Ethical Doctor Blogging

PalMD (of the White Coat Underground) tweeted a link to a 2008 post calling for a code of ethics for MD blogging. A study under review showed:

17% of the blogs include enough information for patients to identify themselves or their physicians

I occasionally blog stuff inspired by my patients. I never worry that they will identify me- if they don’t, I would be really worried! I use my real name and image, after all.

Most of the time I am blogging a condition, such as volume overload or neonatal hypertension. While these posts may have been inspired by one or more in my care, the posts reviewed the conditions; no patient data of any sort were shared!

Could my patients identify themselves from my posts? A number of parents of hypertensive neonates probably believe their child inspired me to put fingertips to keyboard, but they cannot tell from that post. Only one post comes to mind in which the patient concerned would know for sure it came about because of him: the post on Page kidneys. Given the date of the post, the few vague items presented, and the fact that this patient knows he has the honor of being the first and only patient I have treated for this condition, he would figure it out.

I do not feel this post is unethical. Only someone who knows this person’s diagnosis and that I am his doctor can identify the patient. If they already know that much about him, they will learn nothing new from the post! The pathophysiology of Page kidneys, not the patient, remains the focus of the blog.

I would never try not to moan about inappropriate or inconvenient patients in a public forum. All physicians have “war stories” that we share; this blog is not the time or place. Occasionally I write about colleagues when either (1)I do not care if they read it and know it is about them; or (2) I have no clue who it is. Either way, no ethical issues apply. These situations are like complaining about jerks in traffic.

I have to go see a patient now. I am not going to say who, where, or what, though. And this kid will never know s/he inspired my closing today!

Image above is my daughter about 20 years ago. No patients were compromised in the creation of this post.