The L.A. Times on medblogging

This week's host of Grand Rounds (not yet posted as of this writing), Medgadget, has been recently featured in a Los Angeles Times article on medical blogging, The doctor is logged in. Also featured in the same article are fellow medbloggers Nick (the founder of Grand Rounds), Dr. Hildreth (a.k.a. The Cheerful Oncologist), Medpundit, Symtym, and Gruntdoc, among others. All in all, it's an interesting article on the relatively niche area of blogging known as medblogging. There's only one problem.

Why no Respectful Insolence?

Oh, well. Maybe next time...

One statement from the article did immediately catch my attention, though:
And yet, curiously, most of the doctors don't tell their patients about their blogs. As Dr. Charles, a 30-year-old family medicine physician in Philadelphia who asks that his name not be used, says: "We have to maintain an air of professionalism in the office. But on the Internet we are much more candid about what we are thinking about healthcare and patient care."
Why "curiously"? It's not "curious" at all why doctors who blog usually don't tell their patients about it.

When I first started blogging, as someone who straddles the line between medblogging, science blogging, and occasionally just plain political blogging, I noticed immediately that, in notable contrast to most scientists who blog, most doctors with blogs use a pseudonym. It makes perfect sense. Whenever anyone asks me why I use a pseudonym rather than my real name, my answer is really simple. These days, patients often Google physicians and surgeons they are scheduled to see. I don't want my blog to be the first thing that comes up on such searches; I want my university and medical group web pages to be the first things that come up. After all, I doubt most patients would understand why a doctor might want to adopt a pseudonym based on a cranky computer from an old BBC science fiction series, mix it up with alties and pseudsocience advocates, and pseudohistorians, while adopting a very strange mascot for his blog. Some might understand. But most won't. Also, unlike many medbloggers, I'm not in private practice. I work at a relatively large medical school. Consequently, I need to make it clear that my online meanderings have nothing whatsoever to do with the official policies and positions of my employer, and a pseudonym is one additional way to do that, other than my disclaimer. If Dr. Charles, whose excellent blog doesn't delve into the strangeness that Orac regularly likes to mine, admits to being hesitant to tell his patients about his blog, well, then, tell me, what should Orac do?

Come on, admit it, regular readers. There are times when you wonder if this Orac character isn't just a little bit off his rocker, aren't there? Sure there are.

Hmmm. Maybe the writer for the L.A. Times actually did see Respectful Insolence after all, and it was all of the above that scared her away. (EneMan sometimes has that effect on people.)

Yeah, yeah, that's the ticket...


  1. Have you ever had a patient who, by coincidence, was a longtime reader of your blog and put the various clues together to figure out that Orac was, in fact, her surgeon? (I recall you saying that your colleagues at work discovered your blog a while back...)

  2. Not as of yet, but it's coming someday, I'm sure.

  3. I remember getting an email form her to respond. I didn't. Damn!

  4. "I need to make it clear that my online meanderings have nothing whatsoever to do with the official policies and positions of my employer, and a pseudonym is one additional way to do that, other than my disclaimer."

    Whither academic freedom? I'm guessing that you are not yet tenured. Maybe after you receive tenure, will you come out of the blogging closet.

  5. Not likely, mainly because of the first I reason mentioned: I don't want this blog to be the first thing patients see when they Google my name.

    Perhaps if I were as literary as The Cheerful Oncologist or Dr. Charles, I might not care.

  6. I started reading that article when I saw it in the paper, and fully expected you to be mentioned!

    Sorry you weren't. Although mildly interesting, the article didn't really have that much illuminating information, so don't feel too badly about it.

  7. Ah, well, I also remember that I've only been blogging less than six months, although I've had more success at it so far than I thought possible. Even so, I'm still pretty much small fry in the blogosphere.

  8. Actually, part of my reluctance stems from my rather pugnacious attitude towards alties and creationists. Too inflammatory for an initical impression and they might alienate a patient before we even established a relationship.


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