This article defines and describes the interrelated but conceptually distinct terms “confidentiality,” “privilege,” “privileged communications,” “privacy,” and “records.” It reviews the parameters of these words, discusses the variance between the extent of the physician-patient and that of the much broader licensed psychologist-patient privilege in Pennsylvania and, in particular, reviews the situations in which assertions of confidentiality and privilege cannot prevent third parties from gaining access to records and the information contained in them and the legal cases which set out the law in these areas. Finally, it reviews the demands to see records by patients and the increasing willingness of courts, legislators, and regulators to grant not only access but also the right to correct, add to, or destroy such records if the patient wishes to do so.