Blogs and columns in a writer's own voice
A blog or column written for the public in a personal voice may be a medical blog, an online diary on health kept by clinicians, nurses, patients and others for readers from professionals to the lay public, or a newspaper column, newsletter or blog that commits its writer to a schedule. A medical writer reads the blogs of a specialism for what each kind offers, judges a blog by what it discloses about who writes it and who pays for it, and, writing one, matches the register to the reader and keeps the language plain for a lay audience. A clinician or medical writer who keeps up a column or blog takes on that schedule, writes in forms from short newspaper columns to question-and-answer blogs and subscriber newsletters, and fits the writing alongside the rest of their work.
What a medical blog is
A blog — from web log — is a form of online diary and a platform for voicing personal or professional views on a topic. Its posts are listed in chronological order and may carry photographs, videos and hyperlinks to other pages or blogs. Readers can usually subscribe, leave comments and follow references onward, and that interconnectivity and capacity for feedback supports knowledge sharing, reflection and debate; blogs often attract a large and dedicated readership. Anyone with a computer and an internet connection can author one. Usually a blog reads as a diary expressing the author's feelings, opinions and ideas; some are educational tools used by students and teachers; others aim to serve as a forum for people who share an opinion or a profession.
Someone with a rash or a fever will more often than not consult the internet before visiting a general practitioner, and a search for a medical topic returns links to online scientific journals, wikis, question-and-answer portals and blogs together.
Of the abundant medical information on the internet, medical blogs are the most common, and they take diverse forms; the general idea behind them is to familiarise different audiences with medical topics, both professional and personal.
Medical blogs differ little from other blogs, though they focus, broadly speaking, on health and health-related issues. Their authors range from physicians, nurses and medical students to patients, patients' family members, lawyers and journalists, and their content runs from diseases, medication, health policies, health research and nutrition to personal experience; typically one blog focuses on a single topic, though covering two or more is not uncommon. Of the three groups of bloggers identified, physicians tend to focus on illnesses, patients mainly on medication, and nurses on their everyday life and experiences. A physician's blog may be about a specific illness, a procedure or a health policy, or about everyday experience and professional communication.
What blogging offers
Some research organisations have blogs to inform and update the public and to express opinions about aspects of research not necessarily discussed in scientific papers, so helping the public to understand science better while increasing their social media presence. A quarter of scientists blog for the same reasons.
The personal diary character of a blog tends to make its writing a stream of consciousness. One writer who experimented with blogging found that a post takes less time to write than other kinds of document, and, even counting revisions, far less time than an editorial. One advantage of this kind of publishing is the direct peer-to-peer dissemination of information, knowledge, opinions and ideas, for which blogs, Twitter and email discussions are far superior to online journals and traditional publishing. A likely reason for that superiority is the informality of blogs, which can also be a disadvantage.
Credibility
Easy access and uncheckable authorship raise the question of the validity and relevance of what medical blogs disseminate. Not all authors reference the information on their blogs to a medical journal or to the traditional medical literature; some are anonymous or write under pseudonyms, and even for those who appear more transparent it is usually impossible to check credentials and identity with certainty. Authors who also publish scientific papers or books tend to mirror the conventions of scientific writing. Some blogs have several contributors, from editors and section editors to consultants; these are often associated with official institutions, so they tend to be more credible.
Because a blog is a personal view it will carry the author's opinions and attitudes, but a medical blog usually supplies readers with facts about health and should therefore be more objective. Credibility comes from naming the sources, by reference or by hyperlink to the research or article; from displaying the author's credentials clearly; from respecting patient confidentiality; and from disclosing any potential conflicts of interest.
Blogs to follow in a field
A list of blogs for following oncology, drawn up after the 2011 American Society of Clinical Oncology meeting, included two that are not cancer-only blogs, a general health one and a pharmaceutical one, because they covered the meeting well. A newspaper's health blog covered the meeting far beyond what the print edition carried, and the blog was free. A pharmaceutical-industry blog covered the same meeting from a pharma-centred perspective.
An aggregator newsletter on the same list gathered cancer-related news from many sources: its recent posts covered a controversy at a Spanish cancer institute, comment on articles in that week's issues of three major journals, and research including a link between obesity and cancer risk. It required free registration. A cancer research organisation's science blog gave a British perspective on the same meeting and on cancer research outside the United States. An academic centre's blog was listed as one of a type, the list-maker being sure that most large academic centres had their own blogs; a recent post gave the blog over to a cancer survivor writing about a melanoma conference. And an individual specialist's blog, written by a biochemist at a consultancy in her spare time, carried her impressions of nearly every major cancer conference alongside posts on questions such as whether maintenance chemotherapy improves progression-free survival in non-squamous lung cancer, and an update on PARP inhibitors.
The writers of surveys of blogs on continuing medical education (CME) in 2011 and 2012 both found too few good ones. In 2011 many were from CME companies, though they still carried interesting information, particularly for anyone who spends a lot of time in the field; the survey's writer was disappointed in their quality and quantity and saw an unmet need in the market. In 2012 the survey's writer was surprised at the dearth of quality blogs focused on CME, which suggested to her that the field was ripe for the people who provide CME content to start their own.
The 2012 survey found three types of blog. One blog it chose, by a self-employed instructional and interactive design consultant, was judged to have an author with the credentials to write it, given his previous post as CME director at a university medical school, and its posts covered the importance of digitally sharing information between CME professionals, how doctors think and the educational value of their mistakes, and a disambiguation glossary for people who write CME. The survey's writer took his description from his professional-network profile, noting that the blog had no "about me" on its home page, which she called annoying. Another, published by a CME provider, was chosen because it was typical of what such blogs carry: self-promotion of the company and its programme offerings. The third type of CME blog offers information in a particular therapeutic area that might help a writer preparing needs assessments; the example chosen was for clinicians, educators and researchers in the neurosciences. A fourth blog, by the president of a CME company, was recommended for its postings on regulations, educational initiatives, certification and pharmaceutical funding.
A 2010 list of blogs for medical writers included a diabetes blog written from the patient's perspective, a perspective that, in the list-maker's view, writers sometimes forget in their focus on physicians and science. It also included an aggregator of health and medical blogs, judged one of the best-aggregated sites on the web by the list-maker, whose own blog it occasionally featured; a hospitalist's blog giving a peek into the daily life of a physician who rarely leaves inpatient care; a site focused on improving the accuracy of news stories about medical treatments, tests, products and procedures and on helping consumers evaluate the evidence for and against new ideas in health care, whose blog, written by a lifelong journalist, was voted Best Medical Blog in 2009 by Medgadget; and a fellow medical writer's blog, with posts on hiring medical writers and on speech-to-text software. Grand Rounds was a compilation of medical blogs sent out weekly, and an edition the list-maker compiled could be read on her own blog.
A 2012 list recommended four sites for learning how accountable care organisations work and what they might mean for the reader. A large health foundation's site is not really a blog, but the line between blogs and websites gets thinner all the time, and it was recommended because, in the list-maker's view, no other site or organisation provides as much quality information on all aspects of health care reform, accountable care organisations included. A relatively new site aggregates stories about Medicare and health policy and adds original content and analysis of its own. A specialty blog aimed at nephrologists and others caring for patients with kidney disease is written by a named physician who is an associate clinical professor at a named university, and also links out to other news on the subject. And a forum site, sponsored by a large health care law firm together with a trade association of device reprocessors, carries news and analysis from experts across the country on accountable care organisations and related health care system issues; its guest bloggers seemed to have the background for it, two being former employees of a health policy consulting firm, and it was recommended for policy specialists.
Register and audience
The language of medical blogs can be technical, semi-technical or informal. Their content can be characterised as informative or affective — informative content uses medical terminology extensively, affective content an abundance of adjectives. Patient-written posts tend to be longer than those of nurses and physicians. Nurses tend to use more adjectives and everyday language. Patients tend to avoid the names of their diseases — writing the beast instead of migraine — or to use only an abbreviation, type 2 rather than diabetes type 2. Abbreviations, enumerations and quoted conversation appear frequently alongside common speech, medical terms and opinion-related words. Sentences tend to be syntactically simple and correct. The format seems to encourage a more conversational style and can sometimes even lead to online discussion boards. The language and the scope of medical terminology, though, differ significantly with the audience the author aims at or expects.
A post answering a question about rhythm strips in a fictional case — sinus bradycardia at about 60 beats per minute with intermittent sinus arrest or exit block, two missing p waves and two ventricular escape beats at a rate just under 40 — is aimed at students or younger practitioners, and its language is highly technical, abundant in noun phrases and abbreviations; an average person with no medical education would probably have difficulty understanding it.
On a doctor's personal blog, whose heading lists topics from medicine, science and the internet to soap bubbles, design, imaginary friends, books and music for robots, a post opens by apologising to readers for more than a year's silence and introduces a first video lecture on ultrasound-guided peripheral venous access. The audience is not specified but the tone is conversational and familiar, as though talking to friends or peers; emoticons and idioms sit beside technical passages, and the language is informal where possible and technical where needed. Its posts range from medical apps to medical emergencies during football matches.
A doctor's post on a medical journal's blog platform, titled Inside secrets to getting the best hospital care, is addressed to patients, and it holds that in theory all doctors should treat all patients equally while in practice nice, friendly patients get better, quicker treatment. Its language is far from technical — conversational, borderline formal, with frequent informal intrusions — and its style is very humorous, one a reader who is a doctor might even call satirical, while a patient might find it a bit offensive, yet practical.
A post on a national newspaper's health blog about the resurgence of measles in the United States and its link to large numbers of unvaccinated individuals is written in journalistic column style: a personal opening from the author's own life, then a factual and narrative account, with terminology kept in the sphere of plain language, as in a patient suffering from a fever, red eyes, runny nose, cough and blotchy rash. The language is adapted for the broadest audience possible.
Writing for a lay reader
Someone who decides to write a medical blog should attend to the type of information it provides, its accessibility and readability, and its language. The main challenge in writing a medical blog is adapting technical language so lay audiences can understand it, and people who go to the internet for health information expect to find it in plain language. Because that information is of great importance to readers, medical blogs need to be accurate and well written, trustworthy and authentic in both form and content.
The language of a post depends on its readership, but the audience is more often than not lay, so authors should try to avoid technical language and rely on plain language where possible: it is better to say that shingles is caused by the chicken pox virus than that herpes zoster is caused by varicella-zoster, with the technical terms added in parentheses where the author wants to retain them. That keeps the post readable and gives the reader the vocabulary for further research. Sentences should be clear and syntactically simple; clusters of noun phrases, abbreviations and impersonal sentences should be avoided and the passive reduced; and the language should be accessible to everyone without being colloquial.
Posts appear in chronological order, so a writer should organise the blog to make it easier to navigate: either topically, by adding sections such as physician, patient, health policy, health tips, audio and video, or by adding tags that act as keywords for each post.
Useful resources for starting a medical blog include plain-language aids, namely a plain-language medical dictionary, a guide to writing medical information in plain English and a medical translator; general how-to guides on starting a blog; two blogging platforms; and medical search engines.
Taking on a regular column
Some physicians write a column for a local newspaper or send out a monthly newsletter from their practices. A column is an agreement to produce written work at regular intervals, so it should not be undertaken lightly. Topics that might be discussed in a newspaper column or newsletter include:
- When to call the doctor if a child is sick
- Who should get a flu shot
- First aid for acute injuries
- How to buy medicine at the lowest cost
- Danger signs in common illnesses
- How to prevent falls in the elderly
- Thoughts about herbal remedies
The key is to keep the contributions short and pertinent. In a 2004 letter, one clinician reported that writing a column, "A Doctor Speaks from the Heart", for the monthly newsletter of a large retirement community near the practice had generated one or two new-patient visits a week over the past year. Clinicians who write for the public also enjoy the reward of readers in their communities remarking that they liked that week's article in the newspaper.
The forms a regular column or blog takes
An internist "of few words" writes a blog offering a quick, Twitter-like read in "life sentences" of fifty-five words each, "often mundane, sometimes funny, frequently sad or frustrating, these are close encounters of the life-changing kind".
A practising physician started a question-and-answer blog to "answer your questions on doctors and the bizarre world of healthcare", giving her opinions on questions such as how to get a straight answer from a doctor, osteoporosis testing with dual energy X-ray absorptiometry, and whether teens are overmedicated. A family doctor in Washington, DC, writes a blog designed to provide "common sense thoughts on health and health care", with posts on primary care and health disparities, quality assessment in primary care, and care management for chronic health conditions.
Perri Klass, a paediatrician, professor of journalism and paediatrics, and author of fiction and nonfiction, chronicled her years as a medical student in the 1980s and then as a paediatrics resident in a series of newspaper columns, since published in two collections, A Not Entirely Benign Procedure: Four Years as a Medical Student and Baby Doctor: A Pediatrician's Training.
Gina Dungworth, a vet, blogs out of hours under a fiction-writing alter ego, contributing to group blogs on reading and writing genre fiction, often as the lone Brit among North American bloggers. Her regular slots are a monthly column for one group blog, Women and Words, and once- or twice-weekly book reviews for another, The Good, The Bad, & The Unread. How often she reviews depends on how fast she can read the new releases that blog sends her and on whether she has read other new releases she wants to share with its followers. Her column covers UK-based happenings of the past month, either a writing event she attended or a historic location she visited that is associated with at least one remarkable woman. Because she wants readers to consider following in her footsteps, she concentrates on what she found most interesting, illustrates the posts with her own photographs and links to where readers can find out more. The review blog focuses on romance novels and women's fiction, though her selections include young adult and middle-grade books and lesbian, gay, bisexual and trans* fiction. Her reviews explain why she liked or disliked a book, pick out outstanding examples supporting either view, and point out the glaring errors North American writers can make about British history and social customs.
One book she reviewed she had spotted on the publisher's list of upcoming releases, and she was able to get an advance copy. A free book given in return for a review puts a degree of obligation on the blogger to finish it, although the blog's grading system includes DNF, did not finish, for books that cannot be read all the way through. Reviewing a book that was a real pleasure, she had to force herself to slow down her reading and concentrate on why she liked the story so much and which aspects of the author's style made it such an easy read.
Regular writing alongside other work
Blogging for pleasure helped Dungworth hone her style when writing technical content for online publication. Besides blog posts for regular clients, she writes weekly posts on her own website. In her experience, blogging places a lot of emphasis on a good teaser paragraph at the beginning, to encourage readers to click through, and on a good summarising final paragraph. Some of its rules can be used for static web pages: writing copy for a new website, she invested time in making the first paragraph of each page make people want to read down to the end. In the other direction, technical writing taught her to make each paragraph flow from the previous one, a rule she finds vital online and especially in blogging, where readers may skim many blogs over their morning coffee or evening glass of wine. In her view, the style and content must be pitched to bring readers back regularly to one blog in preference to similar ones. She expects that reading abstracts to decide which papers to request and read in full should help her decide which novels to request for review from author or publisher summaries, although just as some abstracts fail to reflect a paper's content accurately, many summaries fail to explain what the book is really about.
Klass developed her lifelong passion for writing alongside her career in medicine, often blurring the lines between the two. She quotes the poet-physician William Carlos Williams on writing and medicine: "It's no strain. In fact, the one nourishes the other, even if at times I've groaned to the contrary." She sees journalism and medicine as professions that both involve a keen curiosity to ask the questions that are not normally asked and a desire to tell the untold stories.
Writing first as a medical student and later as a physician, she describes a changing sense of identification in her work, and she remarks on writing from the physician's vantage point of access, privilege and ethical obligations. Her insider's view as a physician afforded her little protection from colleagues who responded angrily to a newspaper piece she wrote on the feminization of medicine, which was given the provocative and unfortunate headline "Are Women Better Doctors?". She places the intersection of the art of writing and the practice of medicine in the way patients' stories evolve into medical stories, which ultimately become human stories.
The epidemiologist Katelyn Jetelina discovered her love for writing and for sharing scientific concepts with the public almost by accident. In 2020, during the COVID-19 pandemic, she was a senior scientific consultant at a nonpartisan health policy think tank and consulted for organisations including the US Centers for Disease Control and Prevention, and at night, after her children went to sleep, she started writing about public health science. That work, bridging the communication gaps between the public, patients, doctors and researchers, led to a newsletter to help ordinary people be "well equipped to make evidence-based decisions". It grew over the next three years, and by 2023 her Substack publication, Your Local Epidemiologist, reached more than 190,000 subscribers in 126 countries, and she was taking a break from her scientific work to focus full-time on processing and translating scientific knowledge for the public. Its topics range from infectious diseases and vaccines to reproductive health, violence, mental health and public health emergencies, and the thread running through them is a clear explanation of statistical analysis that turns profound scientific ideas into understandable chunks of information and actionable suggestions.