There are strong incentives to computerize medical records in the present health care environment, yet medical information is frequently personal and is protected by privacy law and by centuries of a tradition of confidentiality. It is not possible to eliminate all risk of inappropriate disclosure and use of medical information, either in a paper or an electronic system. Computerization of records increases the potential for abuse, but with appropriate attention to security measures, medical data can be made reasonably secure while preserving accessibility for those who truly need the information. Both for technical and legal reasons, paper records are still necessary in 1995, to back up electronic medical databases.