Medical & Health Blogs: A Special Hippocratic Oath for Medblogs?

In the post below David D. Perlmutter, a professor in the KU School of Journalism & Mass Communications, and author of Blogwars, investigates medical blogs. Read other blog posts by Perlmutter here.

As a follow-up to my work on political blogs, I am now starting to examine medical and health blogging. My interest was prompted by the blog of a friend of mine who is waiting for a double lung transplant at Barnes Jewish Hospital in St. Louis. Her family is in my hometown here of Lawrence, KS. She uses the blog to talk about her experience and keep everybody updated.

On March 26, 2008 I spoke to the “Grand Rounds” Public Health seminar at the KU Medical School and simulcast to online participants at other Kansas Public Health Departments. My presentation was titled “PAGING DR. BLOG! Nontraditional Sources of Health Information.” It was a study of how blogs and other social-interactive media are changing the dissemination and reception of health information for both the public and health practitioners.

In my studies I have found that medical & health blogs (medblogs) fall into certain categories:

(1) Personal Illness MedBlogs: blogs written or edited by people suffering from a specific disease, condition, or injury.
These can be:

(a) First-Person
• Focus is on self, really for personal processing of illness.
• Started by one or very few people who are ill.
• Emphasis is on personal “I” in writing style and topics.
• Often contains self-encouragement.
• Often contains a chronology or updates of treatment.
Example: lifebeyondlupus
Hi! I was diagnosed with systemic lupus in 2003. My health challenges forced me to leave behind a career as a social worker, professional musician, and superwoman. My life is quieter now. Come join me on this journey.

(b) Third-Person: Blogs started by relatives, friends, families of an ill individual.
• Often employed for group updates, blasts & notifications.
• Messages of hope and community.
• Sometimes requests for donations.
Example: prayersfortracy.com [by a former student of mine] Welcome to Tracy’s web site! We update this site as frequently as possible in hopes to keep you all posted on Tracy’s continued progress. Thank you for visiting us and feel free to write Tracy a note in her Guest Book! We look forward to hearing from you often. Your emails mean so much to Tracy and the entire Anzalone family. We are all very hopeful 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 those prayers and powerful wishes coming Tracy’s way!

(c) Community Medblog: A medical blog by either patients or practitioners that is run as a community site where a number of people jointly contribute postings or features the individual blogs of a number of people.
• Sometimes commercial enterprises.
• Tend to be people from similar backgrounds or status.
• Often focus on central of thematic issues of the blog.
• Have rules or protocols for entry into community.
Example: caringbridge

(2) Professional/Practitioner MedBlog–“Doctor Blog”: A health professional who blogs experiences, opinions, and expertise.
• Motivations range from educating and training to ranting and revenge.
• Aimed at other professionals/practitioners.
• Community of peers.
• Language of specialization.
• Education and discussion.
• Appeals to insider understanding.
• Culture of complaint.
• Reaching out to peers & public.
• Affect or influence public opinion, public policy.
Example: Mousethinks [open to invited readers only] Example: DB’s Medical Rants

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

Future issues for research:
• Online & interactive as preferred place of patients to get information—how best to reach with best advice.
• Effect of personalization: “Dr. Blog” vs. “Institutional website.”
• Institutional Support: AMA & Web 2.0.
• Dealing with data viruses (false information on health issues)
• Blogging health campaigns.
• Tutoring health professionals on best blogging practices.
• Rise of GenY Doctor cohort with social/interactive media skills & preferences.
• Blogs as extension of practice: “Take 2 blogs…”

Follow up on ETHICS…One very important issue for medblogs resonates with a controversy in political blogging world: codes of ethics. Mary Schoen, one my students and I did a study of ethics codes among political bloggers a few years ago. In brief, we found very few had formal codes or even thought that they needed to have them.

For health care professionals who blog the ethical issues are much acute: lives can be at stake! So I am working on an adaptation of the Hippocratic Oath to apply to the medblogger.

Question: Should professionals who are medbloggers take a Special Hippocratic Oath?

Here is my initial draft:

I swear that:
• I will never reveal information about patients 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 credentials and degrees so that they can assess my expertise.
• If I refer to controversial health care information, I will make sure to recognize opposing views and to provide my readers with adequate citations so that they can read more on the subject themselves.
• I will not blog to sell directly my services, my practice or a product in which I have any financial interest.
• I may state my opinions and ideas with passion and conviction, but I will not engage in personal attacks and the vilification of anyone in a way that would undermine the decorum and dignity of my profession.

More: See my “Medblog Resources.”