|August 2011 · Vol. 23, No. 8
To blog or not to blog?
What’s the answer
for you and your practice?
Should you take the big step into professional self-expression and self-promotion on the Web?
Dr. Gunter, in ObGyn practice in San Francisco, Calif., blogs at www.preemieprimer.com/blog/ and www.drjengunter.com. She is the author of The Preemie Primer: A Complete Guide for Parents of Premature Babies—from Birth through the Toddler Years and Beyond (Da Capo Press, 2010).
Dr. Gunter reports no financial relationships relevant to this article.
Your gyn practice decides to publish an electronic newsletter for patients. You and your office manager spend a lot of time deciding on a format and writing content that you think is relevant to your patients. Everyone in the office agrees: It looks great.
But there’s a problem.
After your newsletter has been “live” for 6 months, fewer than 5% of your patients have signed up to receive it by e-mail (even though you’re sure that a lot more of them are on-line).
You’re perplexed: Why the poor response? The newsletter contains important information that your patients have told you they want—answers to the same questions that you get asked day in, day out.
Why does everyone seem so interested in getting answers to their questions when they’re in the office but not ahead of time and without a co-pay?
The diagnosis: Newsletters are so 1990s.
Offering a Web-savvy patient a newsletter is like presenting her with a VHS tape of a surgical procedure you’re recommending. She will look at you and think, “Huh?”
It’s not that your patients don’t want health information—they are clearly eager for it: 80% of Americans who have Internet access look for health information on-line.1 The quest for health information is the third most popular on-line activity (behind e-mail and using a search engine), and women are more likely to search for health information on-line than men are.2 Nineteen percent of all Internet users search on-line for information about pregnancy and childbirth, and on WebMD (www.webmd.com, the second most popular Internet health site), hysterectomy was the fifth most commonly searched treatment in 2010.1
But getting health information from the Internet today does not mean another e-mail message in the in-box, where it sits waiting to be read or, more likely, deleted without having been opened. For most patients, looking for health information on-line entails 1) general searches (via Google, for example) for symptoms, specific diagnoses, or therapies or 2) searches on specific health-related Web sites (the top two for traffic in November 2010 were the National Institutes of Health and WebMD).1,3
More and more patients, however, are craving a dialogue about their health; 40% of on-line health-related activities involve interactive, user-generated content of social media, the most popular sources being Facebook, Twitter, and the Web-site tool known as blogs that I discuss in this article—with the aim of helping you determine whether placing your professional voice on the Web in a blog is workable, valuable, and respectable.1,3,4
Blog (noun, singular); blogs (plural)
What is it? A shortened form of “web log.” Has a different functional meaning for different people: A journal. A place to rant. A collaborative archive. A source of breaking news.
Whatever shape a blog takes, at its core it is an ongoing chronicle of information plus opinion. For a medical blog, that description typically refers to the perspective of the consumer/patient or the health-care professional who writes the “posts,” or entries.
The Web has thousands upon thousands of medical blogs. Some support an academic institution or a government agency (even the Centers for Disease Control and Prevention has a blog); many describe the experiences of an individual with one or another aspect of health care (from a patient’s or provider’s perspective). With one third of Americans reading blogs, they are an excellent way to disseminate information.1,3,4
Why should physicians blog?
Here are what I consider several good reasons to start a medical blog—reasons that, in part, motivated me to begin blogging (see “Why I blog,”):
A blog is an ideal platform to deliver content to your patients and like-minded medical professionals. A blog allows your patients (and everyone else) to see information that you think is valuable and to hear your opinion on important health topics. Patients really like to know what their physician’s opinion is—how many times have you been asked, in the office, “What do you think I should do, doctor?”
Blogging is good advertising for your practice. Your blog will appear in Web-search results, which may lead new patients to your doorstep. Reporters and other media workers troll the Web, fact-checking and looking for “angles” for news stories; you may be called to give your opinion about something you blogged about. Remember: Being mentioned in the local newspaper is free advertising (yes, people still read newspapers, though often on-line); ask the reporter to include a link to your blog in any story in which you’re quoted.
(A technical note: Because having a blog helps you develop a robust Internet presence, any Web sites that you maintain are more likely to appear atop search engines’ lead “Results” page when users search for your name—instead of sites that contain your name but not content under your control, such as physician rating sites.5)
Blogging helps you learn from your readers. Given the interactive nature of a blog (comments are encouraged), you might find feedback that is interesting at the least, possibly educational. Many people take commenting on blogs very seriously, and often post valuable links to other content.
Contributing credible content drowns out garbage medical information that circulates widely on-line. The Internet is a powerhouse repository of medical knowledge, but it’s only as good as the content provided to it; in fact, 65% of Web pages contain inaccurate medical information.6 Regrettably, most people do not verify the medical information they find on-line.
Blogging helps keep you relevant. Medicine is still trying to figure out how to best integrate itself with the user-centered operation and experience of Web 2.0. If you aren’t engaged here on some level, you risk being left behind.
Why I blog
I started blogging about prematurity 2 years ago, at my Web site, www.preemieprimer.com. I saw this as a way to support my book, The Preemie Primer, and to add content that I just didn’t have enough space for in the print edition.
Recently, I started a more general medical blog geared to women’s health (see an excerpt of a post below). I set up this blog myself, using WordPress (see the description in the main text), in under an hour (I’m of sub-average intelligence when it comes to computers, but I can follow directions). I paid a Web-savvy person to change the domain name to www.drjengunter.com.
Some days, my posts appeal to 20,000 people
Other days, I captivate, oh, a dozen. For me, the most important reasons for blogging are to use my voice (I really do write as I speak) and to add good content to the Web.
Like many of you, I was sick and tired of seeing page after page of what I can only describe as drivel that my unsuspecting patients were spending hours downloading and reading. I decided to stop just bemoaning this reality and to do something about it because—like most of my patients—I also research my own children’s medical conditions on the Web.
Let me tell you: If my son’s pediatric cardiologist had a blog, I’d be reading it every day.
—Jennifer Gunter, MD
Excerpt: “Are condoms with spermicide a good idea?”
“You are standing in the grocery store staring at the overwhelming selection of condoms. The last time you had sex, there was an unfortunate incident involving breakage and you are eager to avoid the pregnancy panic and STD scare that ensued. You look at the condoms with spermicide thinking that extra-protection sounds like a good idea right now.
After all, condoms without spermicide reduce your chance of getting gonorrhea and chlamydia by almost 100%, reduce your risk of catching HIV by 87%, reduce your chance of getting HPV (the virus that causes cervical cancer and genital warts) by 70%, and reduce your chance of getting herpes by 30%. Condoms with spermicide must be even better, right?
Wrong. Condoms with spermicide are no more effective than condoms with regular lube at preventing STDs. Condoms with spermicide are also more expensive and have a shorter shelf-life.
And here’s the big kicker. Spermicide damages the ecosystem and delicate skin of the vagina (it’s a secret garden in there, boys). Because of this, condoms with spermicide actually increase a woman’s risk of getting a bladder infection and can damage local defense mechanisms enough that the risk of catching an STD actually increases!
Source: Gunter J. Are condoms with spermicide a good idea? http://www.drjengunter.com. Accessed July 21, 2011.
How to get started
The mechanics of starting a blog take little time and minimal technical knowledge. If you, or your practice, already have a Web site and a webmaster, he (she) can easily add a blog to the site for you. But you can also get a blog up and running yourself quite easily—at minimal or no cost to you (again, see “Why I blog”).
Two popular blog publishing platforms are WordPress (start at: https://en.wordpress.com/signup/) and Blogger (a service of Google; start at: https://www.blogger.com/signup.g). Both are free, although WordPress also sells a variety of upgrades that allow you to customize your site (if you have time and patience, you can navigate most of the upgrades on your own). Unless your blog needs a very specific look, however, you probably won’t need any of these options.
WordPress exacts an annual fee to keep third-party advertisements off your blog. Blogger does not charge to block advertising.
WordPress and Blogger both offer a variety of different templates so that you can trick out your blog to suit your style. You can delete the comments left by visitors with either platform. (Note: In 2 years of blogging, I’ve never had anyone post a comment that I thought needed deleting. But, you never know….)
So you’re not a writer. That’s OK—you aren’t chasing a Pulitzer.
People don’t linger on a blog. You want to make one or two points, not offer a dissertation. There is so much information on the Web that the only way to digest it is in small bites (think appetizers, not a four-course meal). Here are some pearls to consider for writing a blog successfully.
Take the content that you might publish in a newsletter and simply cut it up into smaller pieces. Instead of a full page about the human papillomavirus (HPV) vaccine, divide what you’ve written into three or four discrete posts: for example, one post on the incidence of HPV; one on transmission; another on the vaccine schedule; and one on other means to prevent HPV (you can never have too many posts on the importance of using a condom, considering that almost 40% of sexually active high-school students did not use one the last time they had sexual intercourse).7
Do some research. Read popular medical (and non-medical) blogs and decide what style suits you and your needs. A useful place to start is Dr. Kevin Pho’s blog at www.KevinMD.com. This is the most popular medical blog; in addition to his own writing, Dr. Pho posts content from an array of other physicians (including me), so you can find a number of different writing styles and viewpoints on a single blog.
Post links to information from other blogs and traditional news sources (CNN, MSNBC, and so on) and add your brief comment to their reporting. This is an easy way to start a blog—just provide attribution and be careful not to infringe on your sources’ copyright.
Answer the questions that you’re asked day in and day out in the office.
Post on topics that are relevant to the moment. In autumn, for example, add information about the influenza vaccine in pregnancy, a link to the CDC Web page on influenza, and the date on which your office will begin offering shots.
Add links to reputable sites; at the least, mention where you obtained specific information. This adds credibility, and people interested in learning more will appreciate knowing which sites are your sources.
State that what you posted isn’t intended as individual medical advice. Given the medicolegal climate, I highly advise you to say this somewhere on your blog.
End every post with a question. Doing so encourages comments.
Stay true to your voice, whatever else you do. Insincerity is obvious. Painfully so.
Promote your blog
Within your practice. Tell your patients that you have a blog. Consider listing the url of the blog on your business card.
And beyond. If you don’t want to promote your blog outside the practice, that’s fine. But if you like the idea of reaching more people, promote your posts on Twitter and Facebook and on information-sharing sites, such as reddit (http://www.reddit.com) and Digg (http://digg.com). Note that Facebook and reddit are currently more popular among women; these two tools may be better suited to your needs if you’re looking to get the most promotion for a blog that’s geared to women’s health.
Promotion takes some work but, if what you write has value, you’ll be surprised at the viral life that a blog post can take on. Example: Recently, on my blog, I wrote a post that I titled “Oprah signs off and doctors everywhere rejoice.” The post went viral thanks to multiple re-postings on Twitter and Facebook and to views from reddit. In 3 days, the post was viewed more than 30,000 times.
This kind of traffic increases a blog’s ranking with search engines; it helped my blog stay at the top of the first “Results” page on various search engines for a while.
A blog can be a great tool for you and your practice
Blogging doesn’t have to take hours a day (although the public is fickle, and people will drift away if you don’t post at least three or four times a week); with only a little time and effort, you can have the satisfaction of self-expression. And, if you’re committed to good content, you will raise the quality of health information on the Web.
4 points of caution about blogging
- If you work in a group practice or are employed by a hospital or other health-care entity (that is, if you are not in solo practice), advise your partners or employer that you have a blog.
- If your blog does not officially represent your practice or group, state somewhere on it that the opinions you express are strictly yours and not those of your employer or group.
- Always be HIPAA-compliant on your blog.
- Be carefulâ€”err on the side of overzealousnessâ€”to preserve the patientâ€™s anonymity when you post about a case youâ€™ve seen. You donâ€™t want her reading a thinly veiled description of her unique medical condition. If you have an interesting case, consider writing only a general post about the condition.
We want to hear from you! Tell us what you think.
1. Fox S. Health Topics. Pew Internet & American Life Project. http://pewinternet.org/Reports/2011/HealthTopics.aspx. Published February 1 2011. Accessed May 20, 2011.
2. Pew Research Center. Pew Internet & American Life Project Tracking Surveys: Trend data. http://www.pewinternet.org/Static-Pages/Trend-Data/Online-Activites-Total.aspx. Updated May 2011. Accessed June 1 2011.
3. McDaid D, Park A-la. Online health: Untangling the web. BUPA Health Pulse 2010. http://www.bupa.com/healthpulse. Published January 4 2011. Accessed June 1, 2010.
4. Pew Research Center. Generational differences in online activities. Pew Internet & American Life Project. http://www.pewinternet.org/Infographics/Generational-differences-in-online-activities.aspx. Published January 28 2009. Accessed June 1, 2011.
5. Gunter J. For better or maybe, worse, your patients are judging your care online. OBG Manage. 2011;23(3):47–51.
6. Thompson LA, Dawson K, Ferdig R, et al. The intersection of online social networking with medical professionalism. J Gen Intern Med. 2008;23(7):954–957.
7. Eaton DK, Kann L, Kinchen S, et al; Centers for Disease Control and Prevention. Youth risk behavior surveillance—United States 2009. MMWR Surveill Summ. 2010;59(5):1–142.
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