Morning Edition, March 13, 2008 · Medical blogs have drawn back the curtain on the inner workings of the health care profession. Online readers can learn about the latest medical gadgets, read physicians' views on health care issues, even get a peek at the inner thoughts of surgeons. But despite their attraction, these blogs have raised concerns about privacy issues on the Web.
Take a stroll through any of the 120,000 health care blogs and you can find opinions on everything from popular pharmaceuticals to celebrity skin problems. There are no precise figures on how many doctor blogs are out there, but they are easy to find. One blog called "EM Physician" recounts a scene of gang members turning up at the ER with severe burns. "Aggravated DocSurg" says that operations are "fun," and "Radiology Picture of the Day" shows a range of horrific conditions from brain diseases to a breast implant rupture.
One physician blogger, who draws about 12,000 readers a day, is New Hampshire internist Dr. Kevin Pho. His blog, "Kevin, M.D.," offers a doctor's eye view on medical issues that appeal to both his peers and the public.
"I talk a lot about primary care because there's a myriad of problems that I as a primary care physician face that I want to communicate to the public. I talk about malpractice and how physicians practice defensive medicine to avoid malpractice lawsuits," says Pho. His daily writings have made him something of a celebrity in the blogosphere.
Blogging can be a great marketing tool for raising a physician's profile and attracting new patients, says health care marketing expert Fard Johnmar.
"Patients who see physicians who blog realize that these physicians understand implicitly that patients are hungry for information. By providing this information sometimes they will become much more trusted by patients because they believe that they are going to be much more responsive," Johnmar says.
But not all physician blogs are geared toward marketing. In fact, just the opposite seems to be the case in some extremely candid blogs, like "White Coat Rants," "Cancer Doc" and "M.D.O.D.," which bills itself as "Random Thoughts from a Few Cantankerous American Physicians." These are more like diaries in which doctors vent about reimbursement rates, difficult cases and what a "bummer" it is to have so many patients die.
Dr. Deborah Peel, a psychiatrist and founder of the group Patient Privacy Rights, thinks physician blogs often step too close to the limits of patient privacy.
"The problem with physicians blogging about patients is the danger that that person will be able to identify themselves, or that others that know them will be able to identify them," she says.
Peel's group worries that information about a patient's case could be traced back to the individual and adversely affect his or her employment, health insurance or other aspects of his or her life.
Certainly if a doctor violates a patient's privacy there could be legal consequences. Under the federal Health Insurance Portability and Accountability Act, physicians could face fines or even jail time. In some states, patients can file a civil lawsuit if they believe a doctor has violated their privacy. Still, it's not just privacy issues that trouble Peel.
"If you are unhappy with the people that you're supposed to be serving and taking care of, you probably need therapy," she says. "You don't need to be venting your frustrations in a public manner like that. That's very inappropriate and unprofessional."
Insight and Entertainment
Dr. Robert Wachter, author of a blog called "Wachter's World," disagrees. As a leading expert on patient safety who writes extensively about medical mistakes, he counters, "You might say we as doctors should never be talking about experiences with our patients online or in books or in articles."
He says it's important for doctors to be able to share cases, as long as they change the facts substantially. But he says that's one reason patients shouldn't take all the information on blogs at face value.
Wachter says taken for what they are — unedited opinions, and in some cases entertainment — blogs can give readers some useful insight into the good, the bad and the ugly of the medical profession.