Drawing on the performance appraisal and medical literatures, we examine representative ethical issues involved in current appraisal practices of individual physicians: the use of invalid and unreliable measures; organizational goals conflicting with patient health goals; using individual measures for what are group performance results; making individual attributions for what are systemic causes (and results); and using clinical feedback for organizational purposes. Suggestions for developing more ethical performance appraisals include reflecting upon the multiple purposes and means of appraisals, and the limitations (...) of current practices. Greater understanding of the effects of current appraisal practices on physicians can help minimize its potentially adverse consequences on the delivery of quality healthcare. (shrink)

Clinical photography is an important tool for medical practice, training and research. While in the past clinical pictures were confined to the stringent controls of surgeries and hospitals technological advances have made possible to take pictures and share them through the internet with only a few clicks. Confronted with this possibility I explore if a case could be made for using clinical photography in tandem with social media. In order to do this I explore: if patient’s informed consent is required (...) for the publication of any clinical images that depicts her, irrespective of whether the patient can be identified from the image or not, if social media is an adequate place for clinical images to be displayed, and finally if there are special considerations that should be taken into account when publishing clinical images on social media. (shrink)