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Fitness is a way of life.

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It began with WebMD and similar sites - patients started trusting and turning to Internet resources for medical information. Once patients began coming to the doctor’s office prepared with Internet-based diagnoses and medicine requests, doctors started paying attention to the Internet as well. Fast-forward to the present - not only do patients frequently turn first to the Internet for medical information before calling their doctor, they are now organizing into social networks like Wellsphere, DailyStrength and iMedix. We recently learned from sources like Mashable and TechCrunch that Internet heavies like Google, Microsoft and AOL are setting up systems for storing health records. And now, doctors are apparently getting into the scene with social networks and blogs of their own.

Digg recently directed me to this story at NPR about doctors who publish blogs. Apparently, according to the article, blogs published by doctors are on the rise and many people have concerns with this development. Physicians have been discussing patient information for years in journal articles, papers and books, so what is it that makes this story sensational and important to report? Is it the larger population and wider access Internet readership enjoys over published content? The fact that self-published blog articles are published faster than print material and not subject to any oversight (beyond that the law provides, of course)? Or is it just the Internet makes any story sexy and timely? Personally, I feel the issue is about the answer to this question - is it a doctor who blogs, or a blogger who happens to practice medicine? In other words, do we hold doctors (and perhaps other professionals, such as attorneys, who deal with confidential patient information) to a higher standard than anyone else who blogs?

Patient privacy seems to top the list of concerns, and the NPR article presents both sides of the debate. One the one hand, Dr. Deborah Peel, a psychiatrist and founder of the group Patient Privacy Rights, thinks these blogs may skirt close to invading patients’ privacy rights:

“The problem with physicians blogging about patients is the danger that that person will be able to identify themselves, or that others that know them will be able to identify them,” she says.

Peel’s group worries that information about a patient’s case could be traced back to the individual and adversely affect his or her employment, health insurance or other aspects of his or her life.

“If you [are a doctor and] are unhappy with the people that you’re supposed to be serving and taking care of, you probably need therapy,” she says. “You don’t need to be venting your frustrations in a public manner like that. That’s very inappropriate and unprofessional.”

On the other hand, Dr. Robert Wachter, author of a blog called “Wachter’s World,” disagrees:

“You might say we as doctors should never be talking about experiences with our patients online or in books or in articles.”

Wachter says taken for what they are — unedited opinions, and in some cases entertainment — blogs can give readers some useful insight into the good, the bad and the ugly of the medical profession.

This seems to be a movement that is growing, despite how you feel about possibly being the semi-anonymous subject of your doctor’s blog. The NPR article points to several particular blogs published by doctors, including KevinMD, which in turn links to many more. And privacy concerns will only get worse as “gated communities” like iMedExchange, who claim to verify all community members are themselves doctors, become more popular - the assumption will be, if all the readers are doctors, why even bother sanitizing the identifying information?

How about you - do you care if your doctor is blogging about you? Let us know how you feel in the comments and poll.

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photo credit: jon.nelson

Consumerist turned me to the latest battle in the war on the restaurant industry - making calorie information readily available. San Francisco’s new ordinance requires any restaurant with more than 20 locations to display calorie information on menus or posters, and carries a $500 fine for each violation. This is great news, since bills requiring restaurants to display calorie information, which common sense tells me is a necessary part of treating the obesity epidemic, has historically been fraught with resistance. As the article on Consumerist points out,

San Francisco joins New York City and Washington’s King County in the battle to protect consumers with information, a fight that has not gone well for municipalities. California Governator Arnold Schwarzenegger recently vetoed a bill that would require nutrition labeling throughout the state, and New York City was barred by a judge from enforcing its regulations until April 15, when the plan may be tossed altogether.

The CPSI is serious about this issue. In a press release marking the San Francisco bill, the CPSI outlines their vision of the future:

No one expects to learn the price of your restaurant meal by checking online in advance or by finding out only after you’ve ordered. And at chain restaurants, where menu items are so carefully calibrated and standardized, it would be easy for chains to put calories right on menu boards and even more nutrition information on printed menus.

…It’s hard to imagine that not many years ago, packaged foods in the supermarket did not have to bear the standardized, easy-to-read Nutrition Facts labels. We’re optimistic that twenty years from now, it will be hard to believe that calorie counts were confined to web sites and tray liners, and absent from menus and menu boards.

In order to empower all of us to assist in the fight for what seems like common sense legislation, the CPSI maintains a “Menu Labeling” resource site at http://www.cspinet.org/menulabeling/. Information offered includes a template for requesting menu labeling legislation from your governor, up-to-date news on menu labeling legislation and PDF documents on different related topics. For example, the PDF document on “Myth vs. Reality: Nutrition Labeling at Fast-Food and Other Chain Restaurants” lists and refutes commonly-used responses to requests for calorie information, like the one I received from Disney recently:

Myth: Special orders are common, and it would be impossible for a menu to list nutrition information for all possible different food preparation options and combinations.

Reality: Restaurants only would have to provide nutrition information for standard menu items as “offered for sale.”

• Menu labelling does not apply to customized orders or to daily specials (neither are standard menu items).
• If restaurants can provide nutrition information on websites and brochures, they should be able to put those numbers on menus where people can see them and use them when ordering.

For my part, I’ll be sending an e-mail to my governor and continuing to write about calorie information in restaurants. What about you - would you like to see your municipality or state adopt legislation requiring restaurants to list calorie information in the restaurant?