This article will explore the risks that patients and HCPs assume related to privacy and confidentiality of personal health information in the digital age. The discussion will apply the obligations inherent to the Hippocratic Oath to practitioners to generate and collect PHI in a world where big data rules. The article will follow the data from its origination through its collection, use and distribution including commodification of data and data breaches. The heightened risks imposed by irresponsible digital practices and commodification will be elucidated. It will address the roles of various stakeholders who interact with such data including physicians, health care institutions, data brokers and even patients themselves and how they can act more responsibly to mitigate the risks. The article will also explore the impact of big data, artificial intelligence and machine learning on the ease of re-identification of so-called “de-identified” data sets. We conclude with a call to action for all stakeholders with an emphasis on patient education and improved digital hygiene among healthcare providers all in an effort to uphold the principle of “Primum Non Nocere” (First, do no harm).