Downloaded from bmj.com on 3 October 2007 Who are the doctor bloggers and what do they want? Rebecca Coombes BMJ 2007;335;644-645 doi:10.1136/bmj.39349.478148.59 Updated information and services can be found at: http://bmj.com/cgi/content/full/335/7621/644 These include: Rapid responses You can respond to this article at: http://bmj.com/cgi/eletter-submit/335/7621/644 Email alerting Receive free email alerts when new articles cite this article - sign up in the service box at the top left of the article Notes To order reprints follow the "Request Permissions" link in the navigation box To subscribe to BMJ go to: http://resources.bmj.com/bmj/subscribers OBSERVATIONS Downloaded from bmj.com on 3 October 2007 MEDICINE AND THE MEDIA Who are the doctor bloggers and what do they want? Medical blogs are sometimes seen as just rants about the state of health care, but they have also been credited with spreading public understanding of science and rooting out modern day quacks. Rebecca Coombes checks out the medical blogosphere In “internet time” blogging has been around ter at investigative jour- for almost an eternity. Now, with the possible nalism than journalists exception of the odd intransigent high court are. All sorts of facts judge, blogging has achieved household name about dodgy practices status since catching the public’s imagination appear on blogs long nearly a decade ago. before they reach the The medical “blogosphere” is an especially regular magazines or crowded firmament. The opportunity to access papers; that is both fun and useful, I think.” Silver surfer: blogger Professor David Colquhoun raw, unfiltered material, to post instant com- Today annual awards are given for the best ments, and to share information with a (often medical blogs—including a prize for the best ern day quacks, correct ignorant journalism, niche) community has become an addictive literary medical blog—and competing websites digest interesting stories, or comment on big pastime for many doctors. The field has devel- offer rankings of the best blogs. The site www. official reports, for example. Many also use oped to the extent that devotees rely on their edrugsearch.com ranks more than 400 of the details that would not meet the BMJ’s policy favourite blogs as their first port of call for topi- most popular blogs on health and medicine. on patients’ confidentiality. Dr Crippen, for cal opinion and debate. Taken as a group, the It’s hard to gauge just how popular some of example, keeps a work diary that details con- medical bloggers—the popular ones, at least— these sites are, as top rated bloggers—such as sultations with noteworthy patients. are overwhelmingly younger men, and many BMJ columnist Ben Goldacre, who writes www. Ben Goldacre says that blogs are popular have a typically masculine geeky humour. badscience.net—keep this a closely guarded because they are more honest than other But the field is far from just a playground for secret. Many of the most quoted and linked-to media: “It is hard to get away with misrepre- the young. For example, David Colquhoun, blogs are by anonymous doctors, who shelter senting stuff when the original source is but a professor of pharma- under fake names click away. “I see it as a way of making con- cology at University Top five blogs on health and medicine to vent opinions on versation public—what is good about it is you College London, is Ranking by www.edrugsearch.com anything from politi- get unmediated expertise. In the old days, you 71 and now a cel- 1. Random Acts of Reality cal interference in the had to rely on a journalist to tell you what, ebrated blogger in (Trying to Kill as Few People as Possible . .) NHS to how science for example, Iain Chalmers, told them. I think his field. Professor (http://randomreality.blogware.com/) is misrepresented in journalists were often really bad at this. On a Colquhoun thinks 2. Bad Science (www.badscience.net/) the media. blog, there he is. In the press it’s hard to know that a blog’s power 3. MedGadget.com (http://medgadget.com/) NHS Blog Doctor what is true. But with blogs people can link lies in its independ- 4. Kevin MD, Medical Weblog (http://nhsblogdoc. directly to the original source—this never hap- (www.kevinmd.com/blog/) ence. Unlike news- 5. NHS Blog Doctor blogspot.com), by a pens in a newspaper.” papers, blogs don’t (http://nhsblogdoc.blogspot.com/) general practitioner He complains that newspapers will also feel bound to present writing under the plagiarise blogs without giving credit, whereas a balanced picture, pseudonym of Dr blogs will refer and link to a person’s site. And he says, “which, only too often, means giving John Crippen, is described as an “extremely on an online blog people can make instant equal space to people who believe the earth is depressing” look at the NHS. Dr Rant (www. comments, verifying a story or adding more flat and those that don’t. drrant.net) does what it says on the tin: rant information, whereas “in newspapers the com- “On a blog I can just give my view. It’s about medicine related topical issues, laced ment is published a few days after the original obviously that—and people can take it or with lots of strong language. These sites article, when everyone else has moved on,” leave it. Also, bloggers often seem to be bet- examine political interference, root out mod- says Dr Goldacre. 644 BMJ | 29 SEPTEmbER 2007 | VOLUME 335 OBSERVATIONS Downloaded from bmj.com on 3 October 2007 and of zero interest to MEDICINE AND THE MEDIA the public. So it’s fun to talk about things that do interest the public. It’s Patients’ blogs: also fun to be able to influence politicians and vice chancellors, though do doctors that is rather harder.” He says that before have anything blogs the ordinary aca- demic had no chance to influence anything to fear? much, other than by voting every five years. Blogs written by parents about Now—with a little techni- cal expertise—“they can their sick children’s care can be post stuff for the world to beneficial if handled sensitively. see while sitting in front of the TV or even on a Matthew Hurley and Craig hilltop.” Blogs are also Smith point out the pitfalls easy and cheap to pro- duce—many blog hosts are free. In recent months we have had very different What turns off many experiences of parents using blogs. One fam- would be users is the ily used a blog simply to update family and S A feeling that the blogo- friends overseas about their extremely prema- OM sphere is a wild west ture baby. It contained a daily record of events, TH RK A of crackpot opinion- including details of procedures and the names M mongers. How do you of staff looking after their baby. In another Professor Colquhoun was switched on to the determine the relative “value” of a medical blog the parents of a baby with rare congenital power of blogs after fighting a successful cam- blog? Ben Goldacre says that it is easy to sift abnormalities used it to keep detailed records paign to halt the proposed merger of Impe- through the huge choice of medical blogs, of medical care and decisions, including discus- rial College and University College London. building up a bank of trusted sites and follow- sions and disagreements with different medical “Everyone was unhappy about it but said it ing trails to new ones. and nursing staff. Both blogs initially caused was a ‘done deal’ and could not be stopped. He says, “I’m a 33 year old doctor, and I some concern among staff. As soon as I started a blog support came flood- most enjoy reading narrow interest maga- The phenomenon of parents’ blogs may ing in, and it was possible to publish raw, zines. A BMJ editorial is always going to be have a unique association with paediatric and unfiltered information instantly. It took only more interesting to me than a Times editorial, a neonatal practice. It is common practice for five weeks after starting the blog to defeat the Nature article more than a New Scientist feature. parents to take photographs of their babies whole daft idea, and that made me realise the The http://science.reddit.com site [a ranking to log their progress. Electronic dissemina- amazing power of the web.” of science writing that is posted and voted on tion makes sharing these experiences easier, After peace descended on UCL Professor by users] is consistently brilliant, much better and for many the blog is simply the modern Colquhoun found he was addicted, and he than anything in the newspapers.” Blogs also photograph album or memory box. Keeping started to publish opinions on quackery and offer users “grand rounds”: informal syndica- a blog can be beneficial to parents: it lightens also on politics, religion, and education. tion of the best from other blogs. For exam- the burden of daily telephone contact and “It slowly dawned on me that all these ple, a group of blogs will take it in turns to provides written support when others reply to pages were closely related, [were] just differ- host a paediatric grand round, rounding up the site. Many parents already publish their ent aspects of ‘endarkenment’ thinking, and the best of that week’s blog entries related to experiences on conventional websites in the the pages got too big to load quickly, so they paediatrics.