When Roberts -- GruntDoc -- sat down at his computer in 2002 and began posting a running commentary on his professional life, he knew of four, maybe five, other physicians doing the same, he says.
Today, the world of medical blogs is a place so crowded that Roberts says he doesn't know most of their authors. According to Lagu's analysis, roughly 65% are penned anonymously, while the rest of the authors identify themselves by name. Some use their blogs to blow off steam and share their experiences in a profession that most agree has become more trying in recent years; others use it as a link to studies they find interesting; about half, Lagu says, make forays into the political realm of healthcare policy; and a few, including one sponsored by the highly respected Cleveland Clinic and Case Western Reserve University, are primarily teaching tools.
But Lagu says physicians who blog may not be doing all they can to protect the identity of patients described in postings. She cited several cases in which patients had been disparaged by disgruntled physicians. Her study also found 45 blogs -- 16.6% of the 271 she combed through -- that included posts describing interactions in enough detail that patients, or family and friends, could recognize themselves.
Several bloggers interviewed said they are wary of identifying patients and take pains to avoid it. Roberts says he frequently changes the gender, age or other descriptions of patients. Dr. Robert Donnell, a hospital-based physician in Arkansas who writes under his own name at Notes From Dr. RW, says he avoids reference to any clinical cases in which he's been personally involved.
Virtually every medical blogger acknowledges in his or her posts the case of Flea, a physician blogger who anonymously posted on his practice, including damning details of a malpractice suit against him. In the course of the case, the plaintiff's attorney -- recognizing the doctor by the details in his posts -- confirmed he was the author and used his own words against him.
Lagu says that bloggers' intentions are mostly good, but it's not clear all are doing enough to protect patients' privacy and to avoid undermining patients' trust in physicians.
