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As stated earlier, I recently attended a health blogger summit in New York that was put on by Consumer Reports. It certainly says something about the rising influence of medical bloggers that we would be invited – along with some in traditional media that have crossed over into the world of blogging – to discuss issues related to healthcare online. Good or bad, we have become a voice that is being heard increasingly in the discussion about medical care and medical policies.
As we discussed the role of medical blogging, one attendee used the phrase \”the wisdom of the crowd.\” Others immediately jumped on this phrase, debating if there is, in fact, wisdom in the crowd. Many examples were given (and are still being given) of ways in which the crowd is wrong – my last post about false beliefs in the dangers of immunizations speaks to a dangerous concept that is drawing a crowd. The fact that many people agree to the truth of an idea does not make that idea right.
I think this whole debate, however, misses what the term \”the wisdom of the crowd\” actually means. The crowd has wisdom because of its diverse voices. A single blogger is not as trustworthy as the aggregate of medical bloggers. Falsehood on one blog should be corrected by another blog or by its readers. Multiple differing ideas and debate lead to more reliable conclusions. Unquestioned individuals – even reliable ones – are more likely to err.
This is not a \”majority rules\” phenomenon. The majority of the crowd may be wrong, with individuals standing against the tide. The truth The nature blogging that makes it so powerful is its interactivity. I write something and that expresses my opinion and others are free to criticize and correct. I would certainly hope that misstatements or blatant errors in my posts would be challenged by readers and other bloggers.
Traditional media, on the other hand, does not lend itself to such debate. Reporters do research (some more, some less) and then \”do a story\” on what they find. They may be held to task in editorials or in other ways, but there is little interaction with readers. There are those who challenge the claims of reporters or \”experts\” in the traditional media, but as a whole, something said on TV or written in a newspaper is assumed true by most of the viewers or readers.
Crowds, however, can turn into mobs. Mobs are groups of people that are unified by beliefs that push those beliefs on others. You cannot join a mob unless you subscribe to what they are mobbing about. There are certainly mobs on the Internet – groups of people that put down anyone who questions their dogma. These groups don\’t just to defend their beliefs, they attack others who do not hold them. Mobs are about conflict, not about solutions.
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Not all mobs are disorderly or uneducated. There are many stories of scientists who hold to unpopular theories that are shunned by the scientific community. This is termed \”snobbery,\” but it is nothing more than a passive-aggressive mob mentality.
Our discussion in NY led me to mention the Healthcare Blogger Code of Ethics, to which my blog (along with many others) subscribes. Discussion in blogs needs to be as open and honest as possible, with allowances for contrary opinions. Blogs (and traditional media, for that matter) should not be believed without question. The writer always has a perspective being pushed, and is prone to make mistakes. The idea of the code is to give readers a clear idea of where the blogger is coming from.
Here is the Healthcare Blogger Code:
- Clear representation of perspective – readers must understand the training and overall perspective of the author of a blog. Certainly bloggers can have opinions on subjects outside of their training, and these opinions may be true, but readers must have a place to look on a blog to get an idea of where this author is coming from. This also encompasses the idea of the distinction between advertisement and content. This does not preclude anonymous blogging, but it asks that even anonymous bloggers share the professional perspective from which they are blogging.
- Confidentiality – Bloggers must respect the nature of the relationship between patient and medical professionals and the clear need for confidentiality. All discussions of patients must be done in a way in which patients’ identity cannot be inferred. A patient’s name can only be revealed in a way that is in keeping with the laws that govern that practice (HIPPA, Informed Consent).
- Commercial Disclosure – the presence or absence of commercial ties of the author must be made clear for the readers. If the author is using their blog to pitch a product, it must be clear that they are doing that. Any ties to device manufacturer and/or pharmaceutical company ties must be clearly stated.
- Reliability of Information – citing sources when appropriate and changing inaccuracies when they are pointed out
- Courtesy – Bloggers should not engage in personal attacks, nor should they allow their commenters to do so. Debate and discussion of ideas is one of the major purposes of blogging. While the ideas people hold should be criticized and even confronted, the overall purpose is a discussion of ideas, not those who hold ideas.
I hope we medical bloggers remain a crowd – with our crowdly wisdom – and never becomes a mob. When you read things on a blog (or anywhere else), always read carefully. Weigh what you read against what you get from other sources. Pay attention to the crowd. Don\’t listen to the mob.
And if you ever think I am joining of a mob, please set me right. I promise to put down my torch.
“And if you ever think I am joining of a mob, please set me right. I promise to put down my torch.” Same here, Dr Rob.
“And if you ever think I am joining of a mob, please set me right. I promise to put down my torch.” Same here, Dr Rob.
I’m curious to hear what you think of another confidentiality issue related to blogging. A blog I follow is written by a cancer patient who happens to be a doctor. On more than one occasion, this blogger has included in his blog the full text copy (including name) of his oncologist. I am disturbed by this because I know that emails from the cancer center come with language about sharing the information.
And I know that, technically, HIPAA doesn’t even like doctors to communicate with their patients via email.
What do you think of this blogger’s inclusion of his doctor’s emails?
I’m curious to hear what you think of another confidentiality issue related to blogging. A blog I follow is written by a cancer patient who happens to be a doctor. On more than one occasion, this blogger has included in his blog the full text copy (including name) of his oncologist. I am disturbed by this because I know that emails from the cancer center come with language about sharing the information.
And I know that, technically, HIPAA doesn’t even like doctors to communicate with their patients via email.
What do you think of this blogger’s inclusion of his doctor’s emails?
Technically, the letters are the property of the patient. This means that the patient should be able to do whatever they want with the letter. If you want to publish personal information, it should be your right.
I agree that it makes me uncomfortable, but I can’t see anything unethical about it.
Technically, the letters are the property of the patient. This means that the patient should be able to do whatever they want with the letter. If you want to publish personal information, it should be your right.
I agree that it makes me uncomfortable, but I can’t see anything unethical about it.
Thanks for your perspective on this. I just know I wouldn’t want anyone publishing my private email without my express permission.
Thanks for your perspective on this. I just know I wouldn’t want anyone publishing my private email without my express permission.
I do have one issue with Susan’s story. I’m not happy that the blogger is publishing identifying personal information about 3rd parties (the oncologist and presumably the Cancer Centre involved), without seemingly having their permission to do so.
So I think it’s unethical, but in the broad sense of personal ethics, rather than in the specific sense of medical ethics. For example, I’m happy for someone to repost my comments under my posting name, but would be most unhappy about anyone, Dr Rob included, posting or distributing (say on an open public mailing list) my e-mail without my permission.
I do have one issue with Susan’s story. I’m not happy that the blogger is publishing identifying personal information about 3rd parties (the oncologist and presumably the Cancer Centre involved), without seemingly having their permission to do so.
So I think it’s unethical, but in the broad sense of personal ethics, rather than in the specific sense of medical ethics. For example, I’m happy for someone to repost my comments under my posting name, but would be most unhappy about anyone, Dr Rob included, posting or distributing (say on an open public mailing list) my e-mail without my permission.
I agree that an ethical line was clearly crossed, but not a medical legal one. It has nothing to do with HIPPA or other rules governing physicians and e-mail. It is simply a dumb thing to do for the sake of the doctor. It lacks courtesy.
I agree that an ethical line was clearly crossed, but not a medical legal one. It has nothing to do with HIPPA or other rules governing physicians and e-mail. It is simply a dumb thing to do for the sake of the doctor. It lacks courtesy.
[…] (some of them blogged the event – such as Dr. Val, OrganizedWisdom, eDrugSearch, ZRecommends, Musings of a Distractible Mind, Diabetes Mine). A strong debate: do ratings of hospitals and doctors help at all? 8. Now, did you […]
Published on: http://www.beforeyoutakethatpill.comThe Prevention of Ignorance
Historically, information sources provided to American citizens were limited due to the few methods available to the public, such as radio, TV, or news print. And also this information was subject to being filtered and, in some cases, delayed. This occurred for a number of reasons, which included political ones.
Now, and with arguably great elation, there is the internet, which can be rather beneficial for the average citizen.
Soon after the advent of the internet well over a decade ago, web logs were created, that are now termed ‘blogs’. At that time the blogs were referred to as personal journals or diaries visible on line. As time passed, blogs became a media medium, and blog communities evolved into addressing topics that often were not often addressed in mainstream media, as they crossed previously existing political and social lines. In addition, blogs provide immediate contributions by others, the readers of the posts of the blog authors, instead of the cumbersomeness of opinion and editorial pieces historically and not always presented in such media forms as newspapers or magazines.
The authors of blogs vary as far as their backgrounds and intent of what they choose to address on their blogs exactly, just as with other media forms. Some are employed by the very media sources that existed before them. Furthermore, they are not exonerated from the legalities of what is written, such as cases of libel. While we can presume that bloggers like to write, they may not be quality writers, yet several are in fact journalists, as well as doctors and lawyers, for example. But to write is to think, which I believe is a good quality one should have. Regardless, a type of Socratic learning seems to be occurring due to the advent of blogs.
Yet presently, blogs have become quite a driving force for those with objectives and issues often opposed by others, and therefore have become a serious threat to others. These others may be politicians, our government, or corporations- all of which have been known to monitor the content of certain blogs of concern to them for their potential to negatively affect their image or their activities previously undisclosed. This is why blogs, on occasion, have become a media medium for whistleblowers, which will be addressed further in a moment.
While one disadvantage of blogs is the potential lack of reliability, blogs however do allow in addition to the comments of its readers the posting of authentic internal or confidential documents that typically are not created to be viewed by the public, yet are acquired by certain bloggers. For example, blogger Dr. Peter Rost, a whistleblower himself, not long ago posted a newsletter published by pharmaceutical company AstraZeneca on his blog site, and this newsletter was given to him by AstraZeneca’s employees who called themselves the ‘AZ Group of Seven’- with the intent of this group being to bring to the attention of others the illegal activity of off-label promotion of one of AZ’s cancer drugs promoted by their employer. Yet this particular concern by AZ seven, by surprise, is not what caught the attention of so many who viewed the posted newsletter by Dr. Rost and was read with great interest by others. It was instead a comment included in this newsletter that was stated by former regional AZ manager Mike Zubalagga, who was being interviewed by a district manager in this newsletter. Mr. Zubalagga, who in this newsletter posted on Dr Rost’s blog site, referred to doctors’ offices as ‘buckets of money’, which caught the attention of several readers. This and other statements by this man were in fact published in this newsletter clearly not reviewed before its publication. . Again, the statement and the newsletter created by AZ was indeed authentic and further validated due to the content being in the written word, which added credibility.
Mr. Zubalagga was fired the next day due to this ‘buckets of money’ comment due to the effect it had on the image of his employer. His manager resigned soon afterwards from AZ.
Blogs, one can safely conclude, reveal secrets.
And there have been other whistleblower cases on various blogs in addition to this one described a moment ago, which illustrates the power of blogs as being a very powerful and threatening media medium of valid information disclosure that others cannot prevent from occurring.
This, in my opinion, is true freedom of information- largely free of embellishments or selective omissions. It’s a step towards communication utopia, perhaps, yet a force that has the ability to both harm and protect many others.
Yet again, the information on these blogs should not be taken as absolute truth without proof to verify claims that may be made, as with other media sources. Of course, documents that are authentic is an example of a good validation source. And this, in my opinion, is the blog’s greatest value, combined with the comments on blogs from the growing number of readers who are allowed to contribute to the subject matter so quickly, which fuels the objectives of the blogs, which may be a type of Socratic learning.
Like other written statements, some on such internet sites are composed with respect of the written word. Others are not. It’s the freedom that may be most appealing of this new medium which has the ability to convert citizens into journalists who want to contribute to an issue of their concern they share with the blogger often with great conviction and accuracy.
Because we, the public, have a right to know what we are entitled to know and what we want to know. This is especially true if the information disclosed on blogs could potentially be adverse to our well-being.
Ignorance is bliss, but knowledge is power.
“Information is the seed of an idea, and only grows when it’s watered.” — Heinz V. Berger
Dan Abshear
Published on: http://www.beforeyoutakethatpill.comThe Prevention of Ignorance
Historically, information sources provided to American citizens were limited due to the few methods available to the public, such as radio, TV, or news print. And also this information was subject to being filtered and, in some cases, delayed. This occurred for a number of reasons, which included political ones.
Now, and with arguably great elation, there is the internet, which can be rather beneficial for the average citizen.
Soon after the advent of the internet well over a decade ago, web logs were created, that are now termed ‘blogs’. At that time the blogs were referred to as personal journals or diaries visible on line. As time passed, blogs became a media medium, and blog communities evolved into addressing topics that often were not often addressed in mainstream media, as they crossed previously existing political and social lines. In addition, blogs provide immediate contributions by others, the readers of the posts of the blog authors, instead of the cumbersomeness of opinion and editorial pieces historically and not always presented in such media forms as newspapers or magazines.
The authors of blogs vary as far as their backgrounds and intent of what they choose to address on their blogs exactly, just as with other media forms. Some are employed by the very media sources that existed before them. Furthermore, they are not exonerated from the legalities of what is written, such as cases of libel. While we can presume that bloggers like to write, they may not be quality writers, yet several are in fact journalists, as well as doctors and lawyers, for example. But to write is to think, which I believe is a good quality one should have. Regardless, a type of Socratic learning seems to be occurring due to the advent of blogs.
Yet presently, blogs have become quite a driving force for those with objectives and issues often opposed by others, and therefore have become a serious threat to others. These others may be politicians, our government, or corporations- all of which have been known to monitor the content of certain blogs of concern to them for their potential to negatively affect their image or their activities previously undisclosed. This is why blogs, on occasion, have become a media medium for whistleblowers, which will be addressed further in a moment.
While one disadvantage of blogs is the potential lack of reliability, blogs however do allow in addition to the comments of its readers the posting of authentic internal or confidential documents that typically are not created to be viewed by the public, yet are acquired by certain bloggers. For example, blogger Dr. Peter Rost, a whistleblower himself, not long ago posted a newsletter published by pharmaceutical company AstraZeneca on his blog site, and this newsletter was given to him by AstraZeneca’s employees who called themselves the ‘AZ Group of Seven’- with the intent of this group being to bring to the attention of others the illegal activity of off-label promotion of one of AZ’s cancer drugs promoted by their employer. Yet this particular concern by AZ seven, by surprise, is not what caught the attention of so many who viewed the posted newsletter by Dr. Rost and was read with great interest by others. It was instead a comment included in this newsletter that was stated by former regional AZ manager Mike Zubalagga, who was being interviewed by a district manager in this newsletter. Mr. Zubalagga, who in this newsletter posted on Dr Rost’s blog site, referred to doctors’ offices as ‘buckets of money’, which caught the attention of several readers. This and other statements by this man were in fact published in this newsletter clearly not reviewed before its publication. . Again, the statement and the newsletter created by AZ was indeed authentic and further validated due to the content being in the written word, which added credibility.
Mr. Zubalagga was fired the next day due to this ‘buckets of money’ comment due to the effect it had on the image of his employer. His manager resigned soon afterwards from AZ.
Blogs, one can safely conclude, reveal secrets.
And there have been other whistleblower cases on various blogs in addition to this one described a moment ago, which illustrates the power of blogs as being a very powerful and threatening media medium of valid information disclosure that others cannot prevent from occurring.
This, in my opinion, is true freedom of information- largely free of embellishments or selective omissions. It’s a step towards communication utopia, perhaps, yet a force that has the ability to both harm and protect many others.
Yet again, the information on these blogs should not be taken as absolute truth without proof to verify claims that may be made, as with other media sources. Of course, documents that are authentic is an example of a good validation source. And this, in my opinion, is the blog’s greatest value, combined with the comments on blogs from the growing number of readers who are allowed to contribute to the subject matter so quickly, which fuels the objectives of the blogs, which may be a type of Socratic learning.
Like other written statements, some on such internet sites are composed with respect of the written word. Others are not. It’s the freedom that may be most appealing of this new medium which has the ability to convert citizens into journalists who want to contribute to an issue of their concern they share with the blogger often with great conviction and accuracy.
Because we, the public, have a right to know what we are entitled to know and what we want to know. This is especially true if the information disclosed on blogs could potentially be adverse to our well-being.
Ignorance is bliss, but knowledge is power.
“Information is the seed of an idea, and only grows when it’s watered.” — Heinz V. Berger
Dan Abshear