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Should Doctors Bother To Blog Anonymously?

I see it from time to time. The doctor with a voice who’s uncomfortable with transparency. They post and comment under the cozy blanket of putative anonymity. But it’s bad policy. Here’s why doctors need to be outed in social media:

Anonymity is a fantasy. It’s remarkably difficult to achieve. With small thoughts you can hide – in fact, no one cares who you are. If you offer anything worth hearing people will ultimately find out who you are. And the plaintiff attorneys will always sniff you out.

You need a reality check. Anonymity gives us phony security and opens the door for us to say the things we wouldn’t normally say. There’s no editorial influence more powerful than knowing that my patients and my boss are listening. While an incendiary rant may serve to vent frustrations and drive traffic, it just fuels the perception of doctors as cynical, frustrated folks. And we don’t need help with that.

We need the press. If you spend any time in the health infosphere you’ll see that physicians are the ones left behind. If docs want a seat at the health dialog table they need to raise their hands, speak up and be accountable for their point of view. Speaking from behind a curtain doesn’t help the cause.

“Trust me, I’m a doctor.” Or are you? Medical credibility begins with credentials. The web is lousy with poseurs and your ability to be taken seriously as a medical expert depends upon your ability to first admit who you are and what you do. If you can’t stand on your name and credentials, perhaps you should stay seated.

Privacy is privacy. Pseudonyms don’t absolve you from protecting the privacy of your patients. If you are compelled to tell stories, it’s the identifying details that need to be laundered, not your identity.

So let’s go public. Online medical personalities went out of fashion with Flea. He taught us that much like the great and powerful Oz, a fiery front is only a temporary cover for the man behind the curtain.

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8 Responses to “Should Doctors Bother To Blog Anonymously?”

  1. I’ve signed every one of my blog posts and every comment I’ve made anywhere. Sure, I’ve taken some heat, but posting with a byline gives the piece credibility and earns trust with readers. I wish my commenters would ID themselves, which would give their views more weight, but many prefer to opine from the shadows.

  2. WarmSocks says:

    Some of my favorite medblogs are written anonymously. For the most part I think people blog knowing that while they’re not announcing their identity, that might change in the future and they need to be cautious in what is said. As a patient, I find it helpful to see medicine from the doctor’s viewpoint. Based on things I’ve learned reading medblogs, I am much more comfortable (and to the point) when I must consult my doctors. It’s been quite valuable.

    The various things I’ve learned reading ER blogs were extremely helpful when I was in a car wreck. When you are taken to the hospital in an ambulance, nobody explains what’s going on. However, I knew that I was being taken care of and things were happening even though there wasn’t necessarily a nurse or doctor with me every minute.

    As a patient, I’m happy that there are medblogs out there, and don’t mind that some are done anonymously.

  3. GruntDoc says:

    Hmm, wonder who he’s talking about…

    So, if we’re going to have opinions about how doctors should blog, I think they should have a better sense of humor about themselves, generally, and take themselves a lot less seriously. And offer fewer dumb opinions about how others should behave.

    PS: very very hard to comment here by iPhone (I couldn’t).

  4. I think you are right on with your reasons for blogging transparently. An anonymous blogger can be more provocative and sometimes that engenders more readers and comments because of the ranting and raving but if we want to be taken seriously, I think we need to come out of the closet and claim our views.

  5. DrV says:

    Actually wasn’t referring to you or anyone specific, Gruntdoc. If you look around I think you might find that there are others who share the opinion about doctors who blog anonymously. I should also say that I must have missed the email informing us that bloggers are no longer entitled to have opinions. After reading these comments I’m realizing that it’s a good idea that we don’t all think, act and rant alike.

  6. GruntDoc says:

    thanks for the reply.

    If you look around you’ll find a lot of docs who blog anonymously, thereby agreeing with me. Having opinions is what blogging is; trying to define physician blogging on your terms alone is egotism.

    I’ll make sure you get the email next time, though.

  7. As someone who recently dropped my cloak of anonimity, I can say that coming out was one of the best things I have done. However, it was becuase I was coming out with a blogging reputation that I had already built and a blog full of posts that I was proud. I really doubt that my blog could have become what it is today had I not been anonymous at first. Remember that blogging is still a brave new world for many of us.

    Don’t forget, too, that there are genuine risks in blogging for those of us who are employed by others. I wrote about this in my early days of blogging,

    and still think about it a lot.

    Finally, anonimity on the part of the doctor blogger creates an additional level of anonimity for our patients -

    I also think that none of us is truly anonymous. I’ve figured out the identity of more than one anonymous blogger with just a little targeted googling – had I taken the time to really try, I could probably out ‘em all..

    But that would be no fun.


  8. I blog anonymously under the Happy Hospitalist on the internet but everyone that matters to me knows who I am. Even Dr Val knows who I am. Don’t tell Doc. Remember the pinky swear?

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Richmond, VA – In an effort to simplify inpatient medical billing, one area hospitalist group has determined that “altered mental status” (ICD-9 780.97) is the most efficient code for use in any patient work up.

“When you enter a hospital, you’re bound to have some kind of mental status change,” said Dr. Fishbinder, co-partner of Area Hospitalists, PLLC. “Whether it’s confusion about where your room is located in relationship to the visitor’s parking structure, frustration with being woken up every hour or two to check your vital signs, or just plain old fatigue from being sick, you are not thinking as clearly as before you were admitted. And that’s all the justification we need to order anything from drug and toxin screens, to blood cultures, brain MRIs, tagged red blood cell nuclear scans, or cardiac Holter monitoring. There really is no limit to what we can pursue with our tests.”

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Another nurse reports that delay in diagnosing urinary tract infections (while patients are scheduled for brain MRIs, nuclear scans, and biopsies) can lead to worsening symptoms which accelerate and expand testing. “Some of my patients are transferred to the ICU during the altered mental status work up,” states nurse Anita Misra. “The doctors seem to be very excited about the additional technology available to them in the intensive care setting. Between the central line placement, arterial blood gasses, and vast array of IV fluid and medication options, urosepsis is really an excellent entré into a whole new level of care.”

“As far as medicine-induced mental status changes are concerned,” added Dr. Fishbinder, “We’ve never seen a single case in the past 10 years. Today’s patients are incredibly resilient and can tolerate mixes of opioids, anti-depressants, anti-histamines, and benzodiazepines without any difficulty. We know this because most patients have been prescribed these cocktails and have been taking them for years.”

Patient family members have expressed gratitude for Dr. Fishbinder’s diagnostic process, and report that they are very pleased that he is doing everything in his power to “get to the bottom” of why their loved one isn’t as sharp as they used to be.

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