Health blogs

Medical and Health Blogs: A Special Hippocratic Oath for Medical Blogs?

In the post below, David D. Perlmutter, professor at the KU School of Journalism & Mass Communications and author of Blogwars, investigates medical blogging. Read more blog posts from Perlmutter here.

As a continuation of my work on political blogs, I am now starting to examine medical and health blogs. My interest was sparked by the blog of a friend of mine who is awaiting a double lung transplant at the Barnes Jewish Hospital in St. Louis. His family is in my hometown here of Lawrence, KS. She uses the blog to share her experience and keep everyone in the know.

On March 26, 2008, I spoke at the “Grand Rounds” Public Health Seminar at KU Medical School and simultaneously broadcast to online participants from other Kansas public health departments. My presentation was titled “PAGING DR. BLOG! Non-traditional sources of health information. This was a study of how blogs and other interactive social media are changing the delivery and reception of health information both to the public and to health practitioners.

In my studies, I discovered that medical and health blogs (medblogs) fall into certain categories:

(1) Personal illnesses MedBlogs: blogs written or edited by people with a specific illness, condition or injury.
These can be:

(a) First person
• The focus is on oneself, really for the personal treatment of the disease.
• Started by one or very few sick people.
• Emphasis is on the personal “I” in writing style and topics.
• Often contains self-encouragement.
• Often contains a treatment timeline or updates.
Example: lifebeyondlupus
Hi! I was diagnosed with systemic lupus in 2003. My health issues forced me to give up a career as a social worker, professional musician, and superwoman. My life is calmer now. Come join me on this journey.

(b) In the third person: Blogs created by relatives, friends, families of a sick person.
• Often used for group updates, explosions and notifications.
• Messages of hope and community.
• Sometimes requests for donations.
Example: [by a former student of mine]
Welcome to Tracy’s website! We update this site as often as possible in the hope of keeping you informed of Tracy’s continued progress. Thank you for your visit and don’t hesitate to write a note to Tracy in her guestbook! We look forward to hearing from you often. Your emails mean a lot to Tracy and the entire Anzalone family. We are all optimistic that 2007 will bring great improvements and many miracles to Tracy and our family. Many thanks to all of you who continue to pray for Tracy’s recovery! Please keep these powerful prayers and wishes coming from Tracy!

(vs) Medblog community: A medical blog by patients or practitioners which is operated as a community site where a number of people jointly contribute posts or feature the individual blogs of a number of people.
• Sometimes commercial enterprises.
• These are usually people with a similar background or status.
• Focus often on central or thematic issues of the blog.
• Have rules or protocols for entering the community.
Example: caringbridge

(2) Professional / practitioner MedBlog – “Doctor’s Blog”: A healthcare professional who blogs their experiences, opinions and expertise.
• Motivations range from education and training to speeches and revenge.
• Intended for other professionals / practitioners.
• Peer community.
• Language of specialization.
• Education and discussion.
• Appeals for insider understanding.
• Culture of complaint.
• Reach out to peers and the public.
• Affect or influence public opinion, public policy.
Example: Mouse thinks [open to invited readers only]
Example: DB’s medical diatribes

(3) Institutional medblog: Sponsored by a health facility.
• Dissemination of information.
• Comments on health news and information.
• But… often with a personal face.
American Cancer Society: Dr. Len’s Cancer Blog
Department of Health and Human Services: Secretary Mike Leavitt

Future research challenges:
• Online and interactive as a patient’s favorite place to get information — how to best reach the best advice.
• Effect of personalization: “Dr. Blog” vs “institutional website”.
• Institutional support: AMA & Web 2.0.
• Deal with data viruses (false information about health problems)
• Health blogging campaigns.
• Tutoring healthcare professionals on blogging best practices.
• Rise of GenY Doctor cohort with social / interactive media skills and preferences.
• Blogs as an extension of the practice: “Take 2 blogs…”

ETHICS monitoring …A very important issue for medical blogging echoes a controversy in the world of political blogging: codes of ethics. Mary Schoen, a student of mine, and I did a study of codes of ethics among political bloggers a few years ago. In short, we found that very few of them had formal codes or even thought they needed them.

For healthcare professionals who blog, the ethical issues are very acute: lives can be at stake! So I’m working on an adaptation of the Hippocratic Oath to apply to the medblogger.

Question: Do professionals who are medical bloggers have to take a special Hippocratic Oath?

Here is my first draft:

I swear that:
• I will never reveal patient information in my blog that allows readers to identify them in any way.
• If I blog under a pseudonym, I will still inform readers of my correct degrees and diplomas so that they can assess my expertise.
• If I am referring to controversial health care news, I will make sure to acknowledge opposing views and provide my readers with adequate quotes so that they can learn more about the topic themselves.
• I will not blog to directly sell my services, practice, or a product in which I have a financial interest.
• I can express my opinions and ideas with passion and conviction, but I will not engage in personal attacks and defamation of anyone in a way that would undermine the decorum and dignity of my profession.

More: See my “Medblog Resources”.