My last post (“Other People’s Patients”) inadvertantly caused a bit of anxiety amongst some of my colleagues, and for that, I apologize. I had dreamed up the idea for the post while walking to work, and in my head, it was so funny! A lighthearted satire of the different ways primary care docs practice, a great idea! I actually wrote it in 15 minutes, and as is often the case when we rush through things, it didn’t come out as I intended.
In the ensuing few days, I was approached by no fewer than 3 colleagues, and they all expressed that they had tried to glean from the case details if I was writing about them.
No, I wasn’t. The examples were composite examples, based on multiple such experiences over the years. The case details are always altered, to avoid any HIPAA violations. After all, there are several precedents for docs getting in trouble for writing about real cases on blogs or in social media… They have lost their jobs. Even an anonymous doc-blogger was shut down for writing about a case without altering the details.
In a friendly meeting with our hospital’s risk management folks way back, they had suggested using composite cases or altering identifying and case details as a means to keep the message behind the writing intact, without compromising patient privacy.
I also intended to poke fun at our different styles, not indict them. Heaven knows, I can be possessive; I can also be hands-off. I think we all are. It depends on our relationship with the patient, and how much else we have going on. I once had to get my kid to a doctor’s appointment, and I was paged to do an inpatient medical consult on a very sick, and very dear patient. I left the whole thing to my colleague who had the bad luck to be on-call. I remember saying, as I ran out the door- “Whatever you think is fine!”
Other times, my patients have been seen by colleagues, who ordered tests or studies, and promised they would followup on the results. But me, being kind of O.C.D. at times, have looked up the results and acted before they had the chance to.. “Oh, I was going to followup on that,” they say, and I say, “Oh, yeah, uh, I just happened to see that result and thought I would take care of it…”
So, as my favorite advice columnist growing up would write when she made a blooper, “Ten lashes with a wet noodle!” and I went back and edited the post, hopefully to give it back the lighthearted feel I intended.