Wednesday, October 29, 2008

Hello. I'm Thomas. And I'm a Blogaholic.

Okay.  It's time to dive head-first into the medical blogging controversy.  One of my colleagues at the University of Washington is interacting with administration there to possibly set guidelines and recommendations for medical blogging.  He's got me thinking again about this issue.  As you recall, I thought a lot (and still do) about the line between sharing a patient's story (anonymized) and respecting her rights.  I settle with asking patients or masking identifying facts so much that the patient would not recognize the account as his own.  You can imagine there are a lot of people who have things to say about this.  I respond to my professional society's position in this week's article for The Differential.  Check it out if you have the chance.

Regarding blogaholism, I actually do score positively on the CAGE screen for blogging (A and E).


Anonymous said...

You say that you have settled to ask the patients or mask their identity in the write-up. I simply wonder - the balance of actual immediate "power" seems to be so unequal in the patient-doctor relationship (I mean the patient is "at the mercy" of the doctor - I am not talking about possibility for legal action sometime later on), especially when you are their attending doctor at a hospital. Do we think the circumstances do not affect the the patient's judgment, and it is fair to expect that their reply to whether or not they want to be featured in their doctor's blog, is not influenced by the power balance?

thomas robey said...

I'd say that all of the posts I've made specifically about a patient encounter have included agreement by the patient to have me write about them. As far as all other references I've made, one could have drawn them from thin air with a medical text in one hand and an imagination in the other. That is how distant my references to patients are when I have not received explicit permission. And yes, some patients have not agreed, others are curious but on the fence; I've never written about these. I am a staunch defender of HIPAA and its underlying principles. I also see the value in portraying the aspect of the human experience inherent in the practice of medicine - for providers and for patients.