Thursday, March 27, 2014

Who would ask an anonymous blogger for medical advice?

I'm often asked why I use a pseudonym. When I first started blogging almost 4 years ago, I was still in practice. Some of my posts are a little edgy and my sense of humor is not for everyone. I didn't want patients to google me and have my blog come up on the first page of hits.

Now that I've been retired for over a year, I still have not revealed my true identity. You may ask, "Why not?"

I like being anonymous. I feel that I can be more honest because I am not worrying about what someone is going to think. A quote from Oscar Wilde says it all: "Man is least himself when he talks in his own person. Give him a mask, and he will tell you the truth."

Some people have questioned my credibility. They say how can anyone believe what you write when they don't know who you are? I've been referred to the UK General Medical Council's rule #17, which states "If you identify yourself as a doctor in publicly accessible social media, you should also identify yourself by name. Any material written by authors who represent themselves as doctors is likely to be taken on trust and may reasonably be taken to represent the views of the profession more widely."

Regarding the previous sentence, I agree with the first part about trust and strongly disagree with the second part. How could anyone think that what a single doctor writes is representative of the profession more widely? I am reasonably certain that is not the case in my situation.

You want credibility?

A single post of mine called "Appendicitis: Diagnosis,CT Scans and Reality," which I wrote about three weeks into my blogging career, has received almost 14,000 page views.

In the comments section of that post or via email, more than 50 people have asked me questions about their own or a family member's abdominal pain. I've had to add numerous disclaimers over the years reminding readers that I could not give medical advice without examining the patient.

Despite the disclaimers, the questions keep coming with the most recent one submitted two days ago. I can only guess that they are either reluctant to ask questions in person or not getting satisfactory answers from the doctors they are seeing.

Premed and medical students and residents frequently look to me for career counseling. Last week I even got a question from a high school student who was thinking about becoming a doctor. The students and residents occasionally preface their questions by saying that they didn't want to ask someone from their school or residency program for fear it would reflect poorly on them.

I have been amazed at how many readers seem to trust me enough to ask personal questions about their health or their career. To be able to connect with so many people despite my use of a pseudonym is rewarding.

Patients and aspiring doctors—that's who would ask an anonymous blogger for advice.


Nicholas said...

Here is the reason I choose to use my real name and not be anonymous: even if I tried to be, there is a very good chance that someone who was persistent could figure out who I was. They could use clues from my posts or tweets, connections in social media, etc. There is a good chance that any hypothetical person who was so persistently trying to identify me was doing so for not entirely benign reasons. Thus by being up front with who I am, I do my best to keep myself in line, and not say anything that I wouldn't be afraid to say in front of one of my bosses (or a judge).

My advice to other physicians on social media is not to be anonymous because in this day and age, anonymity is extremely difficult bordering on impossible to maintain.

Skeptical Scalpel said...

Nicholas, thanks for commenting. I do not disagree with anything you said. If I'm not mistaken you are either a resident or a fellow, which means you must be especially careful about what you do on social media.

I have avoided saying things that I would be ashamed of. I don't use profanity and I don't insult people.

A number of people know my real name. It's just a matter of time before I will no longer be anonymous. And that's OK.

Anonymous said...

After a while, most people can get a good figure on who is "real" and who isn't. Besides, for the life of me, I can't understand the need to know who the person is "behind the mask". What matters isn't the mask but the character and experience and education someone brings. I don't have to know a name, but when the character is there, I'll see it. In the end, like any other doctor, that's what matters: not the shape of the box, but what is in it.

and some days I just want to be me without having some one attach a load of baggage to it.

PS I think I heard someone did figure out who you were Skep but I can't remember anything else about it.

Skeptical Scalpel said...

Anon, I agree. Yes, a few people have figured out who I am.

KAC RN said...

SS: As for your sense of humor, well when you are in healthcare, a sense of humor is essential, perhaps mandatory. I think anonymity is a good thing, as you point out, it gives you the latitude to speak plainly. After years of "beating around the bush" because speaking plainly would not have been well received, your blogs are refreshing.
As for asking advice of an anonymous doesn't stop there. In the olden days, before digital media, diagnosis by phone was a frequent request during my stint in the ER.

Skeptical Scalpel said...

KAC, thanks for the kind comments. Good point about the calls to the ED. I seen it happen many times.

Anonymous said...

I have a huge problem with doctors not speaking out. I think there is a time to let things out and see if there is substance to what they're talking about or they just had a bad day, got rough patients, venting, etc. I understand you can't cuss a patient out but there are other ways to approach it then going off on a patient.

I want to know docs who are human. I see them posting or blogging and I like the blog, I'd probably want to be their patient. I am less concerned about what they say as long as I can figure out their motives. If they carp on hospital admin, I would understand being anonymous and I'd probably be asking to be on their patient panel the next day.

Maybe the type of doctor would be helpful. I would think certain groups have more stress, or a different viewpoint, and that would help more than knowing a name.

When I see a doc posting, I want to hear their thoughts as I would any other blogger. The "chats" I've seen on a number of blogs have given me greater insight into medicine and I'm quite grateful.

Skeptical Scalpel said...

Anon, thanks for contributing. I hope you think my blog is enlightening.

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