Electronic letters to:

Salon:
Mark Otto Baerlocher, MD and Allan S. Detsky, MD
Online medical blogging: don't do it!
CMAJ 2008; 179: 292 [Full text] [PDF]
*eLetters: Submit a response to this article

Electronic letters published:

[Read eLetter] Medicine 2.0
Gunther Eysenbach   (21 August 2008)
[Read eLetter] Medical blogging
James Logan   (8 August 2008)
[Read eLetter] Doctors Should Be (And Are!) Blogging
Jude M. O'Reilley   (8 August 2008)
[Read eLetter] What is a blog?
Robert M Centor   (5 August 2008)
[Read eLetter] Perils and joys of blogging
Pat Letendre   (29 July 2008)

Medicine 2.0 21 August 2008
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Gunther Eysenbach
UHN, Centre for Global eHealth Innovation

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Re: Medicine 2.0

geysenba{at}uhnres.utoronto.ca Gunther Eysenbach

I like the article [1], but not the title. Do it - but responsibly. I think / hope that some of these issues will be discussed at the Medicine 2.0 conference in Toronto. There will be a medical bloggers panel at the conference
The idea of developing guidelines is interesting, though a Medical Bloggers Code already exists [2].

Reference
1. Mark Otto Baerlocher, MD and Allan S. Detsky, MD. Online medical blogging: don't do it! CMAJ 2008; 179: 292 doi:10.1503/cmaj.080757.
2. Healthcare Blogger Code of Ethics. http://medbloggercode.com/the-code/. Accessed: 2008-08-20. (Archived by WebCite® at http://www.webcitation.org/5aDEkONrK)

Conflict of Interest:

None declared
Medical blogging 8 August 2008
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James Logan

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Re: Medical blogging

james{at}jamesloganmd.com James Logan

The title of your article, "Online medical blogging: don't do it!" would seem to suggest that you feel "offline" medical blogging is ok. Sure, technically it's not a "blog" if it's done offline, but the content may be exactly the same. Doctors have been publishing fiction, nonfiction, commentary and editorial pieces in various forms of offline media for decades. It seems to me that what you intend to criticize is the content of some particular medical blogs rather than the entire practice of medical blogging. After all, by writing for an online medical journal, the authors themselves have now joined the medical blogosphere!

Conflict of Interest:

I blog at http://www.jamesloganmd.com.
Doctors Should Be (And Are!) Blogging 8 August 2008
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Jude M. O'Reilley
Trusera, Inc.

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Re: Doctors Should Be (And Are!) Blogging

jude{at}trusera.com Jude M. O'Reilley

In response to your recent article "Online Medical blogging: don't do it!" you argue that physicians should not blog about their profession online.  As member of the health technology community and an avid reader of health-related blogs, I disagree. The continued relevance of the medical establishment relies on actively engaging with patients online.

There's no doubt, there are risks to living online. Loose lips on the telephone or golf course are one thing; on the Internet, your comments go on your permanent record.  The business world is replete with examples of people failing to recognize this fact.  No doubt the medical world will be, too.

However, there's also enormous good being done by medical professionals online.  They are relating the personal experience of the profession, giving their candid assessments of health and healthcare, and engaging with patients in a whole new way.  They are doing this on personal blogs like Emergiblog, Running A Hospital, and Reflections in a Head Mirror and on online health networks like Trusera.  These sites create a conversation between doctors, nurses, and patients that's vitally important.  Done wisely, health blogging is a place for both health professionals and consumers to gain in knowledge and empathy. 

The AMA famously and vainly warned consumers in 2001, "If you have a question, trust a physician, not a chat room." This advice missed the point of the Internet tools of the day while it patronized health consumers.  Doesn't your advice risk doing the same to health professionals today?

Sincerely,

Jude O'Reilley
www.trusera.com

Conflict of Interest:

I work at Trusera, an online health network that enables people to share health experience.
What is a blog? 5 August 2008
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Robert M Centor
UAB

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Re: What is a blog?

rcentor{at}uab.edu Robert M Centor

Drs. Baerlocher and Detsky have made an interesting observation, but they have titled it poorly. I suspect that they have not spent much time reading medical blogs.

As blogger for over 6 years, I have never had an entry that resembles their example. Rather my blog focuses on the big ideas in medicine -

  • what is quality?
  • what is professionalism?
  • how does our payment system impact health care delivery?
  • what is the impact of residency "reform"?

I do sometimes include patient stories, but only for the purpose of discussing diagnostic issues.

The world of blogging is quite diverse. I agree with the authors that the type of blog in which one vents about problem patients, with enough information that one could identify the situation, is unprofessional. However, I strongly believe that the best medical blogs represent the 21st century version of Hyde Park, in which we explore ideas and present our opinions on the issues of the day.

Conflict of Interest:

I am the author of DB's Medical Rants
Perils and joys of blogging 29 July 2008
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Pat Letendre
Medical Laboratory Science, University of Alberta

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Re: Perils and joys of blogging

cyberbloodbanker{at}gmail.com Pat Letendre

The authors write a thoughtful piece on blogging about the practice of medicine and identify three issues: professionalism, freedom of speech, and self-protectionism. Their example could be extended to the practice of health care and other health professionals.

Clearly, confidentiality, privacy rights, and professionalism preclude "naming names," and, despite freedom of speech, the safe thing to do is to say nothing in an electronic age that facilitates widespread distribution with a near eternal shelf-life.

Emotion-laden blogging to relieve frustration is folly. But consider blogs that express informed opinions about health policies, educational practices, recruitment issues, emerging ethical issues, the realities of professional practice for those thinking of joining the profession, and more. Is all expression to be shut down in the name of self protection and the more high-minded rationales that will surely be front and centre should such recommendations come about?

Blogs are diverse and can be defined in many ways but tend to have certain characteristics in common.

  • They express personal opinions, much like op-ed pieces in newspapers, and are snapshots of how a person thinks at a given time.
  • Blogs are also conversations, not monologues, with comments encouraged.
  • Blogs are public, leading bloggers to ponder what they should put "out there" for eternity about themselves.
  • Blogs allow the transmission of experience and knowledge that is seldom found in journals and textbooks.
  • Above all, blogs are democratic. Anyone can blog and it is the quality of ones ideas, not who you are in the professional pecking order, that counts.

Expressing opinions about professional practice can be argued on the basis of the most appropriate forum for such ideas and related concepts of confidentiality and professionalism. But surely self-protection, although a real factor, is the least justified. I am reminded of this quotation by the American author Elbert Hubbard (1856 –1915):

  • "To avoid criticism do nothing, say nothing, be nothing."

Disclosure: I have a blog Musings on Transfusion Medicine

Conflict of Interest:

None declared