Hmmm... The way that I see it is that if the patient reads this and recognises themself then it isn't a breach of confidentiality if no-one else can tie my description to that patient. It's a bit of a balancing act, but some things are seperated by time and I always remove all distinguishing marks. It kind of ties in to the 'How to blog without losing your job' post (that you can find on the sidebar).