In Response to “Emergency Medicine in the Blogosphere”

Article Outline

• Copyright

To the Editor:

I am an Associate Consultant in the emergency medicine department at Singapore General Hospital, and read the May 2007 Annals News and Perspective article with great interest, for several reasons. I am familiar with Drs. Allen Roberts and Nicholas Genes, 2 extremely talented emergency physicians and writers whose blogs I link to and greatly enjoy reading. Allen, Nick and I were briefly part of a group of medical bloggers who set up and contributed to The Lingual Nerve (www.lingualnerve.com). Our venture was well received with daily visits numbering more than 1000 during peak periods, but sadly, time constraints and other commitments led to its demise after a year of collaboration.

I too have a personal blog, located at www.spacefan.blogspot.com, which began in 2002. Although it started out by covering more social aspects of my life, its direction changed in 2003, when I reported on the SARS epidemic in my country. It was eventually mentioned on The Guardian’s Web site and garnered a favorable review (http://www.guardian.co.uk/weblog/special/0,10627,932308,00.\html – please scroll to the bottom). SARS-related entries from that year can be accessed via the archive links on the main page of my blog.

The pros and cons highlighted in the article, though cited by US-based doctors, are also applicable in other parts of the world. With regard to the ethical and administrative dilemmas, I’ve had my share of closed-door meetings, stern e-mails and other warnings over the years, first about revealing too much in my SARS-related posts, then about being too vocal in my frustrated rants on emergency department (ED) crowding (which the powers-that-be contend will tarnish the hospital’s image, ED staff’s sanity and morale be damned).

Preserving patient confidentiality is rarely an issue, but with our younger generation of doctors and doctors-to-be jumping on the blogging wagon, there have been times when too much was divulged, with dire consequences.

One intern chose to display his real identity on his Web site, and wrote an angry entry about a nasty patient he encountered, only to be discovered when the patient did a Google search and found his blog, subsequently lodging a complaint which got the intern a harsh censure and a terrible appraisal grade. No names were mentioned at any time, but alas, the patient recognized that he was being described, and the hospital believed him.

Despite all the precautions taken, medical blogging remains a tenuous pastime, with few doctors making any form of profit from it. I personally do not know any doctor who does it primarily for money or fame. Instead, we are driven by a passion for the written word which, when combined with the adrenaline rush and emotional rollercoaster ride of the medical profession, makes for compelling—almost addictive—reading.

Aside from helping doctors connect on a national and global scale, medical blogs also provide invaluable insight for the general public, who know little about our small, exclusive community. While there will always be the occasional heckler, the majority of non-medical readers harbor a deep interest and respect for what we do, and express these sentiments when they comment on our entries. My posts on SARS elicited responses offering encouragement and sympathy from all over the world, providing a great source of comfort to myself and my fellow colleagues during our darkest days.

Last but not least, medical blogging can prove instrumental in raising the profile of various specialties, emergency medicine included. As recently as 5 years ago, few residents in Singapore applied for traineeship positions in emergency medicine, but this number has surged in the past 2-3 years, with many applicants mentioning that they read my blog on a regular basis and developed an interest in this field because of the information I provided. Medical students choose to do elective postings with us because they know where “Dr. Spacefan” works, and quite a number of them have already decided to make emergency medicine a long-term career choice.

The effects of medical blogging are far-ranging and significant, though not without risk. However, the benefits are substantial and constitute the main (perhaps the only) driving force in our efforts to inform, educate and engage.

I salute medical bloggers everywhere for their tireless commitment to this cause, and for inspiring countless others to do the same.