by Martin Young, MBChB, FCS(SA)
Blogging is a great way to get things into an open forum for discussion. But I still have nagging doubts about doctors who post blogs or replies about healthcare issues without giving their names.
As a new blogger, I often look at those replies to my postings that are anonymous and think, “Who are you? Why do you think the way you do? Why will you not put a name and face to your thoughts?” My personal belief is that the anonymous person may lack conviction, confidence or courage. Would they be as brazen or critical if I could research their credentials?
Anonymity is an ethical issue in blogging, with compelling arguments for and against. I understand that someone who is ill does not want to divulge his identity. That level of confidentiality I can understand – the same applies to case histories in medical publications.
I can also understand that a doctor who blogs in a ‘whistleblower’ role, or who is vulnerable to recrimination or litigation, would want to preserve his anonymity. Blogging leaves an indelible record that when tied to a name may come back to haunt that person if the post is not circumspect.
But this is my whole point. Why bother writing something trivial or meaningless anyway? If you would not like to be associated with what you write, what makes you think it is worth reading by someone else? Accountability is a safeguard against irresponsibility, particularly in online media.
I blog as an extension of who I am as a doctor, putting a carefully considered face to the experience of caring for the sick, as a means of drawing attention to issues that do not get into medical journals. As do most other doctors who host their own blogs. These are golden opportunities, and should not be wasted or treated lightly.
I would not accept a referral from an anonymous doctor, or give advice to one. In the same way, I may read anonymous replies to my postings, but they carry much lower weight.
As doctors, our names and reputations are always on the line. So much of the potential in medical blogging is in making public our determination to maintain medical accuracy on the web, and expose fraudulent information. When we blog openly without fear or shame, we further those dreams and strengthen the cause of all who go before and stand alongside us.
Martin Young is founder and CEO of ConsentCare.
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{ 21 comments }
I’m an abortion provider. I keep my online profile as minimal as possible to protect myself, even when my posts are not abortion related. Similarly, psychiatrists may want to protect their privacy, as well as that of their patients. I also think that some patients wouldn’t want to see a doctor whose name is all over the internet. I think there are many very good reasons for doctors to want to maintain their anonymity, and posts should be judged by their content, not by the names associated with them.
I don’t suppose anyone here remembers Flea?
There are reasons to stay anonymous. But no one is actually truly anonymous on the Internet. I can say that with authority because sometime later this year, I’ll be confronting a cyber-stalker in (criminal) Court, and it seems to be a fairly easy thing to do to chase down IP addresses.
That, and the Department of Homeland Security likes to visit my blog on a regular basis. It probably has something to do with the less-than-flattering things I’ve said about Obama.
I blog under my own name because I came to the ether (five years ago) with the hope that the Internet exposure of what happened to me in my own hometown (twelve years ago) might facilitate some press attention and the righting of some very egregious wrongs (so far that hasn’t happened – it’s fairly clear to me now that I’m gonna have to sue somebody – again).
Instead, I’m watching one more crop of idiot know-it-alls trying to “reform” healthcare in Washington (mostly by giving the government more authority and more to do) without giving a second thought to the mistakes government programs have made in the past . . . or the bodies (like mine) lying in that road.
I am irreverent and quite snarky (just ask Kevin) – and as cynical/skeptical as (if not more so) anyone else blogging anonymously (indeed, on a recent “Grand Rounds”, I believe the word was “acidic”). I drop the occasional four-letter word. I blog about controversial issues like abortion and pedophile doctors and execution. And NOTHING, I mean NOTHING, makes me happier than to make a blow-hard politician or hospital administrator sweat . . . especially the two overpaid, mill-town hosebags/unconvicted felons who did me wrong.
But using my own name keeps me honest and largely out-of-trouble. I am an independent-contractor, and I do not blog about current assignments or patient situations (somewhat of a restriction) . . . particularly if the institution I work with treats me nice (and the one I currently work with/for . . . that knows about the blogging . . . does;)
Patients and colleagues also know that I blog and often give me suggestions . . . suggestions that many times I cannot take because they are even more “acidic” than I am.
Nurses, especially, can be pretty spicy;)
I’ve been questioned by some med school interviewees why I choose to host a public site with my opinions, photos, etc, and this post sums up my response to said question rather well. I’ve always been careful about what I write, and in doing so, never had a reason to remain anonymous.
I suppose things might change once I start practicing and actually have a patient base, but for now, conscious blogging with my name has been really beneficial in developing ties with other medical students and physicians.
Yes. I started blogging 3 months ago, and prototyped a blog under a pseudonym, expecting that I’d be snarky and irreverent, and therefore not want people (especially administrators at my medical center) to know who I am.
I got great advice from a fellow doctor-blogger and my wife, who insisted that only under my own name would I have the courage and clarity to say things in a free, but also civilized way. Including humor….
It’s been a great ride, so far–and I’m glad I took the advice.
Thanks for the post. Will be interesting to see what type of pseudonymous comments follow on.
The obvious reason that comes to mind is privacy. Some people choose to express opinions that may not be politcally correct, or coincide with the institutions at which we work. Thus blogging, or commenting anonymously, provides an outlet where we can candidly speak our minds without fear of repercussions. If you wish to remove the veil of anonymity, you will, in fact, cut off a large portion of public debate. Why would you want that?
yes, and those bloggers who put their names in frequently have some business venture that peripherally benefits from them geting their name out. of course they tend to forget to fully disclose or at least minimize the coi.
I don’t have a problem with pseudonyms.
I think it protects the privacy of all involved.
When I see an anonymous post written by a physician, my first thought is, why? Agree with SharonMD, there are times when it must be done, and agree with anonymous: some docs are just drumming. But the others? Zero trust.
I think it depends on whether you want to be a ‘follower’ or a ‘leader’. No one ever led social change anonymously. Leadership demands accountability, and there is no such thing in anonymity. You might as well write graffiti. There is an effect, but transient, and with less impact! Which is fine for a follower.
Hi world. I have decided to come out of the blogging closet. My real God given name is Dr Happy Hospitalist.
There, I feel better now.
(Trying this again.)
Not so much paranoid as amused;)
StatCounter does not lie. “Big Sis” IS watching.
In this era of “reform”, the point about leaders vs. followers is well-taken. Ditto for anonymity being any kind of vehicle to facilitate social change (social change being the reason I’m in the ether).
“You might as write graffit”.
Exactly.
Homeland Security doesn’t visit physician blogs, come on.
Sounds a wee bit paranoid to me.
I’m not a doctor so I can be anonymous.
I actually enjoy this site because it looks like multiple doctors post/read the comments/stories
I am just a patient who gets fed up with doctors at times and this site shows me at times the OTHER side to the story
As long is there is no meaningful tort reform, pure and simply by naming yourself, you become a target. What is to keep a someone that truly disagrees with your opinion from seeking you out and who knows what. As long as malpractice cases continue to be based less on facts and evidence and more about satisfaction, personal interaction and beliefs there is no reason to discuss your true feelings without anonymity No one is truly anonymous on the internet, most people should realize that. If you don’t think so look, I agree with Mary look up Flea.
Because the web is all text based, every person is a persona. Everything that exists on the web is a construct, and knowing that, can anyone really trust the Kevin is a doctor (and a medical one, for that matter)? Yes, we can look up his name and see where he works, but who’s to say he’s the one actually writing? If that’s the case, anonymous is more honest. If someone needs advice from a doctor, he or she should go see a doctor. Blogging is blogging, and only page-rank determines relevance, not real-life credentials.
Flea, as in the bassist for RHCP?
@Tom Farrell, no — “Flea” as in the physician blogger “Dr. Flea” who ended up settling a malpractice suit when he was unmasked by the plaintiff’s lawyer as the blogger. Here’s an article from the Boston Globe with the story.
Cause if I use my real name they’ll lock me up and throw away the key…………….
at least thats what happened the last time I used my real name…..
Frank
My God, some of you folks make me feel like one of the ancients;)
Flea as in Dr. Flea (I miss him so). Although after what happened to him, he may wish he had been a bassist for RHCP:
http://drjshousecalls.blogspot.com/2007/05/fear-not-picking-up-gauntlet-in-medical.html
Jenga, the post linked above discusses how I feel about lawyers threatening to use my “online persona” (not so very different from my offline persona) to threaten me legally . . . because a lawyer tried it once . . . well, actually twice:
http://drjshousecalls.blogspot.com/2010/03/dr-mary-slapps-back-these-days.html
We doctors have got to stop dropping and rolling into the fetal position every time some two-bit ambulance chaser flexes his tiny winkie up and down.
And that, people, was a small sampling of my not-so-carefully-considered, snarky, irreverent, cynical, just-plain-disgusted-with-the-state-of-things online persona.
For me, while some folks have figured out who I am, I blog anonymously because Google exists — I don’t want my blog to pop up as the first search result when people “Google” my name. If I was a solo physician, that would probably be different, but I am in a group and feel that would not be fair to my partners. Plus, I don’t blog to provide advice, just hopefully a little humor and a few opinions.
Dr. Flea’s mistake was talking about the trial before it was over. If he had waited, despite his frustration and the great blog fodder, there could have been a very different outcome.
I don’t blog anonymously, but I do try to keep my professional life separate from my personal blog. I do not list it on my LinkedIn page because it can be silly and irreverent, as we all can be sometimes. But that is certainly not the image I want to convey to a potential client or employer.
I don’t have any problem with people who don’t identify themselves. Good, engaging writing is what attracts me to a blog. I don’t need to know someone’s name to respect their work. However, the reality is anonymity on the web is temporary at best if someone really wants to know who you are.
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