* * Anonymous Doc

Thursday, June 24, 2010

"This patient better die today. He needs to die," said my resident.

And, yeah, the patient's in bad shape, suffering, in pain, nothing we can really do, the family's just waiting for the inevitable.

"And he'd better die by 6:00, because I have concert tickets."

These are the perverse incentives created by the system.

If all of your patients die, hey, you can sign out early!

I mean, you still have to stay until 3:30, but it's a heck of a lot better than being here until 10:30 checking on blood work that's slow to come back.

Well, better for you. Not so much better for the patients.


  1. I don't have time to check back through past posts, and you may have already done this and decided it's worth the risk, but you probably should check out HIPAA. I think you're really exposing yourself to a lawsuit here. Breaks my heart a little to discourage you from writing since I'm enjoying your blog so much (and I think you actually offer some truly helpful insights), but if I was one of your patients or their family member, and I put two and two together, I'd probably be pretty pissed. And that could cost you a lot more than your job. Just ask the UCLA dude who got four months worth of jail time for infringing on patient privacy. If he'd done it more recently, he'd be risking $250,000, as well. Anyway, take it for what you will.

  2. I think literary narrative is protected as long as there is no protected information (patient's name, ss#, birthdate, age, phone, address, email) that is trafficked or released. Also, for safety's sake, probably a good idea to change a few of the key identifying details (man/woman etc) so that no family member could spot their loved one... But I'm pretty sure no laws are being broken


    "Physicians who wish to use patients’ stories without obtaining written consent must “de-identify Protected Health Information.”8 This may take the form of removing from the narrative the 18 identi- fiers that can reveal the patient’s identity. Alternatively, one can create composite patient characters or modify nonessential details to fictionalize the patient. "

    Otherwise, I think all of the Dr's columns in the NYT would also be in violation