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    Doctors and "blogs"

    Physicians are beginning to take advantage of this new-age alternative to journaling, and getting lots more mileage from it.

    Did you know that five Bulgarian nurses and a Palestinian doctor were sentenced to death in Libya in May, having been convicted of intentionally giving HIV to more than 400 children? Allegedly they were part of a CIA/Israeli intelligence plot. Libyan healthcare workers were cleared in the case.

    If your local paper didn't run the story, you could have found it on the Web log—or blog—of Medpundit, who in real life is Pennie Marchetti, a solo FP in Stow, OH. Marchetti is one of a small but growing band of doctors who post their opinions, diaries, and rants on personal Web sites. They also post quirky news items and medical information they deem important. The latter is often an excerpt from a clinical journal or newspaper article with the blogger's commentary and a link to the full text. Often, the blogs act as forums, as well, allowing readers to post their own comments or questions.

    Who has time to read this stuff? You'd be surprised. Medpundit gets 300 to 400 visitors per day, Marchetti says.

    The world of blogs is exploding. That's because blogging is easy and cheap. Many blog hosts, like Blogger (www.blogger.com), are free. Easy-to-use templates can have your personal Web site—complete with Web address—up and running in a few minutes. Adding content—articles, photos, text, links—is a cinch.

    But to gain a following, a blog requires new content a couple of times a week, if not daily. That takes time, a commodity that busy physicians don't have a lot of. As a result, the number of doctors who blog isn't large. We searched the Web and found about two dozen, with perhaps another two dozen medical students. Why do it? Let's take a look.

    Enoch Choi:
    the physician as diarist

    Palo Alto, CA, urgent care physician Enoch Choi became a blogger in 2003. His blog, Medmusings (www.enochchoi.com/thoughts/index.html), is a "fount of unending rambling on toddlers and marriage, food and wine, medical technology, spirituality, and events around Palo Alto," he says. For example, a recent post included a diagram copied-and-pasted from an article in American Family Physician on reattaching amputated fingertips. (There's a link to the article, as well.) "I see someone with that every one to two months," Choi explains.

    Busyness forces Choi to keep blog posts brief. He writes most in a few minutes whenever he has the time. Opinion pieces take longer. "Every three or four days I add a bunch of entries," he says. Still, that's enough to garner Medmusings 300 visitors a day.

    "Many entries are links to the Web sites for CME conferences or other events I'll be attending," Choi says. "It's a way to tell my friends what I'm interested in, what I'm up to, the causes I'm passionate about. I enjoy participating in the community created from conversations with friends who comment on the Web log and in private e-mails."

    Pennie Marchetti:
    the physician as pundit

    Pennie Marchetti started her blog, Medpundit (www.medpundit.blogspot.com), in 2002. The soft-spoken Marchetti (whose nom de plume is Sydney Smith) is an acerbic wit online. Commenting on a recent post about a German man, hospitalized with multiple fractures, who called in a prostitute, she quips: "Sounds like the Germans keep their patients in the hospital too long."

    "I was getting frustrated with news reports of medical breakthroughs," explains Marchetti of why she became a blogger. "It's amazing how much that's published in clinical journals winds up in the local paper, even though a study might not be groundbreaking. I attempt to present a more realistic perspective."

    Marchetti believes reading blogs, especially by doctors in different specialties, can be valuable to physicians. "Take the newer minimally invasive surgeries," she says. "I think you can get a more honest perspective by reading a surgeon's blog than you might if you were talking to a surgeon in your local hospital."

    Robert M. Centor:
    the physician as educator

    Even though internist Bob Centor's two-year-old blog is titled DB's [Dr. Bob's] Medical Rants (www.medrants.com), his comments on clinical issues and the state of medicine aren't red-faced diatribes. Rather, they're short, reasoned, educational snippets of commentary on article excerpts he posts about his great passion—medicine.

    For instance, in response to a recent JAMA article on the possibility that lipid-lowering therapy may reduce mortality after major surgery, Centor posts the comment: "We have interesting data founded in solid theory. But, as the investigator cautions, we still need a prospective study prior to widespread adoption of this new strategy." To a story in The Washington Post on rethinking cardiac risk factors, he simply adds: "I recommend this article as a nice summary of an important topic."

    Centor is associate dean of continuing medical education at the University of Alabama School of Medicine in Birmingham. Students who regularly peruse his blog receive CME credit. Centor had followed a number of blogs before starting his own. "I thought, 'Boy, that would be fun to do,' " he recalls. Blogging has disciplined him to keep abreast of medical news. It has also improved his writing. "I communicate better orally than with the written word," he says. "This was a way to become a better writer."

    Joseph Mercola:
    the physician as entrepreneur

    For more than a year, FP Joseph Mercola, medical director of a 50-employee practice in Schaumburg, IL, has been devoting four hours a day to his blog (www.mercola.com/blog), in addition to co-authoring two diet books and lecturing widely on his main interest—natural health. His blog is one feature of a natural health Web site that also includes a free newsletter with more than 225,000 subscribers.

    Mercola's detailed posts—about three a day, with more than 900 entries so far—cover topics like the efficacy of omega-3 fatty acids in increasing fetal growth during pregnancy, the ability of folic acid and vegetables to build stronger bones, and the link between corn syrup and diabetes. The most popular posts are culled into the newsletter.

    Both Mercola and his readers like the immediacy of blogging. "I employ 15 people to run my Web site, including three editors for my newsletter, where it takes two weeks for an article to appear," he says. "I do the blog myself. It lets me add posts daily."

     

    Neil Chesanow. Doctors and "blogs". Medical Economics Aug. 20, 2004;81:33.

    Neil Chesanow
    The author is a former Senior Editor of Medical Economics.

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