Highlight HEALTH

• Blogger Outed In Court » Universal Health

  N=1 over at Universal Health discusses a medical blogger’s malpractice case settlement and the bigger picture of social responsiblity.

• Dr. Jim Watson’s Genome Sequenced for 2 Million Dollars » Eye on DNA

  Hsien-Hsien Lei at Eye on DNA congratulates Dr. James Watson, co-discoverer of the structure of DNA. He’s the first human to have his genome sequenced.

• 10 Tips for How to Acquire a Disease » ScienceRoll

  Berci over at ScienceRoll gives us 10 tips on how to aquire a disease. A must read!

• How To Lower Your Cooling Costs And Go Green This Summer » The Good Human

  David at The Good Human offers some suggestions on how to lower cooling costs and go green this summer. Save some money and save the planet!

Healthcare Vox published an article earlier this week entitled “Is the Medical Blogosphere Dying?”, commenting on the number of well-known medical bloggers leaving the blogosphere. Although I don’t think the medical blogosphere is dying, recent events have been a catalyst for change and it’s definitely undergoing a transformation.

The Blog That Ate Manhattan agrees, saying “I for one do not think that the medical blog is an endangered species”. The article shares some thoughts on medical blogging and some of the things learned over the past few months.

Dr. Dinosaur shares these thoughts:

“Sometimes several blogs disappear within a short span of time, leaving the erroneous impression that the events are somehow connected. The concern about “Who’s next?” isn’t all that different from the forty-five year old man with a neighbor and cousin who each dropped dead of heart attacks in the last two weeks. To the patient, it makes perfect sense to worry that the same thing could happen to him. It’s much easier to see coincidence for what it is when we can take a step back and re-connect with reality.”

A number of healthcare bloggers have expressed their intent to apply for accreditation by the Health On the Net (HON) Foundation. As I’ve written in the past, the HONcode addresses the issue of reliability and credibility of healthcare information found on the internet. There are 8 principles to the HONcode, including sections on authority, privacy, attribution, justifiability and transparency. From the HONcode website:

“The HONcode is not an award system, nor does it intend to rate the quality of the information provided by a Web site. It only defines a set of rules to:
- hold Web site developers to basic ethical standards in the presentation of information;
- help make sure readers always know the source and the purpose of the data they are reading.”

Thus, the HONcode is designed to protect the reader. However, little is offered in the way of protection for the blogger. This isn’t surprising given that people didn’t blog back in 1996 when the HONcode was established. However, given recent events, that is the issue: protection for the anonymous medical blogger.

Liana over at Med Valley High places blogging “within the scope of narrative medicine”, maintaining that it’s a beneficial resource for patients. Dr. Val suggested something similar in her comments here on Highlight HEALTH recently, maintaining that parables are a legitimate teaching tool. The question is, how to communicate to the public that there are very strict rules regarding what doctors can and can’t say on a blog? Names are changed and details are blurred not to dodge privacy laws, but to comply with them. Scalpel reviewed the HIPAA section that he felt applies to medical bloggers and made the following conclusion:

I’m not certain that non-anonymous bloggers should present medical cases at all unless the cases are radically altered or very generalized. If it is known that a physician, nurse, or other healthcare worker practices at a certain facility, for example, then the second requirement [obtains individually identifiable health information relating to an individual] seems to be violated. Similarly, posts stating that a certain patient event occurred “last night” or “last week” seem to be in violation.

Given the recent bad press regarding doctors and blogging, I think he has valid concerns that should be addressed.

Dr. Rob over at Musings of a Distractible Mind has started some dialog on a code of ethics for medical bloggers, creating a new blog, the Medical Blog Code of Ethics, and proposing a draft code for healthcare bloggers. He says that:

While I like the idea of the HONcode (and am still working on becoming certified), I want something less aimed at medical content sites (sites that give advice to non-medical people) and more focused on medical bloggers (medical professionals and patients).

N=1 over at Universal Health gave the current draft a test run - check it out.

Hsien Lei of EyeOnDNA suggests that:

… we also need to look at promoting blogging as a legitimate platform which should be respected and not subject to anyone’s influence except the blogger’s own truth. As long as we are willing to stand behind our words, we should face no fear of repercussions.

Indeed, I couldn’t agree more. I encourage everyone to read the draft code over at Medical Blog Code of Ethics and contribute your thoughts.

The medical blogosphere lost two important voices this week. FatDoctor was forced to shut down her blog due to privacy concerns. Flea’s blog mysteriously vanished. Given that he has been blogging about his malpractice trial, it’s likely that his blog also was taken down because of privacy issues. Hopefully, we’ll see his blog reappear when the litigation has finished.

Val over at Revolution Health suggests that it may be time for:

… us medical bloggers to create and adhere to a code of conduct to protect ourselves and our patients from harm.

I’ve written about a code of conduct for healthcare bloggers previously, although I was focusing more on the issues of reliability and credibility. Perhaps it is time to look to a healthcare code of conduct, one that protects both the author and the reader.

Kevin over at Kevin MD calls today “Black Wednesday: A dark day for the medical blogosphere”. He points out that:

“With blogs being at the forefront of the Web 2.0 advance, traditional medical institutions are again slow to adapt to the openness that defines the heart of the blogosphere.”

“Traditional medical institutions are either ignorant of, or not ready for, the blogging physician or the blogging health professional.”

Both Kevin and Val point to a recent USA Today article that discusses health blogs and patient privacy. The article raises two important questions:

“Should we all worry that our doctors are blogging about us — and potentially violating our privacy?”

“Can you trust the medical information in these blogs — especially those written anonymously?”

The problem I see is that these two issues are counter to one another. If readers expect doctors to fictionalize patient information for privacy concerns, how then can they expect to trust the medical information in those blogs?