Content of Weblogs Written by Health Professionals: More Bad than Good?

It seems like there are few (if any) positive news stories and studies about medical blogs nowadays. Most of the coverage focuses on breaching patient privacy and inappropriate product endorsements rather than on the way blogs can be used for medical education and interactive learning. As a regular reader of 30-40 medical blogs and author of 3, I am first to admit the medical blogosphere has its problems. John Sharp from the IT department of the Cleveland Clinic and I worked on institutional guidelines for medical blogs in 2005-2006 and I gave it quite a bit of thought during the years.

The most current negative story is from the Journal of General Internal Medicine and, as you may have guessed it, none of the authors seems to have a blog:

Content of Weblogs Written by Health Professionals (full-text PDF hosted by Pharmalot).

Tara Lagu, MD, MPH, Elinore J. Kaufman, David A. Asch, MD, and Katrina Armstrong, MD, MSCE.

The authors identified 271 medical blogs. Over half (56.8%) of blog authors provided sufficient information in text or image to reveal their identities. Individual patients were described in 114 (42.1%) blogs. Patients were portrayed positively in 43 blogs (15.9%) and negatively in 48 blogs (17.7%). Of blogs that described interactions with individual patients, 45 (16.6%) included sufficient information for patients to identify their doctors or themselves. Healthcare products were promoted, either by images or descriptions, in 31 (11.4%) blogs.

The authors concluded that blogs risk revealing confidential information or, in their tone or content, risk reflecting poorly on the blog authors and their professions. The health professions should assume some responsibility for helping authors and readers negotiate these challenges.

They give plenty of examples and link to 16 blog addresses. Somehow the study authors missed some of the most popular medical blogs such as Kevin, M.D., Medgadget and GruntDoc. May be because they used commonly acceptable language or were not controversial enough but, really, how can you write about medical blogs and miss Kevin, M.D.? The guy is on the front page of Google results for both "medical blog" and "medical blogs" (we are a little bit down the list but still there). Update from 07/26/2008: Dr. RW pointed out that the authors quoted one of my posts as an example to follow in the article references: How to write a medical blog and not get fired? I guess I could be considered one of the "good guys."

These are a few quotes chosen by the study authors to highlight the content of medical blogs:

“The unwritten definition of proper patient: attached to a
breathing machine, a lot of wires and completely sedated
or even paralyzed.” Adrenalin Rush

“She was a stupid, lazy, selfish woman all of which
characteristics are personal problems, not medical
issues or barriers to care” Panda Bear MD

The quotes are obviously taken out of context but they still sound troubling. However, there are many stories of great patient care, self-sacrifice and compassion published on medical blogs but somehow they escaped the search strategy of the study authors.

Tips for Medical Bloggers

- Write as if your boss and your patients are reading your blog every day
- Comply with HIPAA
- List your name and contact information
- If your blog is work-related, it is better to let your employer know
- Inquire if there are any blogging guidelines. If there are, comply with them strictly
- Use a disclaimer, e.g. "All opinions expressed here are those of their authors and not of their employer. Information provided here is for medical education only. It is not intended as and does not substitute for medical advice."
- Get your blog accredited by the Heath on the Net Foundation

References:
Content of Weblogs Written by Health Professionals. Journal of General Internal Medicine.
Doctor Blogs Reveal Patient Info & Endorse Products. Pharmalot.
Why Physician Blogs Close Down?
Topics Discussed During the Medicine Consult Service Rotation at Cleveland Clinic in March/April 2008
Dr Flea Blogged His Malpractice Trial, Settles When Outed
Using a Blog to Build an Educational Portfolio
Medical Blog Closed Down by Request of Employer
NPR: Doctor Blogs Raise Concerns About Patient Privacy
Simply Fired - How NOT to Blog About Your Job. Especially If You Are a Doctor

Related:
Should physician blogs be held to a higher standard? Kevinmd.com.
Medical blogosphere subject of Journal of General Internal Medicine study. Notes from Dr. RW.
Another medical journal piles on. Notes from Dr. RW, 08/2008.
What is a blog? Robert M Centor, 08/2008.

As A Busy Physician, Why Do I Even Bother Blogging? http://goo.gl/fSF3 - Excellent summary.

Updated: 08/07/2008