Somebody call the blog police

Ever wondered how close blogging doctors and nurses come to crossing lines of confidentiality?

An academic study in the current Journal of General Internal Medicine has some answers, and if you think Dr. Flea's case might come up as a cautionary tale, you won’t be disappointed.

Researchers from the University of Pennsylvania took at look at the blizzard of blogs written by health professionals over the course of one year and counted how often authors commented about patients, violated their privacy, or wrote with something less than professionalism.

Using a statistical technique called “modified snowball sampling” – jumping from one blog to another – they found 271 medical blogs that met their criteria in 2006. More than half of bloggers revealed their identities and almost half of entries described individual patients. The researchers thought 45 blogs posted enough information for patients to figure out this was their doctor or nurse talking and they were the patient in question. Three blogs showed recognizable photos of patients.

The personal tone taken by the blogs painted patients in a negative light in 48 blogs and positively in 43 blogs.

Dr. Flea's blog, you may recall, would fall into negative territory. Flea was the blog name of a Natick pediatrician who blogged about his malpractice trial, disparaging the plaintiff's case, lawyer, and even a juror for dozing off. The case was abruptly settled when the lawyer asked in court if the doctor was in fact Flea (a surgeon's scornful name for pediatricians). The blog vanished, too.

Despite lapses like these, the authors say these blogs do offer a healthy outlet for medical professionals to share their stories. But the risks of breaching patient privacy and even promoting products in a questionable manner may call for some policing.

"The health professions should assume some responsibility for helping authors and readers negotiate these challenges," they write.