I suggest an alternative policy for the protection of privacy in research, based on the commission’s 1978 reports (8, 10) and developed by the National Coalition for Patient Rights (9) For planned prospective uses of patient records, informed consent should be sought. However, for retrospective research using patient records, the model suggests that prospective consent should be obtained when patients enter a health plan or health care setting. To ensure an added layer of protection, this consent is delegated to a board specifically designed to review these matters: a medical records review board. Such a board would relieve already overworked institutional review boards of an additional burden, would not suffer the institutional conflicts of interest inherent in institutional review boards, and would contain more community representation than institutional review boards. In their article Dr. Simon et al. alluded to this kind of policy when they noted that "health insurers have numerous opportunities to communicate with members regarding research uses of health care data" (2, p. 1735). They suggested that abbreviated or simple consent procedures be incorporated into routine practice and that they might be "preferable to complete waiver of consent" (p. 1735).