Being on the receiving end of reports about imagined misconduct has sensitized me to the misuse of anonymous event reporting systems. Health care organizations need reporting systems to identify events and behaviors that reduce safety and harm patients. Frank and honest reporting is encouraged by making such reports anonymous.

Anonymization invites abuse. A disgruntled colleague, nurse, or administrator can file an anonymous report against anyone, anytime. Since the report is anonymous, all that the presumed offender may learn is that someone was upset about something. Without facts or resources, the institution takes the path of least resistance. The reported facts are presumed to be true. The targeted physician is told to apologize and accept whatever punishment the institution doles out. Usually there is no overt punishment, other than a black mark against the physician buried in the institutional records.

Last February, I sent a note to the ASA Community Open...

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