Tuesday, January 07, 2014

When Push Comes to Shove: The Slow Death of the Medical Blog-o-sphere

Is the medical blog-o-sphere dying?

As I surf the internet these days, I wonder.

It seems to me that there are a few new blogs from time to time, and even some old, fun, stalwart ones, but the adoption of medical blogging by many has fallen on hard times, despite the best efforts of blogging enthusiasts.  The reality is this: the adoption of blogging by physicians has either become flat, or waned.  So some extent, there is a move toward micro-blogging services like Twitter, but even Twitter seems populated by most of the "same old-same" old group of voices, punctuated by a steady and ever-growing stream of marketers.

I believe it's because blogging takes time, passion, and commitment.   And with all of the changes these past years, most of us are finding less and less time for social media as new pressures mount to produce.  Oh sure, a few make real money at this endeavor, but most do not.  The reality is that "google ads" just won't offset what a doctor's day job produces.  And as doctors are pushed toward more production with more computer screen time than ever, something has to give.

Gone are the days of the annual "best" Medical Blog Awards.  Gone are the most of the exceptional story tellers.  Gone are many case studies as legal, HIPAA and corporate gag orders loom large over online medical content.  Sure, some stay because they have something to say, some just like the to and fro interaction,  and a few might have a mission or agenda, but the truth is, real clinical doctors with blogs are a dying breed.  After all. how many social media meetings can one attend each year without compromising patient care?  A dare say, very few.

I do not say this to tout my presence here, but rather to ponder my future.  I still like to write, though I find I do it much less now.  I feel the pressure to produce like never before - bogus MGMA benchmarks and dwindling RVUs have a way of doing that to you.  So it is harder to be a cheerleader for social media when I see the mounting challenges real care-taking doctors and nurses are asked to face. After all,  not only are we tasked with the responsibility of being care givers, we are also being tasked with negotiating minefields of codes, becoming typists, consulting as business efficiency experts, and serving as social psychologists, too. If we could just add another eight hours to every day...

So blogs go untended.  Writing shortens. Or withers away.

I suppose this blog, too, survives now on caffeine, frustration, and a strange sense of duty to report what I'm seeing as health care evolves.

But I wonder, now more than ever, when the plug will have to be pulled here, too.



james gaulte said...

Well, for one I hope you do not pull the plug any time soon.

As a retired doc I cannot blame my diminishing blog output on the increasing demands of a more and more Kafka like practice world but more on increasing cynicism about what is happening to medicine and running out of new stuff to say.

Again kudos to your great blog commentaries which have inspired more than a few of mine.

Art Fougner MD said...

Cheer up, Wes.
There's always Medical Marijuana.

Kidney_Boy said...

I did an analysis of the nephrology blogosphere and presented my results at Kidney Week 13. Peak Blog was in early 2012, but we are not far from that peak 18 months later.

We found significant new voices still coming into the space, though individual blogs almost decrease productivity over time (as measured by posts per month).

Abstract here

Anonymous said...

Seems like it was just yesterday that the management idiots were telling us that we HAD to have a blog/Facebook/Twitter etc. etc. presence to meet the new standard of care.

Bullshit then and bullshit now.

Anonymous said...

My bet is that the ideals (sharing ideas, open communication) will never die, but the platforms are always changing. First it was myspace, then blogs, then twitter. Now it's facebook, which my kids tell me is now for old people. Next is ?, but it will be something.

I'll probably always be a guy who prefers a laptop. Many older then me prefer desktops, and most younger prefer tablets or smartphones.

The medium will change, but there i always room for reaching out, making connections, and a sharing a message.

Anonymous said...

If you go to the political blogosphere and look at the lists of other blogs and click on them at random, you find a LOT of dead sites, either 404 or last post 12 to 48 months in the past. It is not just medical blogs. Panda posted once after disappearing for 12-18 mo and never again. Maybe sermo and similar are sucking them off. Then too, not many of us have
that much to say every week.

Vince D said...

My list of emergency medicine and critical care blogs has never been longer. They're not the same narrative, personal, storytelling blogs that were big when I discovered medical social media five years ago, but that's a good thing. Instead they are almost all educational and part of the #FOAMed movement.

For a nice summary check out the LITFL analysis of the state of EMCC blogging here: http://lifeinthefastlane.com/emcc-blog-update-2013

DrWes said...

Vince -

Thanks for sending that list. I recognize many of those blogs, but some haven't been posted to since 2011 (see one of my former favorites included on that list: http://drcouz.blogspot.com/2011/06/testing-testing-123.html) and then reassess.

Sure there is activity, and some of it bountiful, but the depth and breadth of blogging is waning I still contend. Still, as others have pointed out, new means of expression may arise.

Not that what is being done in some circles isn't remarkable - it is - but we should accept that this form of communication seems to be more on the ebb than the flow, perhaps because of some of the realities I mentioned.

Unknown said...

Dr Wes,

I have only recently found your Blog and it is refreshing that it is very much a 'blog' with your personal commentary and insight! I have featured your blog in my top 5 Cardiology Blogs that I will be posting later this week! I really hope that you do not pull the plug because your consistency and personal touch set you apart from those blogs and without your posts I would have no idea about healthcare in the states!

Carl Robinson

Unknown said...

Dr Wes,

I have only recently found your Blog and have found it refreshing that it is very much a blog with your commentary and insight in to topics that most avoid. It has also helped me understand the issues that currently affect the american healthcare system. I have actually featured you in my Top 5 Cardiology Blogs in the World that I am going to post later this week! So if you do chuck it in I will miss your musings but also that post will need rewriting! :)

Unknown said...

Hello Everyone,
I am new to blogging, twitter and my website. It takes a lot of time but it is worth it if there is a ROI. I never thought it helped when I had my small Internal Medicine Practice, but now that I deal with Obamacare and Medicare Compliance, it is worth the time to expose my services to hospitals and doctors. Feel free to check out my site and my blog www.EpsteinHealthcare.com. I am trying to encourage "honest discussions" but with the "Politically Correct Police" having a problem with any strong opinion that they don't share, it can be difficult to craft your message without offending someone.
Good luck to all and keep blogging and exchanging ideas and best practices!
Warm regards,
Jeffrey E. Epstein, MD

Anonymous said...

I think the 2012 Health Bill killed the medical blogging community.

It sucked the variety out of the community because a large proportion of prominent bloggers took to frequently blogging about the Bill. The Bill became a long, drawn out and ultimately frustrating process that totally switched the public narrative on health to one that is almost exclusively negative and political now, and I think a lot of bloggers (and probably readers) just got bored with having to address such a depressing and in some respects distressing subject.

Especially when the real-world consequences of the bill will have increased pressures in the workplace, making blogging about work while at home especially unappealing.

Chris Johnson said...

I think you're largely correct. I've been blogging since 2007 and have been surprised that I haven't seen more. I'm not sure there's less, but there's been no growth.

For myself, as far as I know I'm the only pediatric critical care physician who blogs. If anybody knows of another one or two, let me know.

Anonymous said...

Try putting in a pacemaker. ;)

Retired FP said...

I was noticing this same thing recently and wondered if was just within the corner of the medical blogosphere that I followed. Your sentiments echo my own. The other aspect that has dampened my own interest in reading/responding to most blogs is that quite a few are now dominated by outspoken (on all sides) patient voices. While those can have merit, I was drawn early on by the "physician voices" in these blogs but too many are now diluted by the same responders in this arena. Kevin's aggregated articles are almost as often policy or non physician authors as practicing physicians. Ah well, c'est la vie.

Anonymous said...

If your blog was cardiology oriented I would not read it as faithfully as I do. I admire your courage and forthrightness in addressing the disturbing evolution of the health care system and the ongoing onslaught against physician autonomy. It is literally a battle against the free and independent thought based practice of medicine. At face value, technological advances might appear to obviate the need for intelligent, critically thinking clinicians. But as any physician can tell you, especially in the most critical situations, much of medicine is still practiced in a gray zone of uncertainty. Practice guidelines and the "team" approach aren't worth a damn in that scenario. Judgment is key, but it is being purged in medical training and practice.

Wes, keep up the good fight for those of us cowered into anonymity for fear of being labeled "disruptive".

Mike Sevilla, MD said...

Six months ago, I was having (and wrote about) the exact same feelings that you're having. I even told everyone that I quit social media, but only returned a month later, because I did miss it.

Yes, I don't write as much anymore, and I don't podcast that much anymore, but I still find social media ways for expression. And that's good enough for me.

Yes, it's not the medical blogosphere of 2006, but I'm still out here, and I found out that we would be missed if we left. Good luck in your decision making process...

Margaret Polaneczky, MD said...

Wes -
I had been thinking your way too, but recently discovered Feedly and find that as I had back to reading more blogs, my own blogging has revived itself a bit. Also a lot of new doc bloggers out there that we don't know about because our old circles fell apart (ie grand rounds.)

I've updated my blogroll and it just keeps on growing.

Stay strong, blogging friend. We need your voice.

And don't let the relative lack of comments make you think you are not being heard.

You are.


GruntDoc said...

Thanks, from this stalwart.

I've wondered the same things about if and why to keep my blog, and keep coming back to: but what if I finally had something to say?

Thanks for your excellence here, Sir.

Dr. Val said...

Totally understand and agree, Wes. But we will always be friends... and that's one great thing about blogging. :-) http://getbetterhealth.com/outsourcing-relationships-and-peddling-influence-why-social-media-is-not-fun-anymore/2013.02.26

Sid Schwab said...

Wes, I bailed mostly because of running out of things to say, largely for having retired. And because I found myself more and more unable to be silent about other issues not belonging on the blog (as I was reminded, often.)

Happily, mine still gets lots of hits by people searching for info, and I still respond to comments and questions. That part is still gratifying.

Rob said...

It's different than it once was, to be sure. For starters, we all drive Mercedes convertibles with all the money we've made off of blogging. Then there are all the groupies. That's annoying to be sure. Finally there's the stream of yogurt that is constantly going through my house. No, that last one has nothing to do with blogging. Damn parakeet.

Dr. Gwenn said...

I totally agree with your sentiments, Wes, and the many excellent comments of all the commenters. It used to be one of us would send out a tweet and get some interesting comments back. These days - silence. Just today I sent out a tweet about the flu just to see if anyone was out there - nothing back. None of us wants to hear our own voices...and that's what it's come to.

David Share said...

Wes- Do not throw in the towel; your efforts are appreciated and you are being read. I, for one, es pecially loved the stuff on the ABIM as I am a fellow victim. So, Dr Phelps, do not give up! -David Share

Unknown said...

You've been heard, loud and clear.
As a medical student, and a relatively new reader of your blog (I came over from 33 charts) - I'd love a post speaking to those of us who have started a medical blog, but are wondering if it's truly worth it in a world that values only step-scores? Heck...sometimes we wonder if anyone but family actually reads our blogs

Yours truly,