1 Comment

Anonymous concerns have long allowed those afraid of retaliation to speak truth to power in the public space. Our founding fathers, like Thomas Jefferson, used pseudonyms so that leaders would face arguments and issues on their true merit without being able to discredit individual authors who could be written off for their politics (disgruntled employees?). Such authors also feared that audiences may question the sincerity of their motivation (fame? publicity? power? the jobs of UVA Health senior leaders?) if they signed their name. Sometimes they were worried about their safety—indeed, state universities do operate with relative impunity, having the backing of multibillion dollar endowments and government resources.

That is an extreme power differential unless the affected groups have similar resources. Thus, it would be all that much more unfortunate if UVA Health senior leaders write off their doctors and nurses as a disgruntled or untalented few, particularly to their Board or community donors.

Consultants have made a serious error in encouraging academic health systems to achieve “alignment with senior leadership.” Alluding to “peer best practices” can lead to conformity, especially if grading things that are undeniably subjective (ASPIRE?). Groupthink can be a form of tyranny in organizations that harms them in the long run.

Anonymous criticism can be essential and productive, especially if recipients genuinely have their own behavior and decisions to blame for people’s desire to be anonymous.

Expand full comment