The Blog is only as loud as the blogger

At LITFL and in the froth of #FOAMed we are constantly faced with a barrage of negative, cynical and disparaging comments on the role of the blog and social media in the provision of medical education and patient engagement. I thought it would be worthwhile to post one of the more erudite commentaries on the subject, from a source that shall remain anonymous…

The Blog is only as loud as the blogger!

Information is powerful and power is dangerous in the hands of the illiterate!

If it is FREE it must be good! They are giving out free tickets to live in Broken Hill, would you take it!!!

How is a blog different to any research articles, just because it can be criticized online and is uncensored…?

Bloggers are confident people who are bold enough to put their views out there; but does that make it best practice???

Does a blog approach ensure that it rids the biases which plague the current medical society?

Just because old methods have fallacies, a new method need not be considered significantly better prima facie!

There is a clear difference between ideas and beliefs. There is then a clear step involved in making those beliefs turn into facts. Facts are then disseminated as knowledge when vindicated… that essentially I believe is the role of research. A thought, belief or idea is only born when a stimulated mind asks a question and then hypothesizes the answer. Thank god for Newton or was it the apple?

New ideas and concepts need to continually be raised and I believe, that is the role of educated minds. A mind that does not ask questions runs the risk of being run by someone else!

Blogs like all other forms of information transfer needs to be handled with utmost care. Opinions are different to educated outcomes and people reading and deriving knowledge from these blogs run the risk of plagiarising the thoughts of the bloggers and practicing a brand of medicine which is no better than today’s fashion! Bloggers and blogs need to be clearly classified – opinions, ideas and researched facts!

Minh Le Cong loves ketamine for agitated patients and published a case series of 23 patients with schizophrenia being air transported in WA. He runs multiple blogs for his love of ketamine and I believe in the same but would we adopt a strategy of same in [our hospital] without researching it? Whilst data/information on NNT.com and other sites which present researched data needs to be columned differently and these blogs can be influenced by the same biases as the researchers who run the NINDS trial! The bloggers looked at the data looking to debunk it whilst the researchers looked at the data to validate their beliefs. Numbers don’t lie but those of us who understand statistics realize that you can surely make your results look good on bases of the statistical methods you use.

Bloggers are smart people so are researchers. Both present self-proclaimed facts and we as doctors (presumably the top 2% of the nation’s intellectual knowledge base) need to have the basic skills to decipher, choose and differentiate facts from ideas, beliefs and hunches. Smart people also have the skills to distort and disseminate knowledge the way that suits their beliefs and though not all of us can be as smart as the bloggers and researchers, we need not be dumb followers to base all our knowledge on hearsay!

Like everything else I think the field of medicine has done a full circle… in the ages of the Sushruta and roman medics, the word of the elder physician was considered gospel. He was the blogger and the one with the loudest voice and longest trail of followers was the dean of the university!

Soon the medical fraternity was plagued by the curse of democratisation! Everyone could do medicine. There was dissent from the students and students who questioned the basis of this practice (history of anaesthesia).  Medicine like everything else would not have progressed from the blood-letting days but for some questioning minds. Soon the body of knowledge holders were writing books about their experiences and facts and findings. These formed the basis of single authored textbooks. Some were meticulous and factual and some weren’t. Soon these texts were replaced by the multi-authored, knowledge rather than belief driven single authored texts.

Over the years, the textbook and publishing cycle was unable to keep up with the ideas, beliefs and thoughts of the medical professionals. And the original blog i.e. medical journal was born! I refer the inquisitive to the first published article in NATURE journal.

It was but only a collection of thoughts, ideas and suggestions. The ideas formed the basis for research and without the pillars of research, medicine would not be where we now are.

Commercialization of research/journals and knowledge transfer plagues every facet of our life not just medical knowledge. But does that mean free press journal or open access research is not free of bias and simply a projection of the author’s idea?

There are 23000 peer-reviewed journals and over a million research articles published each year and only 50 which essentially change practice. This could be looked at as strength or deficiency of current day medicine. Whilst we let more and more researchers voice their opinions, we only let very few change our beliefs. I believe the same rigour needs to be applied to blogs since they are no more than a idea/suggestion/hunch/educated guess/researched fact.

A blog is just another journal and like all other data in this world, it is only as pure as its author. Interpretation of data and knowledge needs an inquisitive mind. I would hope the majority,  if not most of us  still bear a cortex that questions and inquisitively seeks out the answer for ourselves rather than believe every word that the professor told us at the lecture halls!

We owe it to our patients to be maintain high level of skills and knowledge. And as long as we continue to seek and find, we will continue to improve.  Knowledge is powerful and blogs carry significant amounts of information and so do journals… but are we smart enough to convert this information to knowledge? Now does information=knowledge… well that’s a discussion for another blog!

BA MA (Oxon) MBChB (Edin) FACEM FFSEM. Emergency physician, Sir Charles Gairdner Hospital.  Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |

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