LIABILITY UPDATE by Donna Baver Rovito

((I've visited several of these excellent sites, and it's always instructive to read about the battle from the people in the trenches....))

Blogs Offer a Look At Medicine's Front Lines

By LAURA LANDRO
Staff Reporter of The Wall Street Journal

From The Wall Street Journal Online

Doctors and nurses are joining the blogging revolution, ruminating about medical issues -- and providing a rare window into their world.

Their Web logs offer an insider's perspective on a range of important and often contentious issues, from the latest research studies to quality problems in health care. They are aimed primarily at creating dialogue among professionals, but many encourage input from consumers. And some doctors even answer general health-related questions online.

The blogs also give outsiders a sense of life on the front lines of medicine. In an exceptional case, many of the blogs last month provided searing firsthand accounts of hurricane relief work along the Gulf Coast.

While some blogging doctors and nurses choose to remain anonymous, or at least don't advertise their identities on their sites, a number of them do disclose names and affiliations. One of the best known, Robert Centor, is professor and director of the division of general internal medicine at the University of Alabama's Huntsville Regional Medical Campus; doctors can even get continuing-medical-education credits from the university for reading his blog, DB's Medical Rants (medrants.com).

How do harried medical professionals find the time to blog? Many say they enjoy writing and can dash off their posts at any hour of the day or night. Dr. Centor writes his entries early in the morning or whenever he can squeeze them in.

If you want to browse some of the most provocative recent entries, a site called SneezingPo.com offers a weekly "Grand Rounds" collection of medical blogging. And medical blogs often link to others; primary-care physician Kevin Pho's Kevin, M.D. blog (kevinmd.com/blog), for example, compiles a list of "other blogs of note."

Here are some individual medical blogs likely to be of interest to consumers:

DB's Medical Rants (medrants.com): Dr. Centor comments on a broad range of medical issues and the general state of medicine. He often lambastes drug companies for putting marketing ahead of research into risks and side effects -- but he doesn't spare consumers from his rants: After recent news reports about a doctor who was admonished for telling a patient she was obese and needed to lose weight, he blogged: "If we cannot tell patients that they are obese -- and that they should do something about it -- then can we tell patients to stop smoking, or stop drinking -- or what about crack cocaine?"

Medpundit (medpundit.blogspot.com): Penny Marchetti, an Ohio family doctor, started her blog three years ago with the aim of providing critical scrutiny of medical and health news, and adding a dash of skepticism to what she sees as boosterish media coverage of "overly optimistic claims for research findings." Most news stories "give too much credit to the claims made by researchers," Dr. Marchetti says, but "usually, when you look directly at the research, you find either that results have been exaggerated with statistical sleight-of-hand or that the design of the study was flawed."

RangelMD.com: Chris Rangel, a Texas physician practicing as a hospitalist (a specialist whose sole responsibility is the care of hospitalized patients), comments on current news and issues such as the need to practice "defensive medicine." He invites patients to ask medical questions, and posts the answers on his blog -- with the disclaimer that the information should not be used in place of a visit to a licensed physician.

Shrinkette (shrinkette.blogspot.com): Describing itself as the "musings of a psychiatrist in the Pacific Northwest," this site comments on mental-health news, including the use of antidepressants, and explores issues in the psychiatrist-patient relationship, such as where humor can fit into the picture.

Blogborygmi (blogborygmi.blogspot.com): An anonymous doctor blogs about medicine and the media, trends in medicine, the science of evidence-based medicine and whether drug-company marketing overly influences physicians (mostly he argues that it doesn't). The name of the site is a play on the word borborygmi, sounds doctors hear when they put a stethoscope to a patient's abdomen.

GruntDoc.com: Allen Roberts, a North Texas emergency physician and former battle surgeon, discusses emergency medicine and practical barriers to care -- such as the fact that most scanners can't accommodate obese people. He will answer readers' questions and solicit comments from other doctors as well. One recent inquiry was from a patient who encountered an ER doctor with Scotch on his breath. GruntDoc's take: It needs to be reported, but consult a lawyer, because the doctor might sue you for slander.

Codeblog -- Tales of a Nurse (codeblog.com): This nurse's blog posts personal stories about medical encounters, encouraging medical workers to share stories and solicit advice about how to deal with difficult patients, colleagues and situations. Patients are encouraged to submit their own stories about both good and bad experiences with medical professionals and health-care workers. The site also has links to many other blogs by doctors and nurses.

A Chance to Cut is a Chance to Cure (cut-to-cure.blogspot.com): A community general surgeon in Georgia who goes by the pseudonym Dr. Parker talks about surgery and "the socioeconomic problems of medicine in general," including the time pressures that make doctor-patient communication difficult.

Bioethics Discussion Blog (bioethicsdiscussion.blogspot.com): Maurice Bernstein, a retired Los Angeles doctor of internal medicine who is chairman of a community-hospital ethics committee, discusses ethical issues in medicine and science, and invites reader comments on subjects such as assisted suicide, withdrawing life support, how to tell patients they have a terminal illness, and the place of religion and prayer in medicine.

Chronicles of a Medical Mad House (medicalmadhouse.blogspot.com): An anonymous medical resident blogs about the often chaotic world of doctors-in-training.

The Cheerful Oncologist (thecheerfuloncologist.blogspot.com): Craig Hildreth blogs about his experience as an oncologist in private practice in St. Louis, including the lessons he learns from patients. In one post he described his awe at a patient who was inexplicably euphoric in the face of a devastating lung cancer that had spread to his liver: "He was expressing gratitude -- gratitude for his remarkable relief from pain, for the powerful treatments against cancer that exist for his assistance, for the chance to be discharged and return home."

Email your comments to <A title=mailto:cjeditor@dowjones.com href="mailto:cjeditor@dowjones.com" )>cjeditor@dowjones.com.

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