Are Standards of Conduct Needed for Physician Weblogs?

By Randy Hendrickson

Pharmalot recently reported a study (“Content of Weblogs Written by Health Professionals” by Tara Lagu et al) that shows that there are serious ethical problems associated with physician weblogs. Although weblogs have emerged as a vital new way to share experiences and provide a connection between health professionals and the public, they do not have the same standards of conduct as medical books, peer-reviewed journals, presentations at medical conferences, and other more traditional forms of medical communication.

Patient Privacy

Funded by the Robert Wood Johnson Foundation and published in the Journal of General Internal Medicine, this study found that a total of:

• 16.6% (45/271) of physician blogs contained information that allowed patients to identify either themselves or their doctor


• 42.1% (114/271) of the blogs described individual patients


• 15.9% (43/271) portrayed patients positively


• 17.7% (48/271) portrayed patients negatively


• 2.9% (8/271) showed patient radiographs with no other identifiable information


• 1.1% (3/271) of the blogs showed recognizable pictures of the patients

Product Endorsement

Explicit product promotions appeared in a total of 11.4% (31/271) of physician weblogs; however, none of the authors provided conflict of interest information, which is the rule for any legitimate form of medical publishing. Additionally, 29% of bloggers have been approached by public relations firms to endorse a product, and of those, 52% actually wrote a post endorsing that product. Lagu explains that “these endorsements are not advertisements that appear on the website; they are written into the blog narrative, often without any acknowledgment that they are paid promotions.”

According to Lagu, “the ease of use of medical weblogs disconnects blog content from the editorial process common to books, journals, and conventional broadcasts. For the most part, blog authors have few incentives to maintain their credibility and integrity or, in contrast, to compromise it for the sake of ratings or sales.” Most medical literature is subject to peer review; however, weblogs can be written by anyone with an internet connection, regardless of their qualifications.

Although the content of some weblogs shows a lack of respect for the physician-patient relationship, patient confidentiality, and appropriate management of conflict of interest, there has been no formal response from the medical community about the need for standards of conduct for weblog content.

The results of this study show that this new means of medical communication is only going to expand in the future. It is critical that “[p]hysician-leaders and medical educators consider curricular development and educational forums that address the challenges, opportunities, and responsibilities that medical blog authors face, and the place for this new medium with norms of the medical profession.”