As a medical oncologist practicing across various healthcare settings nationwide, I often reflect on the deeply human side of medicine—the day-to-day challenges, emotional complexities, and clinical decision-making that shape patient care. One of the ways I’ve found to process and share those insights is through storytelling—offering blog readers a glimpse into the world of oncology from a clinician’s point of view.
In addition to my clinical work, I bring experience from a broad spectrum of healthcare roles: I have reviewed thousands of disability claims and health insurance determinations, served as an auditor for hospital systems to evaluate adherence to evidence-based care, and contributed expert witness opinions on hundreds of oncology-related medical malpractice cases. Internationally, I’ve served on a genomic tumor board providing guidance for complex cancer cases spanning countries like India, China, Australia, and Italy. These diverse perspectives have given me a comprehensive view of patient care—not only from the bedside, but also from legal, policy, and global health lenses. This multidimensional experience informs how I write, think, and advocate for both patients and the integrity of clinical practice.
It’s also this very perspective that gives me insight into the inner workings of many clinical environments—some of which, regrettably, fall short of the standards we strive to uphold. While this blog avoids discussing any specific institutions, my background naturally brings with it a sensitivity to patterns of care, system-level practices, and moments where quality can—and must—be improved. Having worked side by side with institutions across the country, I’ve seen firsthand how storytelling, transparency, and reflection often succeed where silence fails. These insights, shared respectfully, are never about exposing individual providers or facilities, but about raising the bar across the board.
Recently, there’s been more awareness (and scrutiny) around how healthcare professionals use digital platforms to discuss their work. That’s a good thing. It’s also a reminder of how important it is to understand and uphold the principles of privacy, especially under the Health Insurance Portability and Accountability Act (HIPAA).
What Is a HIPAA Violation—and What Is Not?
HIPAA is designed to protect Protected Health Information (PHI). This includes any data that can reasonably identify an individual, such as their name, address, date of service, or medical record number—when paired with health-related information.
A HIPAA violation occurs only when PHI is disclosed without proper authorization or safeguards. In contrast, generalized, de-identified educational storytelling is not a HIPAA violation when:
- No identifiable patient information is shared
- Names, dates, and locations are omitted or altered
- Clinical details are modified or fictionalized to prevent recognition
How I Safeguard Privacy in Storytelling
As a physician who works as a locum tenens provider across the country, I see patients in different states, institutions, and practice environments. This variability means that no story I share can be assumed to originate from a specific place, facility, or time.
To protect privacy, I follow these principles:
- Stories are modified: Key details—timelines, locations, medical histories, even tumor sites—are changed. Many stories are composites of multiple cases, drawn together to reflect common themes in clinical care.
- The focus is clinical, not personal: These stories are never about identifying or showcasing specific patients. They are about the experience of being a clinician: managing uncertainty, navigating ethical decisions, embracing patient autonomy, or learning something unexpected.
- Disclaimers are included: Each post includes a clear note that stories are fictionalized and not meant to represent real individuals.
Why These Stories Matter
Patients often tell us, “I wish I knew more about what goes on behind the scenes.” Blogs like this are one way to bridge that gap. By offering insight into the human side of oncology, we can help demystify care, support empathy, and spark reflection among patients, caregivers, and fellow clinicians.
Conditions like breast cancer, colon cancer, prostate cancer, or hemophilia are seen every day across thousands of clinics and hospitals. The goal here is not to single out any one person, but to use these universal experiences to foster deeper understanding and learning.
Having spoken at hundreds of hospitals and clinical practices across the country—and worked in both large academic institutions and smaller community settings—I’ve witnessed a wide spectrum of care quality. Every institution has its areas of excellence and, inevitably, areas in need of improvement. Some are minor oversights; others, unfortunately, reflect systemic issues that persist due to institutional bureaucracy, internal politics, or fear of accountability. These observations are not meant to call out any one place, but rather to affirm the importance of transparency and reflection in achieving better care.
In some instances, I’ve encountered providers whose clinical approach left me deeply concerned—providers I would not entrust with my own family’s care. While I don’t name names or cite specific examples, I share these stories not just as a physician, but as someone who has seen healthcare from the inside out. It’s my hope that thoughtful storytelling encourages continuous improvement, rather than quiet complacency.
Final Thought
I believe medicine is built on trust, professionalism, and a shared commitment to doing better. This blog is one small way to contribute to that mission. If you’re reading this as a patient, a colleague, know that your feedback and perspectives are welcome. And if you’re here to learn—about the science, the human moments, or how we make decisions—then I hope you’ll find this a respectful and insightful space.
Disclaimer: Patient stories shared on this site are fictionalized, modified, or composited to protect privacy and confidentiality. Any resemblance to real individuals is coincidental. This blog is for educational and reflective purposes only and does not constitute medical advice.
About the author
Dr. Sajeve Thomas is a distinguished medical professional and a compassionate guide in the field of oncology. With over a decade of dedicated experience as a board-certified medical oncologist/internal medicine specialist, Dr. Thomas has become a trusted expert in the treatment of melanoma, sarcoma, and gastrointestinal conditions. He brings a wealth of expertise to the complex and challenging world of oncology.
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