It didn't start with Farrah Fawcett's medical records landing in the National Enquirer or recent reports on a celebrity website that actor Patrick Swayze was near death.
For decades, the tabloids have made a cottage industry of star ailments -- whether Dean Martin's declining health, Rock Hudson's AIDS diagnosis or Bob Hope's final years in and out of hospitals.
"Bob Hope Says Last Goodbye," the Star reported months before the entertainer actually died.
"While Doctors Battle to Save Her Life . . . Liz Boozes It Up In Hospital," screamed a famous National Enquirer headline from the 1990s.
But celebrity representatives say that a growing appetite for entertainment-related news coupled with an increasing reliance on computerized record-keeping has dramatically increased invasions of medical privacy.
"With the advent of networked computers, the problem has increased exponentially," said attorney Blair Berk, whose celebrity clients include Britney Spears and Lindsay Lohan.
"You are literally and virtually surrounded by people who are willing to trade in [medical] information either for profit or for their own 15 minutes."
Berk and others cite snooping into the medical files of Spears, Fawcett and other high-profile patients at UCLA Medical Center as "Exhibit A" in the threat to the privacy of celebrities.
Nearly 70 current and former UCLA employees -- including physicians -- have been accused of illegally viewing computer medical records of celebrities.
One of them, a longtime administrative specialist accused of looking at the medical records of 61 patients, including celebrities and co-workers, was indicted by a federal grand jury last month for allegedly selling information to the news media.
There also are suspicions that someone at Cedars Sinai Medical Center tipped the celebrity-news website TMZ.com to a story involving a drug overdose for the infant twins of actor Dennis Quaid and his wife, although no one has been charged.
It remains unclear how many of the tabloids' medical scoops come directly from hospital workers snooping through records or from others who glean the information in other ways.
Several tabloid veterans told The Times that the risks of using details from medical files for stories far outweighed the rewards.
What's more, their scoops depend on reporters and "word of mouth" from a broad network of sources.
Iain Calder, former editor at the National Enquirer, said that in its heyday, the tabloid could count on a cross-section of informers to deliver stories.
"The real secret was that in the days when circulation was really high, I didn't have to spend a lot of money to get stories for our audience," Calder said.
"We had sources all over the areas we wanted to cover."
Calder said everyone from orderlies to morgue workers were information pipelines.
Frank Griffin, owner of the Bauer-Griffin agency, said tipsters come not only from hospitals but from all walks of life.
Hairdressers, maternity store clerks, airline employees in charge of retrieving wheelchairs for celebrity passengers and the worker who delivered oxygen to an ailing Marlon Brando have plenty to dish, Griffin said.
"It's still done the old-fashioned way in the sense that it's done through word of mouth," Griffin said. "And you have to be prepared to listen. Then you talk to two or three more people to try to verify the information."
The motive of informants varies. Some are paid. Others won't take a dime but like the power of seeing their information translated into a story. Indeed, many tabloids attribute details about medical dramas to a celebrity's "close friend" or "pal" or "someone in the camp."
Still others blab about sensitive information without realizing it.
But Paul Barresi, a self-styled private investigator who brokered stories for the tabloids in the early 1990s, says the buying and selling of medical records is more widespread than the tabloid industry wants to admit.
"The best way to learn about a celebrity's health status is to see what is inside his or her medical records -- period," Barresi said. "It's proof positive and there is no second guessing."
In one case, Barresi said, a tabloid reporter called a hospital's billing department with information obtained from confidential medical records.
Believing the caller was someone official, the employee would then give up more information or unknowingly confirm information, Barresi said.
Some who have studied the way tabloids cover celebrity illness have found patterns.
"Tabloid deaths generally come in two varieties. One is the 'Sad Last Days' passing, in which the subject dies alone, troubled, heartbroken, and/or having failed to attain some final wish or accomplish some important last objective," wrote Jennifer Mendelsohn, who penned a column about the tabloids for Slate in the 1990s. "The other is the 'Brave Last Days' story, in which the subject, preferably ailing and frail, says goodbye with great flourish, happy memories, and no regrets."
Despite such predictability, University of South Florida Professor S. Elizabeth Bird said such stories are a big draw.
"People feel close to celebrities. They have an imaginary relationship with them, they feel they know them," said Bird, an author of a book on tabloids and culture.
But a lot has changed, especially in recent years
Before, Bird said, "you didn't expect to know everything about them, like their illnesses and their problems."
That barrier has collapsed with the rise of cable television, the Internet and more focus on celebrity stories in the mainstream press, not to mention self-promotion and self-revelation by the celebrities themselves.
"There is so much more stuff about people available," Bird said.