But, realistically speaking, in order to really change things . . . in order for voices to matter . . . in order for our role to be pivotal in any kind of reform . . . doctors MUST sign their name.

I’ve been at blogging for quite a while Kevin . . . invited into the blogosphere in 2005 by a local newspaper Editor touting “citizen journalism.

But “citizen journalism” turned out to be a sad joke. Agenda-driven journalism (that protects local hospitals from scrutiny at all costs) is a far more accurate description.

I’m here for very specific reasons – I’ve taken on the jerks running the hometown hospital that treated me (as a lowly employed physician in public service) like dirt . . . essentially for whistle-blowing on bad care.

Hospital administrations were shutting down practices and careers and lives long before they started shutting down blogs.

I’ve literally bared my soul on my blog. The focus is “hyper-local”, but the issues are universal. I’ve begged for help in getting state and national attention cast my case – which resoundingly demonstrates just how uneven the playing field for doctors really is. I’ve been ridiculed, insulted, spat on, told to “get over it”.

I make my living as a Locum Tenens and I know it has cost me work.

But I’m still hanging in there – because hospitals simply should not be allowed to treat good doctors so badly. It’s got to STOP. The only way it’s going to stop is for more doctors to stand firm and say, “NO! You CANNOT do this!”

You talk about lifting veils.

Yet on your corporately-sponsored blog, Dr. J’s Housecalls still does not merit a link.

It’s an observation. I hope you publish it. And I am once again asking you (as one of the the big bad papa-bear aggregators of the medical blogosphere) to link my blog – so others can hear this story.

Until you do, I have a hard time buying that blogging is an “ideal” medium for ALL the voices in the medical blogosphere.

An extender could spend a few weeks learning the technique of lap chole and manageing surgical infections. An extender could spend a few weeks learning how to drive a scope for endoscopy or managing crohns. An extender could adjust medications for COPD and learn how to hold a bronch scope.

If you believe extenders can do the vast majority of primary care just as well as the primary care doc, you must also believe that they can do it just as well as specialists. And I just don’t believe that to be the case.

While it’s true that both primary care and specialty services by and large spend 80% or more of their time managing 10 medical conditions or less, I argue that those 10 or less conditions have an uncountable number of permutations in management and complications and it takes physician level training to understand how it all works. So, I’m not with you on this one Kevin.

I think your take on these topics is spot on.