transparency

Well, I'm back after a bit of hiatus, due to weather. Yes, weather. It's monsoon season in the Southwest, and often during these bouts of turbulent weather, we lose our internet service. We're also getting a Walmart, and the construction has frequently interfered with our internet service, our phone lines, and our power. Today, for example, I nearly fell onto an infant because the lights went out right as I was walking into an exam room where an infant was sleeping peacefully in his car seat on the floor. One of my colleagues, a dentist, was drilling in a tooth when the lights went out! Bummer! I'm really glad I was not her patient at that moment.

I've been enjoying reading another blog, http://www.ruraldoctoring.com/, written by a family physician in rural northern California. I find her posts interesting and relevant to my work. Recently, she discussed transparency, as it pertains both to medicine and to blogging. Every time I write a post, I think about HIPAA and about my own privacy; I know that I feel like I am exposing myself, my thoughts, etc. But Dr. Chan makes an important point in her writings: "The goal of transparency is a greater common understanding of how processes work, so that special interests and self-promotion cannot corrupt the system." I agree that by writing about medicine and how it affects our lives, we are not only promoting understanding, but we are promoting our humanity. One of my colleagues here who is a physician's assistant told me that I always seem confident when I talk about my patients or when I answer her questions about pediatric patients. This surprised me, as I am most definitely not always confident; I worry about my patients, often waking up at 3am thinking about one or two particular kids, second-guessing myself. I know I'm not alone in this. I am acutely aware of my responsibility practicing in a rural area, however, because if I miss something, it's a really long way to a proper hospital facility. I have learned to be honest with my families, and I frequently ask them to come the next day and the next day and so on if I am unsure of where an illness is going. They too, I think, understand that when I do that, I'm trying to do the best for their child, either by closely monitoring therapy, or by following a fever to determine whether an antibiotic is needed or can be avoided. I sincerely hope that the patients whom I serve feel that I practice in a "transparent" fashion, just as I try to write these posts with candor!