Thoughts on Medical Blogging

In this week that has seen the departure of three of my favorite medical bloggers from the public blogosphere (Fat Doctor, Flea, and now today, Dr Dork), it’s reassuring to learn DB’s Medical Rants is five years old today. (via Kevin, MD.) What’s even more reassuring to me is that Dr Bob is not anonymous and that his blog seems not to have led to any problems with his job as an academic physician.

Which leads me to comment on the doomsaying going around the medical blogosphere. I for one do not think that the medical blog is an endangered species. Sure, we’ve had a rough week. But we’re just getting started, folks. Because we are so new (except, it seems, Dr Bob), we’re having some growing pains. Painful as they may be, this is what it feels like to be on the forefront of something new.

And so we are all learning as we go. Because of the nature of what we are doing, the entire learning process is public. Which is not so good for the bloggers who’ve been hurt, but good for the rest of us.

Here are just some of the things I’ve learned these past few months from my fellow blogger’s experiences.

Employee Blogging

Blogging about one’s workplace or one’s colleagues is risky business, whether we are doctors, Google employees or bookstore clerks. Just because we are doctors does not mean we are immune to censure by our employers. I’ve thought a lot about this.

I do think, however, that being doctors gives us more protection than most employees from being fired for our blogs, don’t you?

Patient Privacy

Concerns about patient privacy are very, very real. And the disclaimers we put on our blogs may not be enough to reassure the public that they will not see themselves discussed on a blog someday. I don’t know the answer to this one, except that I find I am uncomfortable blogging about a specific patient without asking her permission. I’ve talked about this before, too.

Self-editing

Because we do not have editors, we must rely on ourselves to self-edit. Remember the old adage “count to ten”? Perhaps we need something similar. Like “Save it as a draft for 24 hours, and if you still feel the same tomorrow, post it.”

Maybe we should take advantage of our relationships with one another and ask for a little peer review once in awhile. If you’re worried something may be over the line, send it on to a fellow blogger you respect and ask their opinion before you post it. I for one would be happy to peer-review anything you’all want to send me, if only for the joy of getting to read it before everyone else does…

Shop talk

We are also learning that our rants can be interpreted by some as disrespectful to patients. And that “shop talk” commonly heard in the doctor’s lounge may not be appropriate when blasted throughout the blogosphere.

This is where private blogs may provide the “doctors only” locker room forum that we all need occasionally. Therefore I am hoping to get an invitation from Dr Dork to read his private blog and to visit Fat Doctor at her new invitation-only blog whenever she decides to re-enter the blogosphere…

The sad thing is that these private blogs will deprive the rest of the world of the opportunity to get to know these incredible individuals. And that is a damned shame.

Mean commenters

Some people out there who choose to comment in our blogs can be mean-spirited, foul mouthed and cruel. Just take a peek at the comments section over at Dr Wes’s blog after I asked him a simple question about a new test that my brother has been asking me if he should have. (I’m sorry, Dr Wes, to have stirred up so much annoyance for you…) This sort of cruelty led Dr A to take a blogging hiatus recently, although I am pleased that he is back. And now Neonatal Doc is on a blog-break for similar reasons.

I don’t have an answer for this one except to say “Neonatal Doc – come on back already!”

Anonymous or not?

This, of course, is the question that plagues me the most. Anonymity brings a certain freedom, doesn’t it? But I am beginning to believe that freedom is really just a false sense of security. After all, it is not freedom to say whatever we want without repercussions. It is not freedom to talk about others in public without them ever finding out. It is not freedom to say the first thing that comes to our heads without stopping to ask ourselves “Will I be sorry for this later?”

I’m beginning to side with Dr Rob that we should be willing to name ourselves. (His recent post “I am a blogger. I am a doctor” is a must-read for any new medical blogger.)

Revealing my identity makes it harder for me to fall into the “chat room” mentality that uses anonymity as a springboard for behavior that would never happen if my name was known. What I say, I stand behind. If I say something offensive, they have the right to challenge me. If I am wrong, I will say so and make the correction and/or apologize.

My partners know I blog. My staff knows I blog. My wife and my Mom know I blog. If my patients ask, I give them the URL of my blog. I am me on my blog – faults and all. Some people out there seem to think that medical professionals aren’t just normal people. Thanks to the “professionally offended,” we are losing voices of real people doing hard jobs.

 

I have been “outing” myself almost daily these days to patients who want to know more about what I may think on a certain issue. I’ve been holding back from telling colleagues, more so because most are not as into the internet as I am and probably don’t even know (or care) what a blog is.

To be honest, the main reason I haven’t made my blog public is that I hate my photo on our medical center’s website, and figure that if I reveal who I am, someone will google me and see that horrible picture…

Are there any Agreed Upon Standards for Medical blogs?

Thanks to Walter at Highlight Health for pointing out the existence of the Health on the Net Foundations “Code of Conduct” for medical websites. Bloggers that meet HON’s standards can apply for their accreditation. (Anonymity runs counter to the code).

Final thoughts

I want to personally thank Barbados Butterfly, Fat Doctor, Flea, Dr Dork and Neonatal Doc for the opportunity to read their amazing blogs. Their departure has left a gaping hole in the fabric of our blogging community. I hope that together we can re-weave it, but this time with threads that are strengthened from their experiences.

I also hope those who have chosen to leave the blogosphere will consider returning after they have had time to recover and reassess. Because we need their voice.