In general, a person is required to report criminal activity and to appear and testify as a witness if requested by the defendant or the state. As long as the report is made in good faith, the law protects persons who report crimes from being sued for defamation by the person they report.

This creates a conflict of interest with a patient’s expectation that a physician will preserve the confidences of the physician–patient relationship. This conflict is most acute for psychiatrists: their physician–patient relationships are critically dependent on trust, and their patients are much more likely to discuss matters such as criminal activity with them. The general duty of a medical care practitioner is limited to the reporting of possible future criminal activity, not to turn in their patients for past acts that come out in during medical treatment or consultation.

The medical care practitioner’s duties are much more rigorous when dealing with crimes related to medical care business practices.