Why I do This

It was a legitimate challenge.
When I mentioned to a fellow blogger that I was appearing on NPR, and he raised a very important question:  \”Is that really a good thing?  I thought that the point of blogging was to pose a challenge to the mainstream media, but it seems like bloggers feel like they have made it when that same media pays attention to them.\”

This hits at the core of what I do as a blogger (and a podcaster).  Why do I spend so much of my time doing something on that takes a bunch of time and energy, when I already have a very busy life?  Why blog?  Why podcast?  Why do interviews?  Why llamas?  Why spend a weekend in Las Vegas?  OK, the last question has any of a number of answers, and I have no idea about the llamas.  But you get my drift: given the busyness of my life, why should I do all of this?

My answer is this: I blog and do all the rest of this stuff to give my perspective to as many people as possible.

I know that there are those out there who claim that they blog \”for themselves\” and \”don\’t write to the audience.\”  Bull.  If you don\’t care if people read what you say, why do you say it on a public platform that can reach anyone on the Internet?  Why not just write it in a journal?  No, bloggers blog so that they will be read by others, the larger number the better.

This seems to be egotistical, and maybe it is, but the only reason anyone reads a blog is because it interests them.  My readers think what I write is interesting (except my Mom, who reads it to make sure I am keeping out of trouble).  What makes my blog different from the \”traditional media\” is its subjectivity.  I am a practicing primary care physician, and that perspective is a large part of why people read me.  People want to know what doctors think – what it\’s like to be a doctor.  If I quit my practice and went into writing full-time, I would lose that unique subjective perspective and the legitimacy it lends.

I am not doing journalism when I blog; I am writing a personal narrative and giving my opinion on things.  I am explaining things that I know about and entertaining people with my own personal style.  Journalists gain legitimacy from their objectivity.  People rail on MSNBC and FOX because of their bias.  I don\’t want to do journalism; I would lose interest very quickly.

What makes this even more important for me is that I see my perspective as one that is not heard and one that is really important.  Prior to the Internet, primary care physicians could only reach a large audience with their opinions if they stopped practicing medicine.  They could only influence the debate on issues that mattered to them by giving up their perspective.  Blogging, podcasting, and doing all the other stuff gives me an incredible opportunity.  I can voice my opinion to millions of people, and those people seem to really want to hear what I have to say.  It is really remarkable to me.

When I first started blogging, I did it to see if I was a good writer.  I thought I might be able to write entertaining stuff, but had never had much of an opportunity to do so.  It was a hobby for me.  I had no designs to become famous.  It still surprises me that a primary care physician in a small city with an odd sense of humor could actually be seen as important.  It\’s not something I would have ever expected; and had I known, I would have been really nervous.

But it still isn\’t the fame that makes me want to blog.  The truth is, the more people who read me, the more pressure I have to give them something worth reading.  I could write lots of bad posts when I was unknown and could take extended breaks from writing if I wanted to.  Now there is much more pressure, which is definitely a negative from my perspective.  But what keeps me coming back to this stuff is one thing: passion.

I feel strongly about things.  I sit in a room with people pouring out their lives.  I see suffering and struggle, and I see people doing incredibly hard things.  They will never be famous, and their situations and accomplishments might not even be recognized by those close to them.  But I have been given the opportunity to see underneath the hoods of a bunch of people, and I am honored by their trust.  They are what health care is about.  They are the reason I work the long hours I do. But they don\’t have the power to change things, and for some mysterious reason I have been given a small chance to do so.  I owe it to them.  Blogging has given me the voice to give them a voice, and that\’s a thing worthy of passion.

Even my humor is fueled by this.  I don\’t think I could have ever spent three years writing about llamas and muppets.  It\’s a wonderful diversion and it keeps me from burning out; but it is not my passion.

So the reason I am so excited to get attention like this NPR piece is the same reason I do the blog and the podcast.  I think my perspective is important and needs to be heard.  It\’s about people\’s lives.  It\’s about giving a voice to them.  Maybe I can even make a real difference.

That\’s why I do this.

48 thoughts on “Why I do This”

  1. As someone working in the msm, I don’t see an opposition between the msm and bloggers. Seems like we’re all in the same business, trying to document something about the world and amuse ourselves.

  2. As someone working in the msm, I don’t see an opposition between the msm and bloggers. Seems like we’re all in the same business, trying to document something about the world and amuse ourselves.

  3. You got listed as potential spam, but I rescued you. I agree – I think the two can thrive together (and should). I would never want to do the investigative side of things you and your reporters do. I have a unique perspective, and that is all I want to represent.
    Thanks for the interview. It truly was enjoyable. I didn’t catch the stream of the show yet, however.

  4. You got listed as potential spam, but I rescued you. I agree – I think the two can thrive together (and should). I would never want to do the investigative side of things you and your reporters do. I have a unique perspective, and that is all I want to represent.
    Thanks for the interview. It truly was enjoyable. I didn’t catch the stream of the show yet, however.

  5. Well put response to my question, Rob. And quite sincere. I do think that this issue of what we have to say and why we say it is quite complicated. I started blogging to sell a book but realized that it offered me something else. You’ve motivated me to do a post of my own.
    And it was great meeting you. And next time we’ll find a cheaper steak and it will be on me!

  6. Well put response to my question, Rob. And quite sincere. I do think that this issue of what we have to say and why we say it is quite complicated. I started blogging to sell a book but realized that it offered me something else. You’ve motivated me to do a post of my own.
    And it was great meeting you. And next time we’ll find a cheaper steak and it will be on me!

  7. humor? … yes.
    passion? … yes.

    unique, insider perspective? … yes.

    that’s why we read you.

    thank you!

  8. humor? … yes.
    passion? … yes.

    unique, insider perspective? … yes.

    that’s why we read you.

    thank you!

  9. I loved reading this! As a new med blogger, I’ve had to answer a lot recently, “Why are you doing this?” Because patients/friends/family/neighbors ask me every day “What do you think of this story I heard on the news?” “Should I get that vaccine?” “Should I take that herbal supplement?” “What should I eat?” “How can I exercise?” I love answering. And I love writing. And now there are blogs! Thanks for your voice.

  10. I loved reading this! As a new med blogger, I’ve had to answer a lot recently, “Why are you doing this?” Because patients/friends/family/neighbors ask me every day “What do you think of this story I heard on the news?” “Should I get that vaccine?” “Should I take that herbal supplement?” “What should I eat?” “How can I exercise?” I love answering. And I love writing. And now there are blogs! Thanks for your voice.

  11. well now i know why you do this. i’ve reading you for only about eight months now and i have to say that at times i wondered why you did this. at first i wondered if you were really seeing patients.i’m going to see my pcp next week and am going to ask him if he reads you. if he says no, then i will deny him access to my prostate until he promises to read you.

    i’ve been the primary care giver to my parents, and i have a good set of my own health issues so i have had the experience of a lot of contact with the medical system. the one overwhelming factor in good care is having the right pcp. it is right up there with having the right mate, to me more important than a priest. my pcp hears everything from me, he is my first line of defense for every physical and mental question i have, i can say anything to him and for that he gets to feel me up, probe up me bum, and ask me anything. we have a good marriage, because that is what having a doctor should be like.
    thanks for doing what you do.

  12. well now i know why you do this. i’ve reading you for only about eight months now and i have to say that at times i wondered why you did this. at first i wondered if you were really seeing patients.i’m going to see my pcp next week and am going to ask him if he reads you. if he says no, then i will deny him access to my prostate until he promises to read you.

    i’ve been the primary care giver to my parents, and i have a good set of my own health issues so i have had the experience of a lot of contact with the medical system. the one overwhelming factor in good care is having the right pcp. it is right up there with having the right mate, to me more important than a priest. my pcp hears everything from me, he is my first line of defense for every physical and mental question i have, i can say anything to him and for that he gets to feel me up, probe up me bum, and ask me anything. we have a good marriage, because that is what having a doctor should be like.
    thanks for doing what you do.

  13. You made me laugh out loud. Thanks for the comment – I agree that a good PCP is very important. I think care would be cheaper if we trained PCP’s better and had more of them.

  14. You made me laugh out loud. Thanks for the comment – I agree that a good PCP is very important. I think care would be cheaper if we trained PCP’s better and had more of them.

  15. Good to have you in the medical blogging world. It actually helps to always be a little insecure about your writing. I think I have to prove myself every time I write something, and that makes me work harder at doing it. The love you describe is at the heart of it – keep that and you will do very well (and enjoy it).

  16. Good to have you in the medical blogging world. It actually helps to always be a little insecure about your writing. I think I have to prove myself every time I write something, and that makes me work harder at doing it. The love you describe is at the heart of it – keep that and you will do very well (and enjoy it).

  17. I heard you on This American Life. I am an inpatient coder and I was thinking there is a code for weakness 780.79(generalized) or muscle weakness(728.87).You and Ira seemed to not value coders. Blame the insurance companies and Medicare instead of us! I agree all those stupid codes for Swine Flu vaccinations is a problem. I get depressed about being a coder when my bosses pressure me to code a lot of charts, yet ding me when my accuracy rate goes down.And don’t get me started about MD handwriting. I am hoping with the electronic medical record we will be mandated to have I wont have to jeopardize my cervical spine’s health in order to read the writing…

  18. I heard you on This American Life. I am an inpatient coder and I was thinking there is a code for weakness 780.79(generalized) or muscle weakness(728.87).You and Ira seemed to not value coders. Blame the insurance companies and Medicare instead of us! I agree all those stupid codes for Swine Flu vaccinations is a problem. I get depressed about being a coder when my bosses pressure me to code a lot of charts, yet ding me when my accuracy rate goes down.And don’t get me started about MD handwriting. I am hoping with the electronic medical record we will be mandated to have I wont have to jeopardize my cervical spine’s health in order to read the writing…

  19. You get me wrong; I really do value coders. The two codes you give are not for the weakness in the arm/arms, which is something people come here with. If I order an MRI of the neck because of that weakness, neither of the two codes does enough to justify the test (potentially) and neither gives anyone reading my note the truth about what was wrong with the patient. The “Rube-Goldberg” system (as Ira described it) is way too complex. We are gaming the system to get money, and you are caught in the middle of this. I spend way too much of my day trying to figure out these codes and yet I could be brought up for insurance fraud if I code incorrectly. During the interview, Ira asked “who benefits from this complexity?” and the two parties who truly don’t benefit are the doctors and the patients. It just increases the chance that I won’t get paid or the patient will get stuck with a bill for an improperly coded referral. You are blamed for when things go wrong and get no credit when the go right. I would not want to do your job.
    The post that got the attention of the folks at NPR was Decoding Coding – read it and see if you agree. Please don’t think you are not valued – a good billing staff person is worth more to me financially than nearly any other member of my staff.

  20. You get me wrong; I really do value coders. The two codes you give are not for the weakness in the arm/arms, which is something people come here with. If I order an MRI of the neck because of that weakness, neither of the two codes does enough to justify the test (potentially) and neither gives anyone reading my note the truth about what was wrong with the patient. The “Rube-Goldberg” system (as Ira described it) is way too complex. We are gaming the system to get money, and you are caught in the middle of this. I spend way too much of my day trying to figure out these codes and yet I could be brought up for insurance fraud if I code incorrectly. During the interview, Ira asked “who benefits from this complexity?” and the two parties who truly don’t benefit are the doctors and the patients. It just increases the chance that I won’t get paid or the patient will get stuck with a bill for an improperly coded referral. You are blamed for when things go wrong and get no credit when the go right. I would not want to do your job.
    The post that got the attention of the folks at NPR was Decoding Coding – read it and see if you agree. Please don’t think you are not valued – a good billing staff person is worth more to me financially than nearly any other member of my staff.

  21. The insurance companies probably have a list of codes that they will say are OK for ordering an MRI and coding for outpatient you can’t code “rule out cervical myelopathy” for example.The bottom line is that the insurance companies want to find a way not to pay you.

  22. The insurance companies probably have a list of codes that they will say are OK for ordering an MRI and coding for outpatient you can’t code “rule out cervical myelopathy” for example.The bottom line is that the insurance companies want to find a way not to pay you.

  23. Exactly! And each insurance company has a different code that they accept. You probably share the contempt I feel towards the insurance industry (hard to think of anyone having more than I do). They are trying to keep our money from us. I just want to get paid for my job. I just want my patients to get tests I think they need. Yes, they do need to control cost. I understand that. But it is hard to do either of our jobs without becoming very much jaded regarding the motives.

  24. Exactly! And each insurance company has a different code that they accept. You probably share the contempt I feel towards the insurance industry (hard to think of anyone having more than I do). They are trying to keep our money from us. I just want to get paid for my job. I just want my patients to get tests I think they need. Yes, they do need to control cost. I understand that. But it is hard to do either of our jobs without becoming very much jaded regarding the motives.

  25. I agree. I would give up my job in a minute if we could start over and have a fair healthcare system. And I am paid a nice salary to do this job, another cog in the healthcare industrial complex which is driving up the cost of healthcare in this country.Medicare does not want to pay our ER when the MDs order head CT scans, unless the code corresponds to a list(I have seen it!). There have been countless meetings about this “issue”: the MDs are ruling out certain conditions and they don’t like all this scrutiny. I guess CT scans are too expensive now.

  26. I agree. I would give up my job in a minute if we could start over and have a fair healthcare system. And I am paid a nice salary to do this job, another cog in the healthcare industrial complex which is driving up the cost of healthcare in this country.Medicare does not want to pay our ER when the MDs order head CT scans, unless the code corresponds to a list(I have seen it!). There have been countless meetings about this “issue”: the MDs are ruling out certain conditions and they don’t like all this scrutiny. I guess CT scans are too expensive now.

  27. That was sarcastic, right? ICD-10 will probably have more codes – increased complexity. Yay!

  28. That was sarcastic, right? ICD-10 will probably have more codes – increased complexity. Yay!

  29. It took a long time for me, Michael. It will always make you feel odd when you post and nobody comments. You do write well, and I have found that you just need to keep writing. Eventually people read people who write well. Even me.

  30. It took a long time for me, Michael. It will always make you feel odd when you post and nobody comments. You do write well, and I have found that you just need to keep writing. Eventually people read people who write well. Even me.

Comments are closed.