Special Feature: Why I'm a Medical Blogger

11:30PM, AND I WAS STILL TYPING.

Tired and typing. Not clinic notes or even a personal e-mail. No, I was typing an answer to a question posted on MedHelp.com, where I was the “expert” on the adult type 2 diabetes forum. I started serving in this capacity in the fall of 2007, and it was now the spring of 2008. On some days, it was quite enjoyable and interesting. Other days, it dragged, and I asked myself where these questions were coming from and why I was doing this.

My journey to MedHelp and my other blogs was certainly not something I envisioned a few years ago, but there I was in the Internet trenches and, for the most part, loving it. My friends and family found it amusing and surprising that I was so engaged on the computer, given that I am not the most techsavvy person in the world. My approach to computers is that I want them to work when I press keys. If they do not, I get frustrated, and the help desk is next on my speed dial. I have always prided myself on being a great clinician, and integral to that was seeing my patients face to face. So, the idea of communicating via the Web in some ways was a bit alien to me.

But then a few things changed. The first was my decision to leave work for a while. I had been in clinical practice for almost a year and was not very happy. My twin daughters were very young, and I missed being with them during the day. Plus, being a “parttime” physician was not as part-time as I had planned. Even when I was not physically in my clinic, I was spending a lot of time writing notes and answering pages. So, I stepped out for a while to be at home with my daughters, but I was concerned about losing touch with medicine during this time away from clinic. The second major turn of events was the stroke suffered by an aunt who I am very close with. She had diabetes for many years, but was adamant that she did not. She had both a stroke and a MI, which thankfully left her with few defi cits. But the scare reminded me of a promise I had made to myself but that had been somewhat forgotten under the pile of adult-life duties: I wanted to contribute something to my island home of St. Vincent and the Grenadines, where diabetes was rampant. Moving there was not much of an option given my husband’s career in research and need to be at a major academic center.

So, I brainstormed about alternatives and stumbled on a little idea based on my love of writing. I contacted the editors of a national newspaper and off ered to write a free diabetes education column. After reviewing two writing samples, they agreed, and I became the author of a regular “Sugar Matters” column in the Searchlight newspaper of St. Vincent and the Grenadines.

The third development was my decision to start an online practice, the Endocrine Care Group. This one, more than any other idea we had, took the most gumption and also garnered quizzical looks from family and friends. A medical practice entirely online? How is that possible? Unknown to us at that time, there was a whole burgeoning industry of telemedicine, and we have since learned a great deal about the viability of an online practice. But at the start, we felt like we were all alone in this quest. We also felt that we needed legitimacy. While we were searching for advertising venues for our company, I happened upon MedHelp. I was impressed by their scope of services and noticed there was neither an adult diabetes expert on staff nor an adrenal disease expert. So, I off ered to become involved, and within two weeks, the “Adult Diabetes” forum was born. Life became very busy very quickly, even without physically being in my endocrine clinic. Between being a fulltime mom, moonlighting at a local hospital, and being a journalist and blogger, I was always doing something and meeting a self-imposed deadline. But I found that I was enjoying it a great deal. Both of my pro bono contributions were personally satisfying, even accounting for those days when I was so tired that I did not relish the thought of doing anything for free for anyone.

I started receiving e-mails from readers living in St. Vincent and the Grenadines talking about the articles and how they enjoyed reading them and learning more about diabetes in a way they understood. Although the idea initially seemed novel, in retrospect it made great sense to me; I have always enjoyed writing and talking in general, so what better way to include both than with this column? “Sugar Matters” has been a labor of love for me, and I plan to continue writing for the paper as long as they will have me. It’s a small thing, but it’s my way of giving something back to my home that gave me so much when I was growing up. I hope my aunt continues reading it!

MedHelp was something else entirely, requiring more work and with diff erent rewards. With my stepping out of clinical practice for the year, I missed “talking” with my patients about all things endocrine—diabetes and otherwise. And MedHelp gave that back to some extent. It was not “live,” but I still had my communication with others who had endocrine concerns. There were three to fi ve questions posted daily, with some quite spare (“I feel tired, could this be diabetes?”), others quite complicated and accompanied by two pages of data transcribed by individuals wanting essentially free consultation, and others that were totally inappropriate for the forum (“I have this lesion on my fill-in-the-blank”). Some questions were troubling (illicit drug use in diabetes, parents forbidding marriage because of a diabetic fi ancé), and others gave themselves away from the get-go (“Don’t think I am strange, but…”). Although answering some questions was fairly easy, I also learned a great deal when I had to search for answers myself, especially with questions regarding herbal remedies for diabetes. For me, though, the most fun thing about MedHelp was continuing some form of a physician—patient interaction while I was at home. Th ere were many people who had some repeat postings with follow-up questions, so a conversation of sorts happened naturally after the initial posting.

Now, I am officially gone from MedHelp, having stepped down when it all became much too busy for me as I juggled many responsibilities. I do miss it, so I may step back in to some degree. But further blogging fun is on the horizon: I recently teamed up with SugarStats.com to become their senior endocrinologist and will be participating in some live chats and also contributing to their blog. I am especially looking forward to the live chats as I continue my foray into cyber social circles.

You may be wondering how all this affected my secondary goal of improving visibility for my online practice? It has helped a great deal, as good as any newspaper advertising we placed. So, at least for now while our practice grows slowly, I am no longer some obscure, potentially crazy doctor with a Web office. My blogging has allowed people to get to know me a bit more than my bio allows and to see if they like me or not, as well as if they agree with my approach to medicine. Not many folks get that chance when referred in person, so that is a major advantage for patients.

For those of you thinking about heading to Web-based interactions of some sort, opportunities of all kinds are available. The number of medicine-based websites where professionals contribute seems to have exploded during the last 10 years, and it continues to grow. Many doctors and offi ces have amazing websites that provide opportunities for patients to ask questions. Plus, I have found that more and more patients are doing Web searches on their doctors or potential doctors before seeing them, and if nothing comes up, they can become worried. Without us knowing it, the Internet has become the new CV and the new “word-of-mouth” for many people. One year ago, a search of my name brought up some articles I had written in the past and my fellowship grand rounds presentation. Now, there are pages and pages of sites where I can be found, and as daunting as it is for me to see (I certainly don’t feel nearly as popular as the search makes me out to be!), I have already had several patients say that seeing my name associated with other medical articles/sites encouraged them to contact me directly. Whatever your interest, there is a Web opportunity for you, and it has become a fantastic resource for professionals in many ways. Still wondering where you can fi t? Ask yourself what your goal is: Help out on an advice site? Check. Flex those writing fi ngers again? Check. Voice your opinion in a public forum? Check. Increase your visibility, as a person or practice? Check.

Or simply wade into the Internet waters and see if you like it. It’s a great pool party out here, and I think it will only get bigger, so jump on in. And BYOB (bring your own blog).

Dr. Anita Ramsetty is Board Certifi ed in Endocrinology and Internal Medicine, and is the founder of the Endocrine Care Group, an online medical practice devoted to diabetes care and second opinion consulting. She is also a faculty member at the Medical University of South Carolina, and the “Sugar Matters” columnist for Caribbean and US newspapers.