This session is about more than HIPAA violations. Being a physician or a physician-in-training involves loyalties on a number of levels. We have moral obligations to ourselves, to our patients, to our colleagues, and to the community at large. Sometimes, what we want to say on behalf of one group conflicts with the interests of the others. When writing, we don't get to choose our audience; the words are open to all. How can we say something meaningful that serves a community's greater interest without compromising our professional loyalties or damaging our reputation among our medical peers? Or, how can we reflect upon the profession in a constructive way that doesn't alienate the public or further erode the trust between patients and their doctors? Medicine is a tight-knit community where--like it or not--reputation matters and self-policing reigns supreme. Criticism is not always received well, even if it's kept internal. If information is broadcast to those outside the profession, the author can be perceived as anything from less-than-serious to a liability to the profession's image. (Neurologist and best-selling author Oliver Sacks has been criticized as "a much better writer than he is a clinician" and "the man who mistook his patients for a literary career.") There is currently only vague policy and precedent with regard to social media and blogging. "Use common sense" seems to be the theme, but, as we've increasingly witnessed, the boundaries of that "sense" vary widely among physician writers. What kind of balance can be struck to write substantially, professionally, and honestly?