Two items recently caught my attention. On a global level, Wikileaks has stopped undertaking their core business of making government documents transparent through publishing them on the Internet. Their reason – lack of money. The cause – the major credit card companies have refused to process on-line credit card contributions in support of their work. Why? The credit card companies received pressure from the US government and other governments which effectively applies an economic blockade against what they perceive as an on-line security “threat”.
The second more personal story is from a nurse who wrote an op-ed piece for a paper that was critical of the quality of service provided in a Canadian emergency department. The reaction was swift with intimidation from peers, reprimands from managers, and a formal complaint to their provincial professional licensing body.
Some countries, provinces or organizations have formal policies to protect ‘whistleblowers’. That act of disclosing what many know, but few are willing to state for fear of retribution. Given the two real recent examples, the fear of retribution appears justified, irrespective of the legal protection that may exist.
The nurse appears to have been informally vindicated by their professional body but I worry that the personal impact will negate any further attempt by them to rectify similar wrongs.
This blog is in part designed to provide a forum for sharing public health truths, perhaps a veiled attempt at some whistleblowing combined with a forum for discussing current controversial public health events. There is a level of anonymity to the writer which provides a thin layer of separation from what occurs during the public health professional day to the nighttime efforts of sharing shadowy truths. I’ve had my knuckles wrapped enough times to know that it hurts, and that the fingers still work the next day. I’ve not yet had my hands cut off, but I have seen public health people who have suffered the consequences of speaking openly including amongst others - Alberta’s current leader of the opposition Dr. David Swann (speaking out on climate change issues in Alberta) and the past chief MOH in Ontario Dr. Richard Schabas (speaking out on government policy changes). Their stories, and those of others speak to the fine line that we walk daily.
A word of advice, if you feel a need to disclose something, be sure that you:
1. Discuss the matter with trusted professional peers.
2. Advise those that you are accountable to of what you intend to say, and how. Governments and big health care organizations are used to criticism; they do prefer not to have any surprises.
3. Invite the input and suggestions of those that may deem the information potential problematic, there may be a middle ground that meets your needs in a way that meets their needs.
4. Where needed, engage in a conflict resolution mechanism that can be mutually beneficial and meet a need that improves the health of those that we serve.
As I am reminded by friends, it is very thin ice that this blog has wandered on. It is however ice that is worth skating across for the time being.
If you have a story to share, or public health “truth” you would like revealed, email me at drphealth at gmail.com.
I for one very much appreciate your skating technique!Remember in "It's A Wonderful Life" that if you fall through the ice, people who care about you will pull you out, it will change and in fact improve the way others live, and you will become a hero of the health care war.
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