Sleep Deprivation, Blogging, and Anonymity

Last week a guest post on KevinMD by Felicity Billings, MD suggested that attending physicians should have restrictions on the hours they work. She recounted a story about a presumably tired cardiac surgeon (“Dr. Lewis”) who had been awake for more than 24 hours. An anesthesiology fellow, she wanted to tell his next patient how tired he was but did not. Fortunately, the case went well. She stated, “All the research has shown one thing: sleep-deprived doctors are bad doctors.” This elicited several comments including one from me pointing out that all research has shown no such thing. In fact recent papers have found that there is no difference in the outcomes of complex cardiac and thoracic cases done by sleep-deprived surgeons.

Today amednews.com posted a story entitled “Anonymous posts: Liberating or unprofessional?” by Kevin B. O’Reilly. It’s an interesting look at the controversial subject of anonymous blogging and tweeting. I was interviewed for the piece and explained why I prefer to remain anonymous. 

So what do these two events have to do with each other?

I Googled Felicity Billings, MD and found out many things. She works at Brigham and Women's Hospital in Boston. She blogs at “One Case at a Time.” She has written many other posts with rather detailed patient information which she apparently feels she has de-identified adequately. In one instance and to her credit, she obtained permission from a patient and his sister to write about his case.

When I first started blogging, I expressed my concerns regarding such detailed posts involving patients. I pointed out that a smart plaintiff’s attorney could ask a physician if she blogs or tweets. If she says “yes,” I believe everything she has written would be discoverable. Just imagine for example that a patient who had the heart transplant surgery had a late complication and in the deposition phase of a malpractice suit, it came to light that the subject of her post, “Dr. Lewis,” had been awake for 24 hours before doing the surgery.

I choose to blog anonymously for the reasons stated in the amednews.com article. I have avoided writing patient-specific blogs and tweets, because even if de-identified, they may come back to haunt me.