The Anonymity Credibility Conundrum

I promise this post is not about the AMA CEJA report. Just bear with me for a moment or two.

A few weeks ago, Daniel Carlat, MD – noted critic of industry-supported CME – wrote a post on his The Carlat Psychiatry Blog about the reaction of the CME community to the passing of the latest AMA CEJA report. Having been mentioned in the post, I was most interested in reading the comments from his readers. What I found most curious, though, was that of the 10 comments posted, 4 of them were anonymous (possibly all from the same person).

That same day, CME superhero CME Hulk tweeted the following:

Despite his protestations to the contrary (quote: “CME HULK IS CME HULK”), whoever is tweeting as @CMEHulk is tweeting anonymously.

Monday, amednews writer Kevin B. O’Reilly posted this provocative piece on doctors who blog or tweet behind a cloak of anonymity (and those who don’t).

Later that afternoon, completely unrelated to that post, I was part of a LinkedIn group discussion about why more people in the group did not contribute to discussions. One concern raised was the lack of anonymity involved and fear of possible repercussions based on contributions and opinions.

I have mixed emotions about those who blog/tweet/comment anonymously, clinicians or otherwise. On the one hand, it certainly empowers individuals to freely speak their minds, especially those not naturally prone to do so. I’m in favor of anything that leads to a free and healthy exchange of ideas and opinions. Also, a lot of these anonymous contributors are just plain funny. Tweeters like @CMEHulk, @docgrumpy, and @BurbDoc wouldn’t be nearly as entertaining if we knew who they were. I lost complete interest in @BronxZooCobra when I found out it was Ryan Seacrest.

On the other hand…well…to be perfectly honest…anonymous posting is the easy way out. How much courage does it take to stand up for what you believe in if no one knows who’s taking the stand?

As I read through those anonymous comments on Dr. Carlat’s blog – a large portion of which I agreed with – I found myself annoyed at whoever posted them. I felt that they were making valid points, but losing credibility because of the manner in which they were posted. One commenter criticizes Dr. Carlat for what he or she perceives as a lack of disclosure and transparency on Dr. Carlat’s behalf. I actually laughed out loud at that one. How can you critique someone else’s transparency when you yourself don’t have the guts to reveal your name?

When I started this blog back in the spring, I briefly flirted with the idea of doing it anonymously, for all of the reasons already mentioned. I wonder how it would be different if I had done so. I’m sure I would be harsher in my criticisms, more blunt with my opinions, less willing to pull punches. I still have moments when I crave the freedom to write completely and totally what I am feeling.

I started to think about the types of things I would write that I would want to be anonymous. If what I’m writing is so harsh, so controversial, or so mean that I wouldn’t want my name attached to it, is it really worth sharing?

In the end I decided it wasn’t, and I’m glad I chose the route I did. I believe it has made me a better writer by causing me to thoroughly think through my arguments and research my opinions (it hurts a lot more to be wrong when everyone knows it is you being wrong). It has made me more confident in expressing my opinions and more willing to do so verbally (it’s always been easier for me to express myself through writing than through talking). And sure, there’s a bit of self-indulgence involved, too. If I write something I’m particularly proud of or that gets a good reaction from others, I can say “I did that!”

Have an opinion, share it, discuss. And just as importantly, be yourself.

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10 responses to “The Anonymity Credibility Conundrum

  1. I agree with your analysis of anonymity. Like you, when I am tempted to participate or contribute anonymously, I have to carefully consider my motivations. Sharing my identity always wins in the end. Anonymity removes the context and perspectives of the speaker (assuming we know at least a little about them)–cues we normally use to help us assess motivations, opinions and shared comments in a more meaningful and helpful way. In my opinion, anonymity leaves unanswered questions that reduce the value of the comments made.

  2. I certainly think twice about every post or comment I leave. Even then, the mere fact that my face or name is next to whatever I write; that fact has stopped me far more often that perhaps it should.

    • You’re right, Susan, the same has happened to me. When I first started writing this blog, my heart was in my throat every time I hit the “publish” to reveal what I had written for all to see. I had to learn not to think about it too much and just do it. Even now, it’s still not easy. Having your name next to whatever you write is not easy…

  3. I consider being anonymous quite often- not because I don’t believe in what I’m saying, but because my current or previous employers might take what I’m saying out of context. I have experience from which to draw, but it’s also been my experience that the world of CME frustrates the hell out of a lot of people. They don’t understand, therefore what I say may reflect badly on them, even if it’s an open discussion about CME planning and processes. This whole issue of “perceived bias” is a perfect example like that. It’s a game of telephone. Admittedly, I can be pretty blunt and I don’t live in an ivory CME tower like some.

    There’s my role as a CME professional (independent of any organization- just me) and my role at whatever organization I’m working at. If an employer were to do a quick google search for my name, and my name is attached to comments, it could get me in trouble for something that is outside of the purview of my employer. Some employers like to keep a VERY tight rein on what comes out of their employees’ mouths, even if they are speaking as an independent person and not a part of the company. That fear could hinder my ability to have a discussion about something I care about.

    By the way, is that your hand waving that flag in the picture?

    • I hear you, Pam. I have personal experience with negative reactions as well. Not fun. But I’ve found the positives ultimately outweigh the negatives.

      And yes, that is my hand. With my files from my last ACCME reaccreditation (there may have been a few liberties taken via Photoshop…).

  4. I have wavered back and forth on the anonymity thing, too, and for a long time. It’s always been an issue for writers and editors–remember Deep Throat? Especially at Medical Meetings magazine, it can be like pulling teeth to find people on the pharma side who can speak candidly (or at all without the legal department blessing every word). CME providers too worry about speaking their mind in interviews for fear that their employers or ACCME or whoever will retaliate. The internets just take it to another level, I think.

    For me, I almost always put my name on whatever idiocy I’m passing off as commentary, for the same reasons you mention. Then again, I’d rather laugh with @CMEHulk et al than not, so if they need to hide their inner Bruce Banner, I’m OK with it.

    • Interesting point about getting people to speak to Medical Meetings magazine, Sue. One of the frustrations I have with reading about CME in the press – and I would say mainstream press is more at fault with this than MM – is that you can always count on quotes from the same people. There’s usually a quote from Murray Kopelow; sometimes one from whoever is Alliance prez at the time; a prominent quote from one of the anti-industry funding guys like Nissen or Carlat; and a quote from Tom Sullivan. I don’t have an issue with any of them being quoted, it would just be nice to hear someone else’s voice chime in. I never thought that the reason for the lack of variety might be because others wither can’t or won’t talk. If that’s the case, it’s a shame…

  5. Another thought: If Google+ takes off, it could be a game-changer on this issue, too. You could share your thoughts only with those you know are “safe.” But then we risk turning our circles into echo chambers…be curious to hear what you think about how being able to be more selective about receivers will affect the senders.

  6. Well, the kinds of stories that make it to The New York Times are generally ones that need the “voices of authority” (Dr. Kopelow, the Alliance), plus a pro and a con (Sullivan and Carlat/Nissen). I have to do the same when we cover those topics. Plus, once someone becomes known as willing to talk with the press, it’s the easy route to call on the same people instead of cold-calling dozens to find one who a) has something to say on the topic, and b) will let you quote him/her. I end most interviews asking who else I should be talking to about this, which sometimes does lead to new voices.

    Being more involved in the industry and having gone to more CME meetings than most general reporters, I have a slightly deeper well of contacts, but I admit I do still end up relying on the same people all too often–when you have someone you know can/will talk, and will have interesting things to say, you want to get that person into the story. I’m always on the lookout for the next crop of CME leaders to emerge so I can start hounding them instead of the tried-and-true folks.

    Social media has made it easier to find some new voices (for example, Pam wrote a column for us a while ago and let me include her comments in a story, and I’m hoping to get her to write some more), but even those who are willing to opine on the LinkedIn CME group often don’t want to be quoted in print. I’ve been known to cold-call readers on the hopes that they’d have something to say on a topic, but that is not the best use of anyone’s time.

    It is a constant challenge. If you have any suggestions, I’d love to hear them.

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