Sunday, March 18, 2007

Blogging, general -On Blogging and the Self Escaping into the Open

Early each morning I have a ritual.

• I enter my daily blog,

• check my email,

• down a cup of coffee,

• read the health care news in the Wall Street Journal and the New York Times, • turn to – the reigning queen of health news aggregation and analysis web sites.

On occasion, I visit the websites of two rival health news sites --, “the healthcare industry’s daily monitor,” and, “specialized business information for health care managers.” Site

Each week day the healthleaders site displays feature news stories. Today, March 16, I glom onto the site because my article “Pay for Performance and Quality Outcomes: Buzz, Metrics, and Human Nature” made its maiden appearance as the lead story. Bringing attention to my Healthleaders piece isn’t why I blog today. I blog because a Healthleaders newspaper story this day from The Detroit Free Press, dated March 14, is entitled “ Is Doctor Blogging Too Much of a Risk?”

Do Doctors Blog Too Much?

The Detroit Free Press news piece tells of doctors who may divulge too much about patients, including graphic and gruesome clinical details. Critics fear doctor bloggers may be breaking rules of confidentiality and tenets of HIPPA (Health Insurance Portability and Privacy Act)– that aptly named government generated bureaucratic hippopatmus designed to protect patient privacy.

No Blogging Ground Rules

The news story goes on to say no blogging ground rules exist for what’s acceptable. It quotes a neonatologist, now getting 800 hits a day after saying,

“I don’t mind it so much when a young single woman comes in with her first pregnancy because anyone can make a mistake. But when the young woman gets pregnant repeatedly, time after time, she degrades herself and her children, condemning herself and them to a life of dependency and irresponsibility.”

Offending Some, Pleasing Others

Although the neonatologist blogger didn’t reveal names or further clinical details, his message offended some, including secular progressives who believe anything and everything goes, and blogs are no place to cast moral judgments. Other observers said they saw no evidence doctor bloggers were breaking moral codes or violating HIPPA rules, or saying things out of school that should not be said.

One doctor-blogger-friendly soul commented,

“People forget doctors are people. There’s a tendency to think they’re either God or people who just want to shove pills down your throat. When you’re in their blogs, you see they’re real people. Also, in these blogs, comments are open. If you have a concern, you can easily leave a comment. It’s a wonderful way for patients to have access to doctors.”

Blogs as Springboards for Physician Creativity

Blogs are also great springboards for unleashing physician creativity – for revealing latent gut feelings about the real world behind those white coats. Physician blogs sometimes remind me of this passage from The Elements of Style by William Strunk and E.B. White (second edition, McMillan Publishing Company, 1972)

The mind travels faster than the pen. Consequently, writing becomes a question of learning to take occasional wing shots , bringing down the bird of thought as it flashes by. A writer is a gunner, sometimes waiting in his blind for something to come in, sometimes roaming the countryside to scare something up.”

That’s a good definition for medical blogging, in essence a form of health care gunning.

White proceeds to take this wing shot.

Every writer, by the way he uses the language, reveals something of his spirit, his habits, his capacities, his bias. This is inevitable as well as enjoyable. All writing is communication, creative writing is communication through revelation – it is the Self escaping out into the open. No writer can remain long incognito.

The Inevitable Concluding Verse

The last quote leads inevitably to this perverse verse:

There once was a prolific medical blogger named Al Frito,
Who tried methodically and doggedly to remain incognito.
He fought to conceal his inherent bias.
He sought to reveal himself as pious.
But try as he may, in his blog, his basic bias
he could not pocket veto.


Dr. Val said...

I think medical blogging is a window into the healthcare soul... it's a wonderful, democratic way of engaging patients and professionals in the important dialogues that don't always happen in the examining room. However, I do believe that great care should be taken to protect patient anonymity. Details must be altered to make it impossible to discover the true identity of patients described in blogs.

jscherger said...

I'm the Men's Health blogger for Revolution Health, but I continue to have mixed feelings about blogging. One the positive side, it is rapid publication of thoughts and ideas. Health care publication has been a painfully slow process, undertaking by the few who tediously go through the process of submission, peer review and eventual publication, long after you thought about what you wrote! On the other hand, blogging seems like "talk radio". It is spontaneous expressions by the many. Lots of noise to me. Who has time to read it all? I wonder who the people are who still have time after squeezing in their emails for the day, actually read blogs? They must never excercise, enjoy a relaxing meal, meditate or do the other finer things in life! Great blogs have been pivotal and timely for sure. If only we could separate the pearls from the sand.