Doctors Dish on Their Patients in Anonymous Blogs

Other blogs are equally candid:

"I got called to the ER to deal with a man who had placed a piece of plastic tubing (an aquarium pump tube to be exact) up his urethra, and it was now stuck inside and neither the patient nor the ER physician were able to retrieve it." (That's from http://urostream.blogspot.com.)

"I informed a patient's parents that we would call them when their child was off the heart bypass machine and back in the intensive care unit. That went down like a lead balloon as the child was in fact having spinal surgery. Oops." (From http://mediblogopathy.blogspot.com.)

Critics find the trend troubling, not only because of the risk of compromising patient privacy but also because of potential liability for hospitals.

"We're talking about professions that have legal and ethical obligations regarding privacy that are governed by federal statutes," said Terry Bonnette, a labor and employment lawyer in Detroit. "You should assume when you're blogging that your anonymity is not absolute.

"Employers should be very careful about this. They are the ones who have the most to lose, really. A hospital has every right to protect its image and reputation."

Some blogs give advice on how to comply with HIPAA. The site http://www.geneticsandhealth.com has an "honor roll" of blogs that do well at abiding by privacy laws and disclosing biases.

"I just felt sites were not upfront about their affiliations," said Hsien Hsien Lei, who has compiled this list. (Not a physician, she has a PhD in epidemiology.)

"The line is very fuzzy," Lei added, when it comes to maintaining patient privacy. "Every single doctor who blogs kind of defines it for themselves."

The only acceptable way to blog safely about patients is to ask for their consent, said the University of Michigan's Stern.

"Absent that, you're on shaky moral ground," Stern said. "The only way you can totally protect confidentiality is to not say anything." ·