose about using the gift certificate. And Rose isn’t scheduling because she’s got a tough health issue she isn’t ready to talk about. It’s none of my business, it’s none of Blanche’s business. And we just made it an issue.

Or, if Rose did come in, we could say, “Yes! She used the gift certificate. Thanks for sending her in.” But now we’ve just violated Rose’s confidentiality. Maybe Blanche is actually a big pain in the rear, and Rose prefers to have some privacy.

Some of this gray area could be easily resolved with a line on your intake form that says, “Referred by” and asks “May I thank them for referring you?” Then, you know it’s cool to acknowledge the appointment to the referrer or gift certificate purchaser.

If you don’t want to violate Rose’s privacy, what’s the appropriate answer here? I like, “Well, that would be a great question to ask Rose!” or “I’ll let you ask Rose that question.” Be polite, smile. Most people will get it. If they press the issue, just say straight out, “It’s important to me to protect client confidentiality, so I prefer not to acknowledge whether someone has or has not been in.” That’s clear, kind, and will likely earn you some serious respect.

Often, we treat several people within the same family or group of friends, and it’s common for someone to ask a question like, “How is Dorothy? Is massage helping her headaches?” These suggestions apply to those situations too.

Privacy Mistakes Can Hurt Clients

A client will be less likely to tell you about her postpartum depression if she’s worried you’ll tell her husband. A great massage therapist can be a useful resource in this kind of situation, but not if the client stays quiet. Another client simply won’t tell you about his cardiac event and new medications if he thinks you’ll tell the friend who referred him. In this case, the massage could actually become dangerous.

Don’t Discuss Clients at Home

The details—even those you think are “vague” references to clients—do not belong at your dinner table. You may think you are being obscure enough to make it acceptable. But, over time, references to the same clients are enough to make a full picture.

Telling your spouse or your kids that client information is private is not enough. It is your responsibility to keep a client’s confidentiality. You. And the moment you overshare, you give that responsibility to someone else. These same rules apply with close friends. Your personal confidant should not be your professional confidant.

So, how should you answer (and be genuine) when a friend or family member asks, “How was work?” You can say: “Great! Everyone showed up on time, and I remembered my lunch,” “Hard. I didn’t sleep well last night, and the whole day dragged,” or “Challenging. But good.” It is possible to be honest and still not talk about clients.

We all need to vent and process both typical and challenging client cases. This is what trusted colleagues and mentors are for. And even then, you should keep confidential any identifying client details (especially if your colleague lives or works in the same community as you).

Confidentiality is Good for Business

Clients of quality will notice and respect your radical confidentiality. In fact, when a client knows you won’t tell their sister about their pulled hamstring from a rather passionate weekend with a new beau, that client is more likely to send their sister in. Other health-care practitioners will be more likely to refer to you if you adhere to strict privacy standards.

When you have a policy of adhering to strict confidentiality, it’s better for everyone. Current clients feel safe. Prospective clients trust you more. And you can sleep better at night knowing you’re doing everything you can to properly protect the privacy of your clients.