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The Limits of Transparency

September 26, 2021
by Mark David Siegel

Hi everyone,

My commitment to transparency runs deep. If I have an opinion, I’ll share it. If I agree with you, I’ll tell you, and if I disagree, I’ll tell you too. If something important is happening in the residency, you’ll know it. That’s why we have so many town halls and committee meetings, and that’s why I write every Sunday. You deserve to know what’s going on in the program, and your input is priceless.

But this transparency has limits. Residents count on me to protect their privacy. Like any large community, many of us struggle with personal burdens, including family stresses, physical and mental illness, self-doubt, and traumas of all kinds. Helping trainees navigate these challenges and steering them to the right resources is a core part of my job. But I can only help residents if they know I’ll protect their privacy.

There are plenty of confidants to talk to besides me: MACs, APDs, trusted attendings, Chief Residents, GME faculty, YNHH Employee and Family Resources, and peers in the Call-A-Friend and DocTalk programs.* All are dedicated to helping residents, and all are committed to your privacy.

There’s a tension between transparency and privacy. We’ll tell you whatever you need to know and are entitled to hear, both good and bad, from COVID policy debates to new rotation ideas. But transparency ends when it comes to private matters like job performance, personal health, and anything someone tells us in confidence. Whether you’re a Chief or an intern, and whether you’re categorical or preliminary, when it comes to private matters, our lips are sealed. The only exceptions are rare break-the-glass concerns, for example if you’re in danger. Even then, we only share information with those who need to know and we let you know who they are beforehand.

Thriving residencies depend on a balance between transparency and privacy. Both are essential to building trust, for the program as a whole, and for individual trainees.

Perhaps I didn’t need to say any of this, but in the spirit of transparency, I wanted to say it today.

Wishing you all a peaceful Sunday, and if you’re in the hospital, pop by the MICU to say hello.

Take care,


*See the Chiefs’ ChOC Announcement each week for links to additional resources.

Submitted by Mark David Siegel on September 26, 2021