New directives of the Health Insurance Portability and Accountability Act (HIPAA) laws in the United States specify confidentiality rules of medical practices. By definition, email is not confidential unless encrypted. Thus, receipt of your email implies that you are willing to waive any confidentiality provisions of HIPAA. Your email, our response, and any subsequent messages are also not confidential. We do not, however, have any intention of disclosing the information in your email. If you wish to pursue any matters in confidence, you will need to do so by traditional mail or a personal visit.