Tuesday, 10 August 2010

Another One Bites The Dust

First Medic999, now NeeNaw. There seems to be a trend appearing here. No-one comes out and says why. Not in so many words. We all know why we write. I can guess why some of us stop. Pressure. Pressure from above, to stop giving away our sectrets. To stop giving away the secrets of those we serve - our patients. Confidentiality is one of the cornerstones our our professions - without it, no-one would ever trust a doctor or health care professional again.

I believe strongly in confidentiality. Mrs RRD could tell you a thing or two about being the wife of someone who holds as a sacred secret anything they find out in the course of their work. It wasn't easy for her at first; the cryptic phone calls from friends and family, asking for advice, or occasionally for a visit. And she hears nothing! Our friends don't always get it either. "Didn't your husband tell you I was really ill?" they ask, expecting her to know all about their ailments, expecting her to be party to their secrets.

And why do you, Constant Reader, come back for more? Isn't it the same need to know, need to see, that makes people slow down to gawp at accident victims? Do you think I don't slow, even if I know that I can do nothing? Even while on holiday these past few weeks, I would casually wander past a parked ambulance, "just in case they needed some assistance." Some assistance, my foot!! I just want to know what's happening. I'm nosey, just like everyone!!

I think I do quite well in my blog. I don't breach patient confidentiality. Some bloggers retain anonymity, and so have little problem with confidentiality. That was how I started out, but it soon became apparent to many out there just who I was. So I had to change tactic, and modify the stories, so that they became just that - stories. Sure, someone who was there may think they recognise a patient or an event. But they don't. I change enough so that it is not possible to discern which patient I am describing. Some are recent; others far less so. And remember, I have been a BASICS Doctor for nearly 10 years, and a HEMS Doctor before that. So I have a lot of cases to call upon.

But it is still a risk. If someone thinks they recognise a case, that might be enough to cause trouble from one's seniors. And, I guess, that is where I have an advantage over my ambulance colleagues. Up until now, I haven't really had a boss, when it comes to my prehospital work. I am tasked by the Ambulance Service, but I am not employed by them. That is, I wasn't. There is a change afoot in London. We will all have contracts with the London Ambulance Service, a contract which, I have no doubt, will have a clause somewhere about keeping confidentiality. And, at that point, I will be in exactly the same situation others have found themselves. And I will need to have a long, hard think...


  1. The reason I keep coming back to read what you write is because first and foremost I want to know how you are. Your writing is really quite compelling and I freely admit that reading some of the cases you describe is interesting to me, mainly because I learn such a lot.

    Since talking on that thread that turned into a mammoth comment conversation I feel as though I've let you, and of course your other readers, in on my life. Maybe you don't know my real name or anything but actually you know an awful lot about me.

    Usually I don't let people in. This time I'm glad I did.

  2. MrsInsomniacMedic read the above with a knowing acknowledgement. Confidentiality becomes practically a way of life to us. It's sad that those in the higher echelons are still so scared of their own shadows that they are missing a great opportunity to showcase the job we love. They have at their (our) fingertips the best publicity and chance at public education possible, and yet misunderstand the intentions of bloggers everywhere. Shame.

  3. Same confidentiality problems happen for clergy, but it is often easier to disguise or adapt. Tricky but worth it. Thanks for sharing.