Medical blogs, in particular those written by doctors, have come into the spotlight thanks to a study of 271 medical blogs published recently in the Journal of General Internal Medicine, titled ‘Content of Weblogs Written by Health Professional‘.
The study found that over half of the medical blogs examined contained enough information to identify the doctor writing the blog. In addition, 42% described individual patients, and 16% included enough information for users to figure out the identity of the doctor or patient. (The Pharmalot blog helpfully has a PDF of the full text version if you want to peruse the data yourself) Granted, this study was looking at blogs that published in 2006, so the conclusions may well not reflect the level of professionalism among doctors who blog today, but it raises some important issues about patient privacy.
Of course, the study got the media frothing about whether blogs written by doctors compromise patient confidentiality and prompted the American Medical Association ethics committee to discuss the issue.
Most doctors and medical bodies seem to agree that medical blogs have an important role in providing medical information and demystifying the medical profession. However, the issue of unguarded blogging and patient privacy is real, and there are many instances of doctors’ blog posts coming back to bite them.
Canadian Medicine describes the case of pediatrician Robert Lindeman, who blogged anonymously about the death of a patient and the subsequent malpractice trial under the pseudonym “Flea”. As the Boston Globe reported: “Unexpectedly, during cross-examination, the prosecutor asked Dr Lindeman if he was ‘Flea’. The case was lost, his lawyers realized immediately. They settled the next day.” Dr Lindeman used his blog – and his anonymity – to say on permanent record things that he would not otherwise have said in the open. He lost his case and his professional reputation was trampled on.
The main point of the Journal of General Internal Medicine study and the case of Flea seems to be that, anonymous or not, doctors who blog should always remember that the internet is a public space and write about patients with this fact in mind. Of course, this concept brings up questions of free speech, but inappropriate blogs could comprise the trust that forms the foundation of the patient-doctor relationship and undermine the authority of the medical profession.
However, as Canadian Medicine points out: “Whatever the subject, blogging is a positive development in medicine and something that doctors should not and must not abandon because of some medical association analysts’ largely unfounded fears”
- The Clinical Cases and Images blog recommends guidelines for doctors who blog, which includes complying with the somewhat outdated Health Insurance Portability and Accountability Act (HIPAA).