More than 175,000 are created on the World Wide Web every day. Every second, more than 18 are updated.¹ Blogs, or Web logs, are a growing Internet self-publishing trend, one especially worth noting as the use of health care blogs proliferates among physicians and patients. A quick introduction to a selection of health care blogs reveals their promise as educational and patient care tools, as well as their potential pitfalls.

First, the basics

The word blog can be used as a noun, as in “Jane writes a blog,” or as a verb, “Jane blogs every day.” Blogs occupy a virtual segment of the Internet known as the “blogo-sphere,” and those who contribute to blogs are referred to as “bloggers.” A blog entry, also known as a “post,” often reads like a diary entry.

In contrast to most Web pages, which are generally static and convey information in only one direction, blogs are dynamic. Here's how a blog works: An administrator, usually the author, posts an entry on a blog site. Readers post responses. The author responds to the readers' comments and posts entries on other topics. Some blogs include links to other blogs on similar subjects, creating complex virtual communities in which posts refer to related discussions occurring on other sites.

Physicians as bloggers

Some physicians use blogs to chronicle events in their lives or to inspire readers. “Kevin, MD” (http://www.kevinmd.com) is one of the better-linked (i.e., “popular,” in blogging terms) physician blogs. The author, New Hampshire internist Kevin Pho, MD, regularly blogs on topics such as the medical liability crisis and the importance of vaccinations. He also offers podcasts (i.e., audio broadcasts in digital file formats that can be downloaded to a computer, an iPod or another MP3 player). Other physician bloggers choose to remain anonymous, such as the family physician author of “Notes from the Country Doctor” (http://www.notesfromcountrydoctor.blogspot.com) who covers issues related to rural family medicine. Another anonymous family physician blogger is the self-described “Medpundit” (http://www.medpundit.blogspot.com).

Jacob Reider, MD, has blogged since 1999 on “Family Medicine Notes” (http://www.docnotes.net), but he may be better known as the creator of “Medical News Feed” (http://www.medlogs.com), a medical news and blog aggregator. This site is particularly helpful in getting a flavor of the wide range of health care blogs on the Internet.

Many blogs focus on health care policy. Retired physician Marcus Newberry, MD, writes Fixin' Healthcare (http://www.fixinghealth.blogspot.com), and the journal Health Affairs offers opinions from physicians and other bloggers on its site (http://www.healthaffairs.org/blog).

Other physician blogs are written primarily with patients in mind. For example, approximately 30 health care professionals' blogs appear on WebMD (http://www.webmd.com/community/blogs) on a range of topics. Entries often summarize recent studies or begin with health stories from the day's news. Similarly, Len Lichtenfeld, MD, blogs his thoughts on cancer screening, treatment and patient support at the American Cancer Society Web site in “Dr. Len's Cancer Blog” (http://www.cancer.org/aspx/blog).

Patient-written blogs

Patients write many of the health care blogs published on the Internet. For those dealing with chronic or other serious illnesses, blogging can be a therapeutic experience. They can blog their thoughts and experiences and in the process share their knowledge with others who may be going through a similar situation. David Arenson, the author of “CLL Diary” (http://www.clldiary.blogspot.com), shares his experiences with chronic lymphocytic leukemia (CLL). His thoughtful entries examine the frustrations of the disease and the uncertainties of medicine. His blog site includes links to other CLL blogs, online support groups and sources of medical information. Amy Tenderich, who has type-1 diabetes, blogs on “Diabetes Mine” (http://www.diabetesmine.com). She writes about a wide array of topics relating to diabetes, from the cost of supplies to the latest in islet cell transplantation. Her journalism degree shows through in her sophisticated writing style, and the up-to-date information she includes makes her blog a good read for both health care professionals and patients.

Some patient blogs are not mainstream. Numerous blogs promote fads, such as the warrior diet, jambalaya diet and alkaline diet. Some seem to have an agenda, while others are just plain bizarre. One that caught my attention recently claims that mental health issues are really caused by a parasitic disease.

The Health on the Net Foundation (HON) (http://www.hon.ch) attempts to validate Internet health information and certifies Web sites, including blogs, that contain accurate information. Accredited sites can display the HON seal. In some cases, the seal may appear on the main site's home page rather than on the blog site. For example, the HON seal is displayed on the home page of the American Cancer Society but not on “Dr. Len's Cancer Blog.” HON also offers a Web search engine that returns results from HON-accredited sites (http://www.hon.ch/HONcode).

Looking into the future

While blogs have a lot to offer family physicians and their patients now, their impact could be greater in the future, as imagination and motivation advance their use. Just 10 years ago, replacing some office visits with e-mail communication seemed inconceivable to most, but it's happening. Blogs won't replace face-to-face interactions either, but they may enhance doctor-patient communication.

For example, blogs have the capability to revolutionize group visits. A physician can give patients with diabetes an Internet address for a blog site that the physician has created. The physician can post his or her thoughts about lifestyle modifications or other relevant topics. Patients can then comment on the physician's original posting, share solutions or problems they encounter, and offer support to one another. Physicians can respond to patients' posts and introduce new subjects. I am working on launching blogs for diabetes group visits and well-child care. The diabetes blog will include posts on diet, exercise, medications and routine testing. The well-child blog will focus on growth and development, immunizations and other guidance for parents.

Check out this rapidly growing piece of the Internet. You may find interesting patients, fascinating stories and worthwhile information. It is easy to get started, and once you do, the blogosphere can take you wherever you want to go.