I am a blogger. I am a doctor.
Big happenings in the world of medical blogs.
First Barbados Butterfly disappears. Then Fat doctor is “exposed” by a coworker (or cow-orker, as Dogbert would say). Finally my dear friend Flea goes AWOL. You all know the story (if you at all read medblogs).
I understand the situation with Flea (I think). He is in the middle of a lawsuit, and has actually blogged about details of the suit. I suspect his lawyer (or Mrs. Flea) saw the fact that this is risky. Should the contents of his blog become part of the court proceedings, his statements could become a liability. I hope that once his suit is done (and he has won, hopefully), he will once again be part of the medblog community. He is sorely missed.
The other two instances are harder for me to grasp.
Yes, these are medical professionals telling about their lives. Yes, their lives touch on the lives of other people. Yes, they have a professional responsibility to respect patient confidentiality. We live with that every day. I come home to my wife and she asks me “how was your day?” I learn to live as a normal person, needing to vent, complain, or rant at times about things that I have encountered; yet I also know that my patients have the right to expect that I don’t tell others about what they tell me.
That does not mean I don’t tell about my day. It simply means I don’t give specifics. Can I say: “I saw a guy today with appendicitis?” I think I can. Can I present the case on my blog? Again, as long as I don’t give specific identifying information, I think it is simply me expressing my freedom of speech. I do write knowing that my patient could possibly read my blog and read about themselves. It might just happen one day. But I won’t let my life be run by fear of the opinions of others.
As a medical student and resident, I was warned to not engage in “elevator talk.” It is common for students and residents to discuss their work while walking through the hospital. If you do so while in the elevator with others standing by you, you don’t know who these people are. They may be related to “that kid on the fourth floor with the rash.” So we avoided this. I think it is good practice.
Yet one time I think it went too far. I was called into the office of one of our attendings because the parent of a child was angry at me. I had made an off-hand comment on the elevator about a certain medication being worthless. We were just talking shop and doing our usual resident strutting. Apparently, this parent had felt that the drug that fell under my derision had done wonders for their child. They were so upset about this that they took down my name and told the attending of my waywardness. I thought this was ridiculous. If I had said that I don’t like Ford Escorts, would I have been pulled aside and chided because the child was brought to the hospital in a Ford Escort? I was voicing an opinion. It is certainly the parent’s right to disagree and even get angry, but I have equal right to hold and express my opinion.
I think some people feel it is their job to get offended. They look for ways to feel pain from innocent statements and then blame the person who made the statement for callousness. There is nothing wrong with talking about our lives, and even our frustrations with other people. We need to be sensitive in how we do it, but so does everyone. I would not talk about my neighbor any more harshly or openly than I do a patient. It is just plain courtesy.
That is why I am not anonymous.
Revealing my identity makes it harder for me to fall into the “chat room” mentality that uses anonymity as a springboard for behavior that would never happen if my name was known. What I say, I stand behind. If I say something offensive, they have the right to challenge me. If I am wrong, I will say so and make the correction and/or apologize.
My partners know I blog. My staff knows I blog. My wife and my Mom know I blog. If my patients ask, I give them the URL of my blog. I am me on my blog - faults and all. Some people out there seem to think that medical professionals aren’t just normal people. Thanks to the “professionally offended,” we are losing voices of real people doing hard jobs.
This is ironic, given the popularity of the new book: How Doctors Think. People want an author to tell them how doctors think, but God forbid that the doctors themselves should say how they think!
Val, you still want to go for that beer?
Clark, I think it is the secularists.
Flea, I am sending my psychic energy in your direction.
Fat Doctor and Barbados Butterfly, your loss is our loss.
It’s a crazy world.
May 17th, 2007 at 8:45 pm
Timely post. I’ve been heavily considering emerging from anonymity, probably with an entirely new blog. I don’t think I’ve ever written anything that would be considered “risky”. Anyway, back to the mulling…..
May 17th, 2007 at 10:18 pm
[…] I am a blogger. I am a doctor. - Dr. Robert Lamberts. […]
May 18th, 2007 at 5:25 am
I can’t imagine being in the medical profession and having to feel like my right to freedom of speech is being limited. It is a disgrace.
However, I agree with you about Dr. Flea and for his own good I am glad he took it down, atleast for the time being. When it is all over I hope he comes back and then tells it all. I stated this on another blog tonight and receieved an unfavorable response, but it was from someone who I’m sure has never read at his blog, so they did not know the significance of what he had been blogging.
Dr. Bartram, please send me email if you get a new blog.
May 18th, 2007 at 9:04 am
Hi Rob:
You expressed all of this so well, and it is truly sad - and not a little bit intimidating.
I had a thought about your experience with the upset parents over a seemingly harmless comment about the worth of a particular medicine:
You carry great weight and power as a physician. To the parents, your off the cuff opinion may have been perceived as a threat that you could influence the medication to become unavailable to their child.
We all attach meanings to information based on the perceived prestige, authority and power of the sender. It’s just a given that physicians are seen as ultimate authorities and are granted power - in this case - perceived access to a drug - even when that may not be the intent of the messenger.
I have no way of ascertaining whether this was part of how they received your particular remark, but in nursing interactions with patients, it’s a very common theme.
May 18th, 2007 at 9:15 am
Thoughtful and timely post, Dr. Rob. You’ve made very useful observations on the ‘professionally offended’ and how much we lose when we lose the authentic voices of those in frontline positions that have a direct impact on people’s lives.
Regards - Shinga
May 18th, 2007 at 12:24 pm
Great post. Strong case for why NOT to blog anonymously. There is a sense of accountbility for putting yourself out there.
I’ve also read posts this week making the case for anonymous posting. There’s no right or wrong here. There are strengths and weaknesses for both. I guess it just comes down to personal preference. Thanks for continuing the discussion
May 18th, 2007 at 12:44 pm
Have you heard….
Dr. Dork is gone too
This is becoming a major pandemic!!
May 18th, 2007 at 3:03 pm
You know, it seems weird that employers and cow-orkers would be so eager to gag people, especially since most of the medical information presented in blogland is not identifiable. I know that every patient I present about either has a condition so common that they wouldn’t be identifiable that way (i.e. pregnancy with a c-section) or else I allow time to pass and mangle some of the details to prevent identification of the patient.
I am under the impression that other people do the same, for the most part.
So why people get upset about this doesn’t make much sense to me.
May 18th, 2007 at 4:14 pm
Your post is very good, Dr. Rob. Everyone at work knows about my blog, including my boss. I invited her to read it anytime. I’m glad you’re acting as the voice of reason during these challenging times in the medical blogosphere.
MJ
May 18th, 2007 at 6:27 pm
Dr. Rob, thank you for that post. It was great. You expressed a lot of things I’ve been feeling, but was unable to articulate clearly.
I’m hoping to post again either later tonight, or tomorrow. I hope you don’t mind if I quote a bit of your wisdom …
May 18th, 2007 at 8:37 pm
I think I have a solution under a terms of use agreement. Essentially, the blog is only offered under a “terms of use” where the user agrees to not use the content to identify the blogger or individuals blogged about, and agrees that if the user does identify the blogger and disclose that to a third party, that the user is responsible for all damages plus 3x punitive damages.
May 18th, 2007 at 10:24 pm
Moof: Feel free to quote away.
Overall I feel frustrated at this whole thing. I am looking into the HON code (Healthcare on the Net). I don’t like to have to make my stuff look like it is scientific research (can you do that on llamas?) but there needs to be some standard of blogging.
May 19th, 2007 at 12:35 am
Hello Dr. Rob,
You spoke very, very well here.
I am another person saddened by Dr. Flea and The Fat Doctor’s departures. I am also an “anonymous” blogger. I am a librarian and my profession has an (I think) admirably hardline stance on freedom of speech AND confidentiality.
I am on a waiting list for “How doctors think” — a lot of people want to read that book! Nice article in this Tuesday’s NYT, Science of the Times: Doctors Who Wield the Pen to Heal the Profession.
You are healing. Balm to my chafed Laundress self. Best to you and all of the other medbloggers out there (nurses and other healthcare professionals too, not just you MDs).
Thank you for doing what you do!
Appreciative and respectful fan,
TL
May 19th, 2007 at 8:51 am
Hi rob. Getting very sad as medicalblogs starting to shut down. DrDork is down too and I wonder why!
I too tell everyone about my blog. For me a case presented is a form of education for the public as long as personal spesifics are not told.
Very sad!
PS I have changed my address
May 19th, 2007 at 11:56 am
wth?! all the good med blogs are going, going…
the rate we’re going all that will be left are the likes of people like me.
seriously, this is sad.
best of luck to all who have closed up shop and let’s be careful out there.
May 19th, 2007 at 11:59 am
It’s indeed very scary that someday someone may infer general attitudes about you based on your bloggings, and use that against you regarding a specific patient, whether it’s a privacy or malpractice issue.
Flea’s blog removal sets a very dangerous precedent, and I now feel forced to think twice about what I write on my blog in the future.
This is really a very sad time for the first generation of web-savvy doctors.
May 21st, 2007 at 12:00 am
[…] Rob Lamberts:Â I am a blogger. I am a doctor. […]
May 21st, 2007 at 1:25 am
Oh, I am SO with you on this. I even wrote a post about why I don’t blog anonymously before all this even started.
My work knows, my family knows and hell will freeze over before that blog ever comes down. I can have an opinion - what happened to first amendment rights? I’ve already decided I will leave my job if it ever becomes an issue - it is that much a part of what I do and who I am. Even if no one ever read it, it’s mine.
Fortunately, I work in a cool place.
May 21st, 2007 at 9:57 pm
It’s all such a shame.
September 11th, 2007 at 5:53 am
[…] Rob geeft de volgende redenen om onder eigen naam te bloggen: I think some people feel it is their job to get offended. They look for ways to feel […]
September 11th, 2007 at 6:01 am
[…] Rob geeft de volgende redenen om onder eigen naam te bloggen: I think some people feel it is their job to get offended. They look for ways to feel […]
May 27th, 2008 at 7:48 pm
[…] from disapproving employers and patient-privacy legal worries [KevinMD first, second posts; Distractible Mind, […]