Musings of a Dinosaur

A Family Doctor in solo private practice; I may be going the way of the dinosaur, but I'm not dead yet.

Thursday, August 23, 2007

Smart Blogging

There's been an ongoing discussion in the medical blogosphere about the ethics of blogging. Much of it centers around patient privacy issues, authenticity and authority (l'affair TNT), and commercial transparency. There have been several attempts to formulate honor codes in the name of "ethical blogging", with varying degrees of penetrance and relevance to the general medical blogging public.

I'd like to suggest that conduct not in keeping with these codes -- blogging about identifiable patients without their consent and such -- is more unprofessional than "unethical." Some kinds of blogging -- about court cases in real time, for example -- are just stupid.

Several months ago there was an upheaval of sorts as a few bloggers disappeared, but many more got all bent out of shape and either pulled or curtailed their blogs. In the fullness of time, some of these latter have come back, supposedly "more careful" than they (thought they) had previously been.

Much of the ado is about anonymity. As we all know, there is no such thing as anonymity on the internet. In reality, though, the only way to get in trouble with attempted anonymity is to take it too seriously.

Many anonymous bloggers have an overinflated sense of how much the general public gives a shit about their real identity. In the process of going on and on about how worried they are that they may be outed, they do one of two things to their readers:
  1. They bore them.
  2. They annoy them.
Neither is good.

In the first case, readers will go elsewhere to read blogs where people are actually saying something of interest. In the second case, it's annoyed readers who are sometimes moved to "out" the blogger just because they can. Though bloggers may not realize it, it's almost as if they're daring readers to expose them.

The vast majority of bloggers -- including doctors -- have to realize that as long as they don't say stupid things on their blog, perilously few people actually care about their identity. As a rule of thumb, anyone who really NEEDS to be anonymous probably shouldn't be blogging in the first place.

What of the exceptions? I believe Barbados Butterfly was the victim of an overzealous and/or controlling employer. And Flea (sorry to put it like this, buddy) was just stupid; like a little kid thinking no one can see him because he's got his hands over his eyes.

In the final analysis, whether you choose to amuse yourself with the game of anonymity or not, the issue isn't one of ethical blogging vs. unethical blogging: it's smart blogging vs. stupid blogging. Don't be stupid, and everything will be fine.

(Dedicated to Dr. K.)

(edit: To clarify further on Anonymity:)

Anonymity only has meaning when people care about who you really are, which far fewer people do than most bloggers think. If you think about it, what makes people care who you are: You've said something that can be used against you in the real world (Flea) in which case the people who want to use it against you will move heaven and earth to find you; or you've annoyed the hell out of someone, and they try to out you to get back at you for being so annoying. So the bottom line is don't piss people off, and don't be stupid.


At Wed Aug 22, 08:12:00 AM, Blogger The Shrink said...

Sage counsel.

It's good to see that the Fat Doctor returned, that Shiny Happy Person started blogging again and that Milk & 2 Sugars returned to the blogsphere even though she's doing so more privately.

But could part of it be that frequent continuous blogging isn't readily sustainable and you take a break like Dr Tempest or Dr Crippen or you go under, anyway?

At Wed Aug 22, 12:24:00 PM, Blogger Dino William Ramzi said...

I agree, it is probably overblown, but people have been known to wish others ill for any number of reasons, logical or otherwise.

My blog is new and when I was faced with a decision to blog under my own name or a pen name, I elected to use a pen name.

There are enough clues that it shouldn't take a private investigator to figure out who I am. I am careful anyway, I wouldn't trust the veil of anonymity anyway.

At Wed Aug 22, 06:37:00 PM, Blogger Dr. Rob said...

The purpose of the blogger code of ethics is not to get the blogger off the hook, or even necessarily change their behavior. The original intent was to allow bloggers who did blog by those basic rules (none of which are anything extraordinary) to say concisely what the ground-rules of their blogging is. I just want my readers to know that I have standards and am not going to pull something on them. This also helps avoid the Barbados Butterfly (or Fat Doctor) situation where an employer worries about the person blogging - they can show the standards by which they blog. We now have almost 60 sites that thought it a good enough idea to sign up. My hope is that it serves a purpose.


At Wed Aug 22, 09:30:00 PM, Blogger MedStudentGod (MSG) said...

I've pondered these same topics as well - since I've found a portion of my class actually knows about my blog. However, talking about being concerned about being "outed" caused me to believe that someone would actually do that, because I had given them the idea.

As always, great reading and advice.

At Thu Aug 23, 01:07:00 AM, Blogger Judy said...

I've given enough personal information in my blog that anyone who knows me moderately well should be able to peg me.

I deal with that by trying not to say anything that would upset my employer too much.

I know I haven't said anything nearly as upsetting as that nursing journal article I wrote several years ago under my real name.

If they didn't fire me for that, they aren't likely to fire me for my blog. It does keep me G-rated, though.

At Thu Aug 23, 02:57:00 AM, Blogger Dr. K said...

I appreciate the dedication and have emailed you with my further thoughts. Luv ya, Dino *grin*

At Mon Aug 27, 10:43:00 AM, Anonymous Anonymous said...

Your recent musings reflect that of one of our editors, who posited medical ethics and blogging:

As you state in your post, there is and always will be exceptions to any rule. Docs have to be careful with regard to HIPAA regulations, as any of us do when it comes to sharing our thoughts on the Web.

At Mon Aug 27, 04:40:00 PM, Blogger William the Coroner said...

I've got a pen name, but my blog is linked to my University blog. Sometimes pissing people off is unavoidable. I don't go out of my way to be contentious. The rule, though is not to put anything out there that I wouldn't sign my name to and have put on the metro section of the PD.

I agree, blogging about an ongoing trial was bloody stupid.


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