The “Risky Business” of Web 2.0 Doctor Bloggers

Posted on May 16, 2008 by Dr. David Edward Marcinko MBA MEd CMP™

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A Mashed-Up Opinion

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chiefdem2]

Today, after personally reviewing far too many blogs, and according to www.NPR.org, there are more than120, 000 health care forums on the Internet with opinions ranging from pharmaceuticals, to sexual dysfunction, to acne.

The same goes for commercial doctor blogs that promote lotions, balms and potions, diets and vitamins, minerals, herbs, drinks and elixirs, or various other ingest-ants, digest-ants or pharmaceuticals, etc. Link: www.MyFootShop.com

And, to other doctors, the blogging craze is a new novelty where there are no rules, protocols, standards or precise figures on how many “medical-doctor” or related physician-blogs are “out there.” Unfortunately, too many recount gory ER scenes, or pictorially illustrate horrific medical conditions, or serious and traumatic injuries. www.physicianspractice.com/index/fuseaction/articles.details/articleID/1136.htm

Of course, others simply are medical practice websites, or those that entice patients into more lucrative plastic surgery or concierge medical practices. Some are from self-serving/credible plaintiff-seeking attorneys wishing to assist patients. Link: www.FootLaw.com

Disgruntled Doctors

But not all physician blogs are geared toward practice information, marketing or medical sensationalism. In fact, just the opposite seems to be the case in extremely candid blogs, like “Ranting Docs”, “White Coat Rants,” “Grunt Docs”, “Cancer Doc,” “The Happy Hospitalist,” “Mom MD”, “Cross-Over Health”, “Angry Docs” and “M.D.O.D.,” which bills itself as “Random Thoughts from a Few Cantankerous American Physicians.” Link: www.thehappyhospitalist.blogspot.com 

According to some of these, they are more like personal journals, or public diaries, where doctors vent about reimbursement rates, difficult cases, medical mistakes, declining medical prestige and control, and/or what a “bummer” it is to have so many patients die; not pay, or who are indigent, noncompliant, etc.www.CrossOverHealth.wordpress.com

We call these the “disgruntled doctor sites.” Some even talk about their own patients, coding issues, or various doctor-patient shenanigans.

Privacy Issues 

But, according to psychiatrist and blogger Dr. Deborah Peel and others, the problem with blogging about patients is the danger that one will be able to identify themselves – the doctor – or that others who know them will be able to identify them.”  Her affiliation, Patient Privacy Rights, rightly worries that patients might tracked back to the individual, and adversely affect their employment, health insurance or other aspects of life.

And, according to Dr. Charles F. Fenton; III, JD and Dr. Jay S. Grife; Esq., MA, both frequent posters to this Executive-Post blog forum, it is certainly true that if a doctor violates a patient’s privacy there could be legal consequences. Under HIPAA, physicians could face fines or even jail time. In some states, patients can file a civil lawsuit if they believe a doctor has violated their privacy. Still, internet privacy issues are an evolving gray-area that if not wrong, may still be morally and ethically questionable. Link: www.patientprivacyrights.org

Opinions May Vary

Our colleague Robert Wachter MD, author of a blog called “Wachter’s World,” says it’s important for doctors to be able to share cases, as long as they change the facts substantially. On the other hand, the author of “Wachter’s World” and a leading expert on patient safety alternately suggests “You might say we as doctors should never be talking about experiences with our patients online or in books or in articles.”

But, he says that “patients shouldn’t take all the information on blogs at face value. Taken for what they are — unedited opinions, and in some cases entertainment — blogs can give readers some useful insight into the good, the bad and the ugly of the medical profession”. Link: http://www.the-hospitalist.org/blogs

Assessment

Well, fair enough! But, the above caveats are a big “if” according to Gene Schmckler of the Institute of Medical Business Advisors, Inc. Link: www.MedicalBusinessAdvisors.com

Eugene Schmuckler, PhD is a behavioral psychologist and stress management expert who opines that “doctors unhappy with their current medical career choice, or its modern evolution, should probably consider counseling or even career change guidance, re-education and re-engineering.” It is very inappropriate to vent career frustrations in a public venue. It’s far better for the blog to be private and/or by invitation only; if at all. Link: www.healthcarefinancials.wordpress.com/2007/12/03/physician-career-development-essay

In My View – Risky Business

I believe that a hybrid mash-up of both views can be wholly appropriate, or grossly inappropriate in some cases. Of course the devil is in the details; linguistics and semantics aside. Nevertheless; what is not addressed in electronic physician “mea-culpas” are the professional liability risks and concerns that are evolving in this quasi-professional, quasi-lay, communication forum.

For example, we have seen medical mistakes, and liability admissions of all sorts, freely and glibly presented. In fact,

“some physicians find that the act of liability blogging as a professional confession that is useful in moving past their malpractice mistakes. And, it is also a useful way to begin a commitment to a better professional life of caring in the future. It helps eliminate the toxic residue and angst of professional liability and guilt. Moreover, as they are unburdened of past acts of omission or commission, doctors should remember to also forgive those who have wronged them. This helps greatly with the process and brings additional peace.”

However, although some may say that this electronic confession is good for the soul, it may not be good for your professional liability carrier, or you, when plaintiff’s attorneys release a legion of IT focused interns, or automated bots, searching online for your self-admissions and scouring for your self-incriminations.

Of course, a direct connection to a specific patient may still not be made and no HIPAA violation is involved. But, a vivid imagination is not need needed to envision this type of blind medical malpractice discovery deposition query even now. www.jbpub.com/detail.cfm?TemplateName=alliedhealth&bc=3342-3&ThisPage=Table%20of%20Contents

Q: “Doctor Smith, I noted all the medical errors admitted on your blog. What other mistakes did you make in the care and treatment of my client?”

And so, the question of plausible deniability, or culpability, is easily raised. 

If you must journalize your thoughts for sanity or stress release; do it in print. And, don’t tell anyone about it so the diary won’t be subpoenaed. Then tear it up and throw it away.

Remember, with risk management, “It is all about credibility.” Don’t trash yours!

These thoughts may be especially important if you covet a medical career as a researcher, editor, educator, medical expert or something other than a working-class or employed physician.

Link: https://healthcarefinancials.wordpress.com/2007/12/07/122

Assessment

Remember, there are all sorts of new fangled risks out-there for the modern medical practitioner to consider; so beware!

Conclusion

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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4 Responses

  1. Dr. Pruitt, on May 25, 2009 at 8:28 PM said:

    Blog control is only an illusion

    Randy Duermyer is a nice guy skirting a reputation problem. He’s an SEO/SEM vendor and the manager of Randy’s Home Business Blog. He’s sharp, and he provides good advice to those who make their living at promoting products on the Internet. He is professional, but he is also a real funny piece of work for someone in marketing.

    In my defense, I honestly did not set out to flame the poor guy. I plead that it was a case of self-immolation on the Internet.

    I actually like Randy, and have not even once considered aggressively attacking him like I have attacked other PR types like Trajan King of ADA/idm and Ross Blackstone of BCBSNM.

    Randy first caught my attention a little over a week ago with his article titled, “How Do You Use Twitter?’ Since I like Twitter for a different reason than anyone else I have come across, I offered that I use it to hold BCBSTX and Delta Dental accountable for their policies. He liked what I wrote, and posted a reply on the growing thread – even promising to take up this interesting topic of unconventional PR on his blog. But a short time later, I unfortunately pushed the envelope like I am inclined to do. I started in on Christine and LinkWorth – an SEO/SEM marketer similar to Randy Duermyer. He naturally didn’t like the tunes in that part of my repertoire, and cancelled two of my three comments.

    That is when I submitted my “no hard feelings” farewell on Saturday.

    http://community.pennwelldentalgroup.com/forum/topics/i-will-hurt-you-delta-dental?page=2&commentId=2013420%3AComment%3A30394&x=1#2013420Comment30394

    It’s the one above that begins with, “Since you de-posted my comments, Randy, I assume that after a period of time, you determined that they are more aggressive than you wanted on your blog. No hard feelings”

    So what does Randy do? He posts it, followed with his explanation that he did not agree with me “flaming” a fellow marketer (Christine from LinkWorth) who may not even deserve it. He accused me of using “negative PR gamesmanship.” No kidding.

    So that brings us to yesterday – Sunday. Here is my reply that he again deleted after a few hours of contemplation along with its jagged follow-up:

    Thanks for your honest response. That took courage.

    So you, Randy, a self-described SEO professional, would like to discuss with me, a dentist, “PR gamesmanship.” That is interesting.

    I make no apologies for being blunt with people who yes indeed deserve even more of it, and I think your ideas of “out of bounds” may be well-intentioned and noble, but they are archaic and ineffective at achieving the control you desire. And do you really want to be the ethics police of the Internet? I think you now must agree that you should have just left my comments alone. Here’s an idea that you might try next time: Let your readers come out and shoot me down. They know what I post on your blog is not a reflection of you, and if you think it is your duty to protect them, you’ll lose them for sure. What exactly are you afraid of? Losing control? Control is just an illusion. It has always been an illusion.

    My reasons for being aggressive are more important to me than popularity. And if I choose to use “negative PR gamesmanship,” is that any different than feel-good SEO tricks that you might use to increase a client’s page rank? You get paid for gamesmanship. I’m an amateur.

    So Randy, what do you think of LinkWorth – an SEO vendor like yourself – selling a service they call “reputation management”? It is my raw opinion that LinkWorth offers a product that allows companies to dodge accountability to consumers. Do you also sell such a service? Is that what you call socially acceptable “positive PR gamesmanship”?

    All in all, I have no hard feelings about our exchanges. In the end, you allowed me to say my piece. I’m good if you’re good.

    D. Kellus Pruitt DDS

    But as mentioned earlier, that is not the end of the story, and if I had not pushed one more comment onto the thread, he might not have surrendered and deleted everything from his replies except two comments – a vanilla comment from Jake and a response from Randy thanking Jake for his insightful comment.

    So for those keeping track, the number of comments following Duermyer’s article, “How Do You Use Twitter?” has fluctuated between zero and seven so far. Now it is back down to two.

    I guess I pushed him too far when I pointed out that when one googlesearches “Ross Blackstone,” my comment on Twitter comes up on his first page. Here is something neat about that: One does not even have to click on the link. The metadata says, “Ross Blackstone, you are a coward. You would deprive me of my First Amendment right, yet you hide from accountability.” Now that is what I call negative PR gamesmanship that scares the water from PR types.

    The last words I told Randy Duermyer were, “Our exchanges could have ended worse.” And I guess they did indeed.

    D. Kellus Pruitt; DDS

    Like

  2. Betty, on July 16, 2009 at 11:52 AM said:

    Doctor Bloggers

    Read more on the dangers, here:

    http://www.kevinmd.com/blog/2009/07/is-it-dangerous-for-a-doctor-to-be-online.html

    Betty

    Like

  3. Ray Fanning, on July 16, 2009 at 7:35 PM said:

    What the hell does the first comment have to do with anything?
    Ray Fanning

    Like

  4. Dr. David Edward Marcinko MBA CMP™, on October 16, 2011 at 12:36 PM said:

    Doc strikes back at blogger with $1M libel lawsuit

    Oregon medical spa doctor Jerrold “Jerry” Darm does not have a flawless past. In 2001, Darm was reprimanded for a violation of the Medical Practices Act, cited for “unprofessional or dishonorable conduct” resulting from “an inappropriate boundary violation” with a patient. An ensuing order, which was terminated in 2009, required Darm to see female adult patients only with a chaperone present and to take courses on doctor-patient boundaries.

    But, contrary to what blogger Tiffany Craig posted on her blog, Criminallyvulgar, and Twitter in June 2011, Darm was never stripped of his license or prohibited from practicing. Craig, who was never treated by Darm but researched his past in response to seeing ads for his practice, Aesthetic Medicine, wrote her original post as part of an attempt to “warn people off being treated by Dr. Darm.”

    http://www.upi.com/Top_News/US/2011/10/11/Is-Oregon-doctors-suit-a-SLAPP/UPI-94981318353769/

    Dr. David Edward Marcinko MBA CMP™

    Like

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