Doctoring Reflection

Friday Reflections: Don’t take my stories away

It’s been a rough couple of weeks for medical bloggers.

For us heart rhythm folks, in case you had not heard, there is an ongoing DOJ investigation of ICDs. Electrophysiologists put in ICDs. These life-saving devices are complicated to use, require sound clinical judgment, along with a thorough discussion with the patient. That’s all I will be saying on the matter. You get the point.

But there is more chill for us early adopters of social media.

The brouhaha about a Rhode Island surgeon who was fired and fined for a Facebook post that compromised patient confidentiality looms large over our creativity.

It’s an I-told-you-so moment for the naysayers. Sad.

The details of what the RI doctor said on Facebook have been removed. MSNBC reports that she omitted specific details of the patient, but apparently not enough, as an involved third party was able to identify the patient. Though privacy was breached, there was no mention that the post was malicious.

A case like this has a chilling effect on my blog. As a real-world doctor, some of the best content I can offer are human stories. Taking care of people is what makes medicine the most fun and interesting.

Do you think a blog about calcium channels and action potentials would have much stickiness? Medical practice is about cases; “cases” mean talking about people.

By nature I don’t consider myself overly alarmist, but I am not naive either. Of course patient privacy is important. I don’t want my surgery broadcasted to the world—unless, of course it’s some epic shoulder reconstruction that’s going to allow me to ride wheelies again.

In the earlier days of keeping this blog, it was obvious that changing identifying details of the patient was important. That I worked at multiple hospitals made the task of presenting cases anonymously much easier.

But when writing about a case, how much detail needs to be changed? And if you change nearly everything, does the story become fiction rather than non-fiction? And isn’t a blog post that uses a (detailed-doctored) case from a month ago different than a real-time Facebook status update from a smartphone?

The master of the obvious in me says use common sense and decency in writing about people. Is this enough of a guide?

I hope so.

Because in medicine, real human stories teach us far more than the textbook.


Here are three references of thoughtful commentary for those interested in the matter of doctors in the social media space:

Dr Kevin Pho’s commentary on KevinMD

Dr Bryan Vartabedian on 33Charts.

Dr Wes Fisher on Doctor Wes.

4 replies on “Friday Reflections: Don’t take my stories away”

Talking about cases in specifics without individuals names can certainly improve the treatment or potential of another in need. Because a patient falls within a category and treatment is needed, but what course of action the physician chooses is important due to variable options in most cases. Relapses can and do occur at no fault to the physician.
Share the infomation, the specifics just not the individual names. Improve the cure and care for all.

Obviously pt. privacy is paramount, but I agree that people learn best through example. I’m not familiar with the case in question, but there are clearly people who go over the top with revealing details, and those who have abandoned details to have strictly academic conversation. I think many of us are trying to ride in the middle and crossing fingers for good luck. Of course, that doesn’t stop your patient from discussing everything that they think about YOU, including their opinion of your medical judgment and the hospital at large.

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