When young Toronto doc Norm Furtado got home after a recent overnight on-call shift, the first thing he did was fire up his computer and log on to his blog. "It was a quiet night," he typed, "but the first order of business was to pronounce a patient who had died shortly after 5:00pm. It was my first time pronouncing and completing a death certificate."

He clicked "publish" and his latest entry immediately appeared online on his blog Fabulous, STAT!, located at gaymedstudent.blogspot.com (he's now a resident).

Dr Furtado is among the vanguard of Canadian physicians who have embraced the concept of blogging, an increasingly popular form of online journal-keeping that amounts, essentially, to keeping a public diary. (See the box for a list of Canadian doctors who blog.)

Over the past year, more and more Canadian doctors have joined the so-called blogosphere. Should you follow suit?

BLOGGING BOONS
Blogging not only offers physicians a chance to share their thoughts with the public, their patients and their colleagues, but also to do some self-reflection on the meaning of their work.

The process can be cathartic, says Dr Furtado. "It's usually about an experience that I've had," he says of his two-year-old blog, "It's sort of a post hoc analysis of the experience. That's where the therapeutic nature of it comes in."

Besides the chance to get something off their chests, many doctors embrace the chance to loosen up, speak their minds and show off a bit of creativity. "I mainly blog because I like to write," says Dr Aaron Johnston. He co-writes the blog Adventures in Medicine with his physician wife Julia about their experiences working in Iqaluit. "I'd forgotten that somewhere along the way."

Dr Johnston's blog covers topics as varied as the spread of tuberculosis in the Canadian Arctic, the couple's recent vacation in Jamaica and watching Premier Paul Okalik dance the night away at a charity ball. "These days, doctors are encouraged to be researchers as much as clinicians. While that has many positive aspects, scientific writing is pretty dry," says Dr Johnston "For anyone who enjoys creative writing and playing with language, blogging is a great outlet."

BLOGGING BASICS
There are three broad categories of physicians' blogs, according to a 2006 report by New York-based healthcare consulting firm Envision Solutions: the diary blog, the news blog and the medical treatment blog.

Dr Furtado's and Dr Johnston's blogs fall, for the most part, into the diary category.

Dr Arya Sharma, the medical director of the Edmonton-based Weight Wise weight-loss program, maintains a medical treatment blog at ch-weightwisemd.blogspot.com, where he describes clinical matters related to weight loss, exercise and bariatric surgery.

The Executive Physician (executivephysician.blogspot.com) is a relatively new but already popular news blog, written anonymously by a Canadian physician who's now practising in the US. The author scans the headlines for articles about health policy in the two countries and offers up a no-holds-barred analysis, from a doctor's perspective, on issues like billing fraud, health insurance and the pharmaceutical industry.

The top medical news blog, KevinMD.com, is published by Dr Kevin Pho, a New Hampshire GP. "I think it's important to hear a doctor's voice," he says. "Our opinions and perspectives often get lost in mainstream reports on health."

GET STARTED
One of the big advantages to blogging as a method of online publishing is its simplicity. You can set up and run a blog for free with services like Blogger.com or Wordpress.org, even if your knowledge of the internet extends only slightly beyond that of George W Bush, whose malapropisms "the internets" and "the Google" are destined to live on in infamy.

There are a number of useful physician-specific resources available free online. Some bloggers have even put together a Healthcare Blogger Code of Ethics. Several dozen physicians have agreed to adhere to it.

The biggest question you must ask yourself if you're considering blogging, however, is a very simple one: should you use your real name or not?

It may be tempting to blog anonymously — no hospital admins breathing down your neck about your latest post, and no patients asking you medical advice in the "comments" section of your blog — but it's generally inadvisable. Dr Robert Lindeman, a pediatrician from Massachusetts, found that out the hard way. The really hard way.

Blogging under the pseudonym "Flea," Dr Lindeman had been writing about a malpractice suit brought against him in Boston over the diabetic ketoacidosis death of a 12-year-old patient. On his blog, he revealed the defence strategy and made jokes about the jurors. Unexpectedly, during cross-examination, the prosecutor asked Dr Lindeman if he was "Flea." The case was lost, his lawyers realized immediately. They settled the next day.

"No wonder when doctors write, they write namby-pamby noncommittal crap," says Dr Lindeman, "it might get you in trouble someday." His advice? "Don't blog anonymously. For physicians, writing is dangerous. There is something really messed up about that."

Despite the dangers, you can minimize your risk. Don't discuss real patient cases, include a disclaimer to make clear that your writing shouldn't be misconstrued as medical advice, and, suggests a humbled Dr Lindeman, don't write about your trial.

Check out NRM's news blog Canadian Medicine, online at canadianmedicine.blogspot.com.