Here are the principles and guidelines I follow when blogging here on my blog.
Truth and accuracy: Everything I write is as accurate and truthful as I can manage, with some important exceptions noted below. (Note: not all my posts are about subjects where this is pertinent.) I welcome comments with suggestions and corrections. If I discover an error, I will either leave the original and add the correction, or make the correction and add a note explaining what was corrected and why.
Anonymity and accountability: I made the decision at the outset to blog under my real name, because I believe I should be responsible and accountable for what I say and do. My father told me before I went to college (three decades before the internet) that I should never say or do anything that would make me uncomfortable if I read about it on the front page of the local newspaper. It was great advice then and is great advice today. This decision acts as a reality check for me while writing my posts, which I see as a good thing. It is especially important for my blogging about medical interactions. (For what it is worth, this is probably moot, as there is no such thing as anonymity on the internet.)
Guest posting: This is my site and my blog. While I do not feel obligated to accept guest posts, I would certainly consider it. At this time I have not solicited guest posters. The requirements for a guest post would be that the subject be appropriate for this site, that it follow the rest of my guidelines here, and that I feel it is of potential value or interest.
Medical advice: I never use this site or my blog posts to provide individual diagnostic or therapeutic medical advice. Full. Stop.
Privacy, medical posts, and HIPAA: I see HIPAA guidelines as insufficient and hold myself to a higher standard here. I take great care to never post in a way that any individual patient could be identifiable, including by the patient. This presents a challenge far greater than the task of finding material. I blog about anecdotes, principles and themes, NOT about patients. This means that, while my medical anecdotes are true stories in the sense of representing something I have experienced or something I believe to be both real and true, NONE of the patients I describe here are real. While every medical post has at its core an experience or anecdote with some underlying important theme, I write using a composite of patient archetypes that are drawn from my 30+ years of primary care.
Patients and respect: Patients and their families reveal intimate and very sensitive information to their providers. This is only possible in a setting of tremendous trust and respect. We all do things that are silly, stupid, alarming, unjustified, reprehensible, incomprehensible and even flat out evil. My posts here are about theme, anecdotes, or events and are not meant to be judgmental or derogatory about individual patients, or patienthood. Each anecdote either has an underlying message or is presented in such a way that the composite patient is human and has redeeming qualities. There is obviously room for interpretation here, but I do not want either an actual patient of mine or a generic patient to read my posts and come away thinking I don’t respect and appreciate them, my patients, or patients in general.
Privacy and non-medical posts: In personal stories or in posts not involving patients, I will on occasion name family members, friends, acquaintances or persons of interest , but only if it is both pertinent to the story and can be done in a way that is not hurtful.
Language: With medical posts I try to either use English rather than Medical, or to include explanatory notes about medical terms or concepts. In terms of acceptable language, I have no hard and fast rule but like to think of this as a conversation among mature adults in my living room, and language or behavior that I would find out of place there is out of place here. Profanity, descriptions of physiologic and pathologic processes, medical talk and discussion of important life issues can require the use of emotionally laden terms or graphic imagery, but such terms and imagery must be necessary and serve a legitimate purpose other than prurient interest or adolescent limit testing.
Comments: I welcome comments about my posts. Obviously, it is nice to be praised and supported, but I also welcome civil disagreement, constructive criticism, alternative perspectives. I will not remove a comment or block a poster because we disagree, but I reserve the right to remove or edit posts and block posters in order to maintain an atmosphere here of civil discourse and tolerance of others. If you want to yell ‘FIRE’ you will have to find another movie theater - that is not allowed here.
Note: These principles have evolved – and are continuing to evolve – during the course of my blogging. Some of my earlier posts would be written differently if I were writing them today.