In catching up on my blog reading, I found a couple of posts that really made me think about some of the obstacles that can impact the uptake of medical blogging. The first post from Toby at Diva Marketing Blog where she describes a discussion she had with a doubting doctor about the values of blogging.

It’s funny… I work with two physicians. Their views of blogs are worlds apart.

One doctor sounds exactly like the doctor that Toby met on the plane. For some reason (probably because of the overabundance of blogs that are merely public diarys or a series of antiestablishment, profoundly pessimistic rants on the ills of everthing from wasabi to the war in Iraq), this doctor has generalized his thinking to be that blogs are of no value to him. Another factor that contributes to this is lack of time. Because of the state of healthcare today, this physician has very little time to “waste.” Rounds begin at 6:00 am. Office hours begin at 8:30 am with patients every 15 minutes and evening rounds at the hospital after that. Then he has a wife and family with which he wants to spend time. That leaves very little time to kiss enough blogging toads to find a prince or two.

So what would change the mind of this doctor? Well, that’s hard to say. In a general sense, blogs that help him to conserve time and effort during his work day would surely have value. What would those look like? I’m not really sure. However, I feel certain that his wife and children would welcome anything that eases the work load and allows him to come home in a good mood and with a little energy in reserve.

Just so I don’t get tagged as the harbinger of doom and gloom for medical blogs. Let me share with you the view of the other physician I work with who loves blogs and blogging. With a little effort, he has been able to find a number of colleagues (Blogging princes) who have enriched or shared his understanding of some finer points of medicine and psychiatry. To him, these blogs and bloggers provide a sort of a cyber journal club, akin to the ones he participated in during his training. They help him quickly find key research and discoverys. He also uses them as an time-saving way of consulting with colleagues to understand others’ interpretation of significant findings and how they can be used in actual clinical practice.

The second post that I found while catching up was by NHS Blog Doctor where he bid a fond adieu to GeekNurse. In this specific posts, NHS laments that Rich at GeekNurse was asked by his employer to take down his blog. His last post simply reads:

“Owing to concerns raised by staff and management, GN’s archive has been removed from public display. Thank you to all those that took part.”

This is rather disconcerting not just to me but to the 12 people to date who have left comments. Interestingly, the comments reflect what some of the big thinkers in blogging have had to say about good blogs vs. bad blogs. Geek Nurse had readers because he conveyed important information to his readers in a personal way.

I think this example teaches us a few things about medical blogging. First, unlike the Microsoft example provided by Scoble and Israel in the first few chapters of Naked Conversations, some healthcare organizations do not value employee blogs as providing a personal face to their facility.

Interestingly, GN did not proclaim to be the official or even a representative blog of his organization. Nonetheless, no one can deny that healthcare organizations feel the pressure to be concerned with risk management. Especially in the areas of:

  • Maintaining confidentiality: It is essential that any medical blog maintain the confidentiality of patients (The HIPAA police will surely get you for that!).
  • Upholding commonly assumed ethical standards and evidence based medical practice: One simply can not go out and advocate for inhumane, unethical, or non-evidence based treatment of patients.

    • It is important to note that I had not read (and others seem to support me on this) anything on GeekNurse that was crazy medicine, unethical or breached the confidentiality of patients. So it would seem our litigious society combined with rising risk of malrpactice suits and malpractice insurance premiums may be other formidable obstacles to the success of medical blogs.

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