The established professional practice requiring informed consent for the disclosure of personal health information with its implied right to privacy suffered a serious setback with the first federal privacy initiative of the Bush administration. The new Health Insurance Portability and Accountability Act (HIPAA) of 1996 (P.L. 104-191) privacy regulations supplant the patient's veto regarding disclosure with the requirement that the patient simply receive a written notice of the provider's policy on disclosure of personal health information. As the privacy paradigm shifts to balance the business interests of the health care industry with those of individual patients, this policy presents new challenges for protecting the confidential relationship between the practitioner and the patient. This article reviews the significant modifications in the new HIPAA regulations, briefly critiques these changes, and suggests strategies for practitioners to manage these changes.