Saturday, 26 February 2011

Uh oh, part 2

Right, well then.

I guess this is going to happen more and more. I've not sworn people to secrecy, but I'm not going to mention it in class. Primarily because I don't want to be "everyone read my blog" guy in class. If people find it, read it and figure out it's me, fine.

It does raise some interesting issues around confidentiality, though. I've asked one of the ethics lecturers about my potential concerns about blogging and the impact it might have on my standing with the British Medical Association re: appropriate behaviour for a medical student. He said he'd contacted the BMA and the MDU (medical defence union) about numerous issues around breaching confidentiality and said he'd not got much in the way of a firm answer. This came up because he'd lectured us on how discussing your day with your spouse was a breach of confidentiality (at least in a literal, textbook way), even if you changed the names to protect the innocent and whatnot. I know most medical types shoot the shit in the pub after a bad shift, talking in generalities in public, and most might unload to a wife or husband or whomever at home to clear their heads - never mentioning a name or age or ethnicity or anything that might identifiable information. That this is fundamentally a breach of confidentiality, I find troubling and a little difficult to wrap my head around. So that gave me pause for thought about all of this.

Certainly within the field of blogging, we all say we anonymise patient information but there is always the chance (however microscopic) that someone might recognise themselves and decide to pursue legal advice - something no-one wants to have happen. My lecturer seemed to think that there weren't any hard and fast rulings on issues of confidentiality re: blogging because no case had come up yet, coupled with the fact that the BMA didn't want to prevent doctors (and presumably medical students, too) from what is arguably reflective practice, albeit done in public.

I have seen some people have signed up to the healthcare blogger code of ethics which I think is an excellent idea and I have every intention of signing up after I finish this post. I mean to behaviour in an ethical way and never to breach a patient's (or a co-worker's, for that matter) confidentiality. It is so essential to medical practice, so very valuable to a healthy and successful relationship with your patient or your own healthcare provider, that we should never belittle it. It is a standard that we should hold as high as any other as it reflects on us as professionals and as people, too.

As for my blogging, no-one has suggested anything I have done is inappropriate and this is something I coming to value more and more as the course becomes more demanding. So I shall keep on as I am doing until I hear otherwise, hopefully entertaining and maybe even educating y'all as I spill my brainguts to the internet at large.


  1. I think this is a good start. But we have to do more than protect our patients identity. We need to protect and respect the patient physician relationship. It's my opinion that too many of the blogs out there serve to ridicule and mock patient encounters, serving as little more than gossip rags. Its unfortunate that its these blogs that often have the largest following. Everyone needs to blow off steam and vent, but the internet is like a giant elevator. If you wouldn't say it in the elevator in the hospital in front of patients and visitors, then don't say it in your blog either. I'm not saying you have done this, just trying to remind all of us that we need to keep this in mind, there's more to it than just confidentiality.

  2. That's a great point and nicely put. I totally agree that the internet can a bit like a giant lift but I think it's a simile that reflects only part of the experience.

    I consider this blog a bit like sitting around in the pub next to hospital with co-workers, there is a commonality of experience and this is reflected in the way I construct my posts. I hope I've not denigrated anyone I've looked after. If a patient does something notable, be it funny or sad or stupid and it's relevant to the point I'm discussing, then I'll include it. I do intend to approach it a bit more aplomb than just blowing off steam, though :)

  3. It is a tough line.

    I try and think, "would I be embarrassed if the Dean or a patient of mine read this?" if the answer is "no" I hit the publish key.

    There are a handful of my classmates who read my blog, though I do my best to keep it under wraps. It is weird and freaky when I see ISP's near me spending A LOT of time on my blog. My old roommate said he googled "anatomy spotter" and Asystole was the first link. YIKES!!!!

    You seem to have a healthy respect for patients and your school alike so I wouldn't fret too much. The people that seem to get in trouble are the ones who violate trust/privacy as TH pointed out.

  4. Oh and I am happy to hear about your fathers angio results! Good news! :)

  5. You are handling this "zomg-someone-from-my-real-life-knows-about-my-blog" thing so much better than i would have. It almost seems to me easier to let people I know from the blogging world into my real life than to let people from my real life into my blog. Hmmm. Does that make any sense at all?
    By the way, I hope everything is alright. :-/