Another thing that article accomplishes is to condition the R&F to accept the actions of others who break the confidentiality agreements and go tattling to the elders. They simultaneously instruct some to break the law and others to quietly accept.
My OBGYN hired an elder's wife during my first pregnancy. (I had been going there for many years) I gave the NP a copy of that article and asked that none of my records be available to that specific clerk. When I went in for my next appointment, the NP thanked me for the information and told me that they had a discussion with the woman and decided that she was not fully committed to their policies, so she didn't make it through the probationary period. Their office copied and distributed the article throughout the medical facility so that all could be aware of a possible breach. After all, they could face legal action if their clerks are giving out info.
I was already out by then, otherwise I'm sure I would have faced some pissed off elders over that one...