Monday, August 11, 2008


I would just like to say that I didn't expect all the positive comments. I'm afraid if I get anymore, my head will get so big it will actually explode, which would be messy. Seriously, many thanks for the support.

I haven't quite figured out what I'm going to do. I feel like I'm probably going to do a little blogging about residency and what I'm doing, since (as Midwife with a Knife pointed out), the First Amendment still applies to me. I will try to avoid writing about patients as much as possible, though, since I'd hate to violate someone's privacy. Writing about other people, particularly patients, brings a whole other level of complexity to this equation.

It puts me in a bit of an awkward situation at work, though. I'd like to participate in some kind of discussion about blogging, but just by doing so it threatens my anonymity at work. Right now, the only person at work who knows I blog is an upper-level resident whom I confided in, so now I'm in a weird spot, since he's the one who forwarded the email to me about blogging. If I continue blogging about work, and he's the one who told me the policy is not to do so, then in essence I'm lying to him, or at least betraying his trust. As ridiculous as it may seem, I've considered contacting a lawyer (or at least, a friend who happens to be one) to get legal advice on this issue. After all, this is my current job and future career that could be at stake.

I really would miss blogging terribly, though. I love having a reason to write. I've never been good at keeping a diary or journal, but I've managed to write a little bit in this for nearly 3 years now. That's something to be proud of, no matter how poor the writing is sometimes (or most of the time), or how many times I simply degenerate into curse words. And all joking aside, I was really moved by all the positive comments. Thank you, thank you, thank you.


Chris Jenness said...

I previously commented saying you should keep blogging, but after reading this, I'm not sure if that is the best idea. I really do like your blog, but is it really worth jeopardizing your future career. That's pretty huge.

Tiny Shrink said...

Yeah, it's a really tough spot.

Midwife with a Knife said...

Why, exactly would you feel like you're betraying this upper level resident person? If you promised not to blog, then you would, be, I suppose, but you could say, "thanks for the email" and continue to do what you want.

After all, they can't fire you for the first offense (or for any single offense). They first would have to tell you to cease and desist (and that's where you have to make a decision). Then if you didn't, they would have to justify putting you on probation for 6 months (ACGME guidelines, I think), and then they would have to document how you hadn't met the conditions of your probation, and then they could fire you.

The likelihood of them doing any of that is really relatively small. And even if they did decide to shut you down, you'd have plenty of warning, and you'd have plenty of chances to decide whether to fight it or not.

My suggestion? Anything that happens to you belongs to you, and you get to write about it anywhere any time. Any patient stories (although you still have some right to them because they still are about your experience) you should confabulate or change to be unrecognizable.

Some patient problems (like depression or a stroke) are so common, they are unrecognizable, especially if you do a few things like change genders, change specific deficits, etc. I've never seen you write anything I would consider to be sacrificing patient confidentiality (or even close, really). The real test is would this patient's neighbor, if they read your blog, recognize that patient in the writing? If not, don't worry about it.