When patients blog about their doctors

An e-mailer wanted to know: what are the ethics of posting about my own doctor? Dr. Bernstein, of Bioethics Discussion Blog, sends his reply:

I heard the page for me..so I came running. I understand you want an ethics consult? OK. Here are the questions and my answers:

"What are the confidentiality ethics for patients writing about their experiences?" If you desire to disclose your personal experience for the world to read, you do so at your own risk and pleasure. It is ethical because it is your autonomous decision to do so. "Not use the doctor's name?" Using the doctor's name or any information that may cause someone to identify the doctor would be unethical (the doctor deserves the same right as the writer to decide about publication) and it might be illegal if comments are made about the doctor's behavior or practice which could be interpreted in a court of law as libelous.

"Should a patient mention it to the psychiatrist?" Sure, again emphasize to the doctor he/she was not identified in any way. This informing by the patient, if the patient desires, will facilitate the physician to perform the act in the next question. "Should the psychiatrist read the blog?" Absolutely. As every physician should know, patients might not tell the physician everything, particularly regarding emotions or about the doctor-patient relationship, in the office. The doctor is right there looking the patient in the eye. On a blog, the patient may find some freedom to express what the patient really feels.

However, and here is the caution, on a blog there may not be a chance for the doctor to discuss the patient's concerns (remember, the world is reading and also eye-contact and body language is missing). Soo... be prepared to discuss your views openly with your physician at the next visit. He or she may very likely initiate the issue after you enter the office and sit down. I hope this ethics consultation is helpful and it is free. ..Maurice.

(Now I have visions of twenty or thirty patients asking me,"Did you read my blog?" In psychiatry, we usually focus on the interaction between doc and patient, during sessions...the process, not just the content. Through that interaction, we explore the patient's life and symptoms. Have psychiatrists begun to consider the implications of patients' blogs?)