Home > Rants and Raves, Social Media > What is it with anonymous medbloggers?

What is it with anonymous medbloggers?

Something has got my hackles lately….anonymous medbloggers.

I just don’t get it.  If a physician is going to take the time to create a blog to spread his or her opinions and expertise, why wouldn’t they do it under their own name?  In a way it really bothers me.   There is so much information on the web, and a great deal of it is poorly sourced and unreliable.  I would like to think that physicians will publish medical information that is accurate, at least as well as we know, and that the MD or PhD credential will lend credibility to their writings.   But to me it just destroys that credibility when the doc chooses to blog under a psuedonym.

I think that some docs are worried that their words will be used against them in a court of law.  I believe that people believe this, but I certainly don’t believe that myself.  Its just paranoia.  At some level that’s like thinking that there’s somebody listening to you, just dying to take you out of context and destroy you.  The problem with that thinking is that it ignores that the original source is always available for review later, and ultimately the blogger controls the context.  We have the ability to write whatever we want.  I’ll occasionally write something inflamatory, but I’ll stand by it as what I believe.  Whatever I write certainly reflects what I believe when I write it, but that doesn’t mean I don’t reserve the right to change my mind.  The idea that any idea I write down defines me forever more is just obtuse, and seems almost frightening to me, an affront to the potential for personal development.  Is every author defined by their first novel?  Is every musician defined by their first album?  I would hope that everybody matures with time, and doesn’t perpetually agree with every bit of material they ever produced.

More importantly, writing anonymously ignores the potential for branding oneself.  Every blogger has the opportunity to create their own brand, through all facets of social media.  Why would you want to brand a faceless image?   This is not V for Vendetta.  The ails of the medical system are not going to be cured by some faceless crusader and a bunch of bald headed rebels.   We need real faces with real names who can bring real arguments.  If I am trying to effect some real change, my credentials are a weapon to be used, and hell if I’m going hide them.   All medical professionals are respected members of society.  Hiding behind a mask undermines that respect, and in some ways hurts us all.

If the goal is to educate, the mask undermines that as well.  There are so many poor sources out there, and I have no interest in getting my education from a source that claims to be a physician but doesn’t want to tell me his or her name.

Sermo, the physician’s social network, gets around this somewhat by requiring that all registered users prove that they are licensed physicians.   But still the anonymity of it bothers me.  Over time I have gotten to know the more prevalent posters, but do I really know them?  I know that “OBGYNFlyer” is a strong surgeon who is pretty thoughtful, that “Andrea333″ is a psychiatrist that has no tolerance for anything remotely pro-choice, and that “steeldoc”, having been sued at least once, will do absolutely anything to avoid a repeat courtroom appearance.  But do I really know these people?   Ultimately these people are creating an image of themselves that may or may not be real, and there is no way for anyone to corroborate them at all.  Sermo doesn’t even require that MDs represent themselves in their actual specialties.  For all I know their characters could be complete fabrications.  It happens all over social media, so why not on Sermo?  And that bothers me.  In some cases certain screen names have been demonized, and others have been canonized.  One character eventually left because of all the abuse he/she got on the site.  Another character “wonposet” is held up as a near-deity.  But who really knows who these people are.  “wonposet” posts many beautiful and thoughtful posts, but who knows how much of that is really his/her character.  I’m sure he is a normal person, with light and dark parts, who chooses to only post the light.  Similarly some folks who seem to always post negatively are virtual pariahs, but in reality they are probably just getting their angst out a bit.

Those that post on Sermo under their real names are often criticized for somehow exposing themselves to dark forces of medical malpractice.   By now most OBGYNs on Sermo know that “markalanis” is a smart young MFM in Charleston, SC, “creasman” is William Creasman, and “nickfogelson” is a cocky young generalist with a blog.  If I get sued I’ll point to this blog entry as my defense.

So I encourage all you anonymous medbloggers out there to come out from under the sheets and reveal yourselves.  The biggest benefactor of this decision will be you.  Or at least comment on this blog and explain your motivation.

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  1. November 24, 2009 at 12:45 am

    could it simply be that the “doctor” is not a doctor? lots of people who are not HCP’s would seem to have something to gain from influencing opinions of those who read Sermo blogs/comments, etc

  2. November 24, 2009 at 1:14 am

    Sermo is a physician only social network. In order to look at comments on that site you must be a MD or DO, verified at time of account creation. There are some non-physician sponsors to the site that have access to comments, but in general cannot post there.

    Lots of people have something to gain by reading web based medblogger posts and comments. I just think they would have more to gain if they knew who they were reading, and the writer would have more to gain if his/her readers knew who he/she was.

  3. Aussiedoc
    November 24, 2009 at 1:44 am

    I’d draw your attention to this article: http://www.newyorkpersonalinjuryattorneyblog.com/2008/01/my-interview-with-robert-dr-flea.html

    This is a paediatrician from Natick who did in fact have his words used against him n a court of law and did in fact lose a malpractice suit because of it. Might be an interesting read for you ;).

    In addition this article talks about a Surgical registrar from Australia who was placed on suspension for a week after her blog was discovered. http://msspnexus.blogs.com/mspblog/2007/04/barbados_butter.html,

    I blog – but I don’t do it publically, I have a “friendslocked” journal. Precisely because I was paranoid that patients would see my words and take things out of context. Perhaps it is overly paranoid of me – but well experience of other bloggers makes it clear that even simply blogging can be very dangerous.

    Of course there is an arguement that precisely because these bloggers were anonymous they placed themselves in a position where they did not guard their words in the same way as they would have had their names been attached. But I’m still training and I don’t want to take the risk.

    • November 24, 2009 at 5:33 am

      Thanks for your comments and the links.

      I guess it comes down to what you are going to blog about. I have a few rules that I go by, and will continue to go by:

      1) I blog about my field, and my opinions about general practice.
      2) I do not blog about specific patients
      3) I do not blog about specific colleagues
      4) When I have an opinion, I cite it with evidence, or at least admit that it is opinion only.

      The case you are talking about is of a physician who was blogging anonymously about a malpractice case where he was named. As this physician now realized, this is just crazy. Being sued is an unbelievably difficult thing and I have no doubt that people in that situation need someone to talk to about it, but speaking to the world in general about a very specific case, particularly a malpractice case, is just foolish. Given the discoverability laws in the US, the only safe place to talk about these cases is with your lawyer or your therapist, or perhaps into a soon to be cremated journal. “Flea” even remarks that doctors who blogged under their real names were likely safer, as they would think about what they wrote. I completely agree with that statement.

      The second case regards a surgical resident in Australia. I don’t know what she wrote. I suppose it would be wise to ask your employer if they mind if you blog, particularly if you are going to blog about your place of work in specific. Again, I generally don’t do that, and think it is a dangerous thing to do. Certainly I wouldn’t write anything about anybody or anything that I wouldn’t be completely comfortable telling them face to face.

      The problem is not the anonymity, it is the content. The material cited in the first case was dangerous material to be communicating by any method, and the veil of anonymity probably amplified the nature of it.

      Nicholas Fogelson

    • DrV
      November 27, 2009 at 4:00 pm

      I don’t think its clear at all that ‘simply blogging can be very dangerous’. If you bring Flea into it you can comfortably say that foolish blogging can be dangerous. Otherwise, as someone who has been active in the medblogosphere since 2006, I can attest to the fact that you’re safe if you stick to Nick’s simple, commonsense rules.

  4. Ingrid Jakobsen
    December 4, 2009 at 7:42 pm

    I don’t know about medical blogging in particular, but I blog pseudonomymously (which is not at all the same thing as anonymously) and I’ve been part of enormous fights over internet pseudonyms and all the supposed disadvantages thereof.

    My general conclusion is that people who feel completely comfortable always using their real name online and who are unsympathetic to other people’s choices in this matter are overwhelmingly white, male, American, heterosexual, able-bodied and -minded, and permanently employed.

    In science blogging, I notice that the most prominent female science bloggers have pseudonyms, or are somehow safe from employment repercussions. Talking about how much it can suck being a woman in academia is a fraught issue and I certainly thinks it needs to be talked about, but I can also understand why those who want to speak up about their experience don’t want to be easily identifiable.

    I also follow blogs by people with various disabilities, physical and mental. Again, their desire to share their experiences navigating a disability-hostile world shouldn’t have to come at the cost of their job or other public status.

    I’d also like to point out the experience of Digby: she was smart enough to blog for long enough to establish a reputation before revealing (to much shock, because surely a woman can’t be that smart about politics?) that she was in fact a woman. And of course the experience of Kathy Sierra, who discovered that blogging on something as outrageously controversial as IT was cause for sexual harassment and death threats.

    • December 5, 2009 at 7:06 am

      You bring up a good point I had not considered. The concept of blogging anonymously, developing a reputation, and then revealing one’s self later in life has been around for a long time. Orson Scott Card came up with it in the 1985 book Ender’s Game, and probably he got it from something even earlier. In his book two genius children created pseudonymous political blogs that changed the course of history, eventually leading one of them to become Hegemon (their world’s ruler) by his 18th birthday.

      But Card got something wrong, in that he grossly overestimated the ability of someone to post anonymously. Anonymous blogging is no way anonymous. Nobody should post an anonymous blog under the erroneous assumption that their true identity cannot be determined. Perhaps one can be anonymous to a casual observer, but anybody with a tiny bit of skills can still track you down, particularly if you are working under a your own domain name. Domain name registrations are public, and are very easy to track back to the registrar and registrant.

      Bottom line, anonymity on the web is an illusion. Even email security is an illusion unless you use strong encryption routinely. I have only a college education in computer science and am a geek, which already qualifies me how to find these things out. You have no idea how sophisticated people can be with home computers, a little know-how, and time on their hands.

      I post under my name because its on me no matter what. I would never post anything I wasn’t willing to admit I wrote. That leads me to primarily post about my thoughts on the world, not on specific people or situations. I have all kinds of crazy stuff happen in my life that I would love to blog about, but I know better than that. That’s for family and friends, not my tweeps and blog followers.

      • Ingrid Jakobsen
        December 9, 2009 at 4:49 pm

        I, personally, am not trying to be anonymous when I blog psedononymously. From my pseudononymous identity it’s not terribly hard to deduce my legal name, and many of the people who know me in that context have been told my legal name because I trust them with that information. I’m just trying to make my alternate identity somewhat obscure to someone who casually googles on my legal name. In fact, I don’t think it’s obvious (apart from me telling you here) that I even have an internet pseud. I’m not trying to hide from the determined, I’m just trying to keep certain aspects of my life somewhat discreet from casual inquiry, and that seems to work just fine.

        It’s possibly relevant to note that for the first five years I used google, (up to about 2003 I think) I was the only “Ingrid Jakobsen” on google. If you googled that, every single hit related to me. I wasn’t comfortable with my entire life being that exposed, every interest of mine, work, social and other in one mixed bag of only me. Now that the internet has spread much more broadly, I am no longer unique and I can feel more comfortable that a potential employer for example can’t immediately determine how many of us there are and who’s doing what.

        I notice the sentence that was in the above comment when I was notified about it, where you were somehow able to draw a bright shining line separating medical work and social justice, is gone. Good, because I did think that was a bit embarrassing on your part. emjaybee’s point about corporate power is very pertinent.

        (Not so good – I didn’t realise you reserve the right to edit comments with no notification. I’ll bear that mind. I will say that in my experience of internet culture, there’s a big overlap between the people who have a bee in their bonnet about others not using their legal names, and those who think it’s okay to alter the record/hide the evidence when they make a mistake, rather than explicitly apologise. And that it’s caused you to go down somewhat in my estimation.)

    • December 9, 2009 at 8:23 pm

      You are right that I have an advantage owning the blog, in that I can edit my comments and the comments of others, but I have not used it in the way you think I have.

      In a few cases, I have edited peoples posts that were too long, but only when they quoted big pieces of other sources that could be addressed in links. When I did that I left a link, and a mention that I edited the post.

      In one recent case, I deleted someones comment and banned them from the blog because they made an antisemitic comment that I found intolerable. I think this is what you are talking about, as I did not post after emjaybee.

      The other thing I have done, which maybe now I will not do, is that I have edited my posts immediately after posting them. I often write something as a first draft and then publish the comment, as it then allows me to see how it will read on the page. If I don’t like something I wrote or there is a spelling or grammar error, I will edit my post. Certainly I could just do this in a word processor prior to posting, but I haven’t done that for convenience sake. From time to time I have edited my posts during this process because I didn’t like the way something I wrote sounded. If you looked at the post in the minute or so between revisions you may have seen that. I don’t think I have ever edited my comments after somebody else had already commented on them, or edited a post more than 2-3 minutes after it first went up. Your estimation of me, given that explanation, is up to you :)

      I agree that the fact that the blog owner can do this and others cannot is unfair. I have the same disadvantage at other blogs. If you check my posts on other blogs there are lots more spelling and grammar errors, as I tend to type quick and then publish. This is not to say that the power to edit shouldn’t be there. As a blog gains traffic, it starts to attract trolls, who will write things meant only to antagonize without being useful. It is my opinion that these comments should just be removed. I am redesigning the blog on a new platform, so when that goes up I’ll put a detailed list of this stuff so nobody’s surprised. Rest assured I do not remove anybody’s substantive comment, even if they tell me I’m an idiot.

      ***** This is revision # 5

  5. emjaybee
    December 5, 2009 at 7:23 am

    There’s another issue; corporate power. If Dr. Smith works for Regional Hospital, and blogs about what he or she does (even in a general sense) the hospital could, like many other employers do, take that as some sort of confidentiality breach. Corporations can and do try to restrict internet speech (though many of them are not web savvy enough, yet, to really do more than a cursory Google search, unless a particular site or post is drawn to their attention).

    Whether any employer actually has the right to restrict a citizen’s speech about their work, constitutionally speaking, is hard to say. Many employees are required to sign non-disclosure agreements when they’re hired that are vague enough that almost anything an employee says could be construed that way. Of course, it might be unconstitutional, but corporations have more lawyers; most people would not fight such edicts or firings.

  6. MomTFH
    December 28, 2009 at 9:28 am

    I am currently blogging semi-anonymously, for reasons I think you understand, Dr. F! I am strongly considering “coming out”, but may need to do a little clean up to some of my entries that may be traced back to my institution.

  7. June 13, 2010 at 8:45 pm

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  1. July 14, 2010 at 6:54 am
  2. November 6, 2010 at 6:30 am

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